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Acknowledge Their Experience

As a caregiver, it is important that you show you are sensitive to what your family member or friend is feeling. Seeing things from their perspective will help you better understand and communicate with them. This is a way to acknowledge what they are saying. One thing you should avoid doing in a conversation is to deny or dismiss what your family member or friend is going through. At times, your family member or friend may believe things that are not real to you, but which are very real to them. Believing things that are not real is called a delusion. Acknowledge that these beliefs are real, without supporting the delusion.

Here are examples that show the difference between acknowledging what an individual with schizophrenia is going through and denying or dismissing it.

Acknowledge - conversation 1

(FF): “I don’t want to go to Lisa’s wedding next week.”

(CG): “I understand that you don’t want to go to Lisa’s wedding. May I ask why not?”

(FF): “If I go to the wedding, then the people there will think bad things about me and try to hurt me.”

(CG): “That’s ridiculous. People at the wedding won’t think bad things about you. And there is no reason why they would hurt you.”

(FF): “If you make me go to the wedding, those people will hurt me!”

In this example, the caregiver dismissed her family member’s feelings (“That’s ridiculous. People at the wedding won’t think bad things about you. And there is no reason why they would hurt you.”). As a result, the family member became defensive.

Here’s a better way to approach the situation:

Acknowledge - conversation 2

(FF): “I don’t want to go to Lisa’s wedding next week.”

(CG): “I understand that you don’t want to go to Lisa’s wedding. May I ask why not?”

(FF): “If I go to the wedding, then the people there will think bad things about me and try to hurt me.”

(CG): “Well, I can understand why you would not like to go to the wedding if you feel that people would do those things. That would be kind of scary. Right?”

(FF): “Right. If I get trapped there and there’s no way out they’ll get me.”

(CG): “Well, I wouldn’t want you to feel trapped and I wouldn’t want anyone to get you. You know, I feel you may enjoy seeing your cousing at her wedding, and I’m sure she would enjoy seeing you. If I stay with you throughout the wedding, would that make it less scary for you?”

(FF): “Maybe.”

(CG): “Good. I am glad to hear that. So will you reconsider going if I promise to stay with you throughout the wedding?”

(FF): “Yes, I’ll reconsider.”

In the second example, the caregiver acknowledged her family member’s emotions (“That would be kind of scary. Right?”). But the caregiver did not support the delusion. In other words, the caregiver simply stated that her family member felt that the people at the wedding would hurt her. But the caregiver never agreed that the people at the wedding would in fact do this.

The caregiver treated her with respect, understood that she was scared, and helped her reconsider going to the event. The caregiver also said “I feel” instead of “I think.” Saying “I feel” is more respectful and less threatening.

INVEGA® SUSTENNA® (paliperidone palmitate) is used for the treatment of schizophrenia.

IMPORTANT SAFETY INFORMATION FOR INVEGA® SUSTENNA®

INVEGA® SUSTENNA® is not approved for the treatment of dementia-related psychosis in elderly patients. Elderly patients who were given oral antipsychotics like INVEGA® SUSTENNA® in clinical studies for psychosis caused by dementia (memory problems) had a higher risk of death.

Neuroleptic Malignant Syndrome (NMS) is a rare, but serious side effect that could be fatal and has been reported with INVEGA® SUSTENNA® and similar medicines. Call your doctor right away if you develop symptoms such as a high fever, rigid muscles, shaking, confusion, sweating more than usual, increased heart rate or blood pressure, or muscle pain or weakness. Treatment should be stopped if you are being treated for NMS.

Tardive Dyskinesia (TD) is a rare, but serious and sometimes permanent side effect reported with INVEGA® SUSTENNA® and similar medicines. Call your doctor right away if you start to develop twitching or jerking movements that you cannot control in your face, tongue, or other parts of your body. The risk of developing TD and the chance that it will become permanent is thought to increase with the length of therapy and the total dose received. This condition can also develop after a short period of treatment at low doses, but this is less common. There is no known treatment for TD, but it may go away partially or completely if the medicine is stopped.

One risk of INVEGA® SUSTENNA® is that it may change your heart rhythm. This effect is potentially serious. You should talk to your doctor about any current or past heart problems. Because these problems could mean you're having a heart rhythm abnormality, contact your doctor IMMEDIATELY if you feel faint or feel a change in the way that your heart beats (palpitations).

Atypical antipsychotic drugs have been associated with metabolic changes that can increase cardiovascular/cerebrovascular risks. These changes may include:

  • High blood sugar and diabetes have been reported with INVEGA® SUSTENNA® and similar medicines. If you already have diabetes or have risk factors such as being overweight or a family history of diabetes, blood sugar testing should be done at the beginning and during the treatment. The complications of diabetes can be serious and even life-threatening. Call your doctor if you develop signs of high blood sugar or diabetes, such as being thirsty all the time, having to urinate or "pass urine" more often than usual, or feeling weak or hungry.
  • Changes in cholesterol and triglycerides have been noted in patients taking atypical antipsychotics. Check with your doctor while on treatment.
  • Weight gain has been reported in patients taking atypical antipsychotics. Monitor weight gain while on treatment.

Some people may feel faint, dizzy, or may pass out when they stand up or sit up suddenly. Be careful not to get up too quickly. It may help if you get up slowly and sit on the edge of the bed or chair for a few minutes before you stand up. These symptoms may decrease or go away after your body becomes used to the medicine.

INVEGA® SUSTENNA® and similar medicines have been associated with decreases in the counts of white cells in circulating blood. If you have a history of low white blood cell counts or have unexplained fever or infection, then please contact your doctor right away.

INVEGA® SUSTENNA® and similar medicines can raise the blood levels of a hormone called prolactin, and blood levels of prolactin remain high with continued use. This may result in some side effects including missed menstrual periods, leakage of milk from the breasts, development of breasts in men, or problems with erection.

If you have a prolonged or painful erection lasting more than 4 hours, seek immediate medical help to avoid long-term injury.

Call your doctor right away if you start thinking about suicide or wanting to hurt yourself.

INVEGA® SUSTENNA® can make some people feel dizzy, sleepy, or less alert. Until you know how you are going to respond to INVEGA® SUSTENNA®, be careful driving a car, operating machines, or doing things that require you to be alert.

This medicine may make you more sensitive to heat. You may have trouble cooling off or be more likely to become dehydrated. Be careful when you exercise or spend time doing things that make you warm.

Some medications interact with INVEGA® SUSTENNA®. Please inform your healthcare professional of any medications or supplements that you are taking.

INVEGA® SUSTENNA® should be used cautiously in people with a seizure disorder, who have had seizures in the past, or who have conditions that increase their risk for seizures.

Inform your healthcare professional if you become pregnant or intend to become pregnant during therapy with INVEGA® SUSTENNA®.

Do not drink alcohol while you are taking INVEGA® SUSTENNA®.

In a study of people taking INVEGA® SUSTENNA®, common side effects in the treatment of schizophrenia were reactions at the injection site, sleepiness, dizziness, feeling of inner restlessness, and abnormal muscle movements, including tremor (shaking), shuffling, uncontrolled involuntary movements, and abnormal movements of the eyes.

This is not a complete list of all possible side effects. Ask your doctor or treatment team if you have any questions or want more information.

If you have any questions about INVEGA® SUSTENNA® or your therapy, talk with your doctor.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see the Important Product Information

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