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Awareness & Sensitivity to Client Needs Healthcare Core Curriculum “This workforce solution was funded by a grant awarded by the U.S. Department of Labor’s Employment and Training Administration. The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership.” This work by the Health Professions Pathways (H2P) Consortium, a Department of Labor, TAACCCT funded project is licensed under a Creative Commons Attribution 3.0 Unported License. Awareness & Sensitivity to Client Needs Module Description This module presents: Challenges and issues related to awareness and sensitivity needed to understand the healthcare needs of clients/individuals. The impact that disease has on individuals, the emotional, spiritual and social needs of clients/individuals as well as the type of care needed by different age groups. The process of death and dying and how that affects clients and their families. Module Outline and Instructor Resources This module consists of 8 competencies. Each competency is divided into unit competencies with learning activities to help students master the competency. Each learning activity is explained on the Module Outline and the resources are identified/described Choose the learning activities that best meet your classroom needs. Module Outline and Instructor Resources Find these learning activities and resources on the website or create your own. The Course Outline also has documents that the instructor can use in teaching the lesson. These competencies are listed on the 1. Course Outline and 2. Module Competencies and Instructor Notes will be addressed throughout the remainder of the power point. Module Competencies 1. 2. 3. 4. Describe the major stages of human development and the basic health needs of humans. Describe the needs of clients across the lifespan and how those needs can affect behaviors and attitudes. Describe the types of emotional, spiritual, mental health and social needs of clients and their families. Explain how different diseases can influence the functioning, behaviors, and attitudes of individuals including dementia/Alzheimer’s disease. (see next slide) Module Competencies 5. 6. 7. 8. Describe selected client service strategies including customer service, their impact on quality client care and the importance of client participation in group/family activities. Define the stages and processes of death and dying and the influence those stages have on clients and their families. Describe how to care for the clients’ environment. Using a problem solving process applied to healthcare situations, describe how healthcare workers can be aware and sensitive to their clients’ need/behaviors. Module Competency #1 DESCRIBE THE MAJOR STAGES OF HUMAN DEVELOPMENT AND THE BASIC HEALTH NEEDS OF HUMANS. Module Competency #1: Describe the major stages of human development and the basic health needs of humans. Two units and learning activities round out the learning for this first competency: A. Describe the five common characteristics of growth and development. B. Describe basic human needs theory regarding human actualization. Fun Quotes to Ponder “The growth and development of people is the highest calling of leadership.” Harvey S. Firestone “You’ve got to do your own growing, no matter how tall your grandfather was.” Irish Saying “If you wish to achieve worthwhile things in your personal and career life, you must become a worthwhile person in your own self-development.” Brian Tracy Module Competency #1: Human Development Unit #1A: Growth and Development Recommended Content Growth: Physical change & increase in size Indicators of Growth ◦ Height, weight, bone size, & dentition, sensory adaptation, & development of sexual organs & characteristics Although physical growth is similar for all people, growth rates vary during different stages of growth & development Growth is rapid during prenatal, neonatal, infancy, & adolescence, but slows during childhood & is minimal during adulthood (Ramont & Niedringhaus) Module Competency #1: Human Development Unit #1A: Growth and Development Development: An increase in complex functions & progression of skills Development refers to a person’s capacity & skill to adapt to the environment Development is the behavioral aspect of growth & includes abilities to walk, talk, & run, speak, etc. (Ramont & Niedringhaus) Module Competency #1: Human Development Unit #1A: Growth and Development There are 5 characteristics of growth and development. 1. Growth and development occur in an orderly pattern from simple to complex: one task must be completed before the next one is attempted. 2. Growth and development are a continuous process characterized by spurts of growth and periods of slow, steady growth. After infancy the rate of growth slows down until adolescence. 3. Growth and development affects all body systems, but at different time periods for specific structures. (see next slide) Module Competency #1: Human Development Unit #1A: Growth and Development 4. 5. Growth and development progresses at highly individual rates that vary from person to person. Growth and development form a total process that affects the person physically, mentally and socially. Module Competency #1: Human Development Unit #1B: Human Needs Theory Recommended Content The human needs theory gives healthcare workers a holistic overview of health promotion for the individual and families across the life span Its purpose is to promote the health of the individuals & families Nurses & healthcare workers use the human needs theory: Maslow’s Hierarchy of Needs Human needs are ranked on an ascending (upward) scale according to how essential the needs for survival are (Berman et al., p. 273) (see next slide) Module Competency #1: Human Development Unit #1B: Human Needs Theory According to Maslow's theory, if basic needs are not met then a person will find a way to try to satisfy them Higher needs such as social needs & esteem are not felt until one has met the needs basic to one's bodily functioning (physiologic & safety & security needs) Individuals change & develop over time & do not remain at one level until every need at that level is met, instead they may move up & down levels depending on the situation & need (Juliar, p. 291) Module Competency #1: Human Development Unit #1B: Human Needs Theory Maslow’s Hierarchy of Needs Abraham Maslow (1970) ranks the five levels of human needs as follows: (www.entrepreneursuperstar.com, n. d.) 16 Module Competency #1: Human Development Unit #1B: Human Needs Theory Needs are generally met in the following order from the base of the pyramid upward 1. Physiological 2. Safety 3. Love/Belonging 4. Esteem 5. Self-Actualization Module Competency #1: Human Development Unit #1B: Human Needs Theory Following are limited lists of basic needs within each level of Maslow’s Hierarchy of Needs. Physiological Needs – air/oxygen, water, food, rest, shelter, avoidance of pain Safety & Security Needs – free from threat of physical & emotional harm, stability, job security, medical insurance Love & Belonging – give and receive affection, interact with others, maintain a feeling of belonging, attain a place in a group (see next slide) Module Competency #1: Human Development Unit #1B: Human Needs Theory Esteem Needs – A need to feel important ◦ Internal esteem needs relate to self-esteem such as self respect, achievement, confidence, independence, mastery ◦ External esteem needs relate to social status & recognition Self-respect Achievement Attention Fame, glory (see next slide) Module Competency #1: Human Development Unit #1B: Human Needs Theory Self-Actualization Needs When all of the foregoing needs are satisfied, then & only then are the needs for self-actualization activated Self-actualization: the summit of Maslow's Hierarchy of Needs Quest of reaching one's full potential as a person Unlike lower level needs, this need is never fully satisfied; as one grows psychologically there are always new opportunities to continue to grow (Berman et al., pp. 273-274) Module Competency #1: Growth & Development Recommended Learning Activities Assignments Resources Notes AS Competency #1: Lifespan Growth & Development Assignment on website Student reflects on own growth and development. Questions on generalized growth and development are also included AS Competency #1: The Living Body Assignment on website Students watch the film, “The Living Body”, and answer growth and development questions. Module Competency #2 DESCRIBE THE NEEDS OF CLIENTS ACROSS THE LIFESPAN AND HOW THOSE NEEDS CAN AFFECT BEHAVIORS AND ATTITUDES. Module Competency #2: Describe the needs of clients across the lifespan and how those needs can affect behaviors and attitudes. Three units are included in this competency along with their learning activities. A. Describe the 3 different types of needs that humans have across the life span. B. List the basic needs of infants, children, and adolescents. C. List the developmental needs of young adults and older adults. Module Competency #2: Client Needs Unit #2A: Three Different Types of Needs Recommended Content Major types of human needs Physical Psychosocial (Emotional) Spiritual May describe the types as Mind/Body/Spirit Note Maslow’s Hierarchy of Needs Module Competency #2: Client Needs Unit #2B: Basic Needs Recommended Content All children have basic needs for physical, emotional and spiritual aspects of growth. The age of the child determines the rate of physical, emotional and spiritual development (see next slide) Module Competency #2: Client Needs Unit #2B: Basic Needs Infants Needs Infants & children experience a rapid & marked rate of development and have major milestones in growth. Infants & small children have a high priority for physical comfort, such as food, rest, warmth, safety & security, & emotional needs, & depend on their caregivers to help meet their needs (Ramont & Niedringhaus) (see next slide) Module Competency #2: Client Needs Unit #2B: Basic Needs Preschooler’s Needs Nutrition-Importance of not skipping meals; eating a balanced, nutritious diet; experiences with foods that may lead to obesity Use proper protective equipment when participating in physical activities (helmets, pads); encourage child to take responsibility for own safety (participation in safety classes: bicycle, water) Immunizations; periodic screenings for vision, hearing, dental (fluoride treatment) (Ramont & Niedringhaus, pp. 210-211) (see next slide) Module Competency #2: Client Needs Unit #2B: Basic Needs Adolescent’s Needs Healthy snacks, appropriate food intake & exercise Balancing sedentary activities with regular exercise Responsible for using motor vehicles safely (driver’s ed., wear seat belts, helmets,) Proper precautions during athletic activities (medical supervision, proper equipment) Keep open lines of communication with parents Immunizations, periodic screenings for vision, hearing, &dental (Berman et al., p. 388) (see next slide) Module Competency #2; Client Needs Unit #2B: Basic Needs Young Adult’s Needs Routine physical exams; dental exam every 6 months; No smoking, Nutritious diets & physical activity Personal relationships that promote discussion of feelings, concerns, & fears Motor vehicle safety (wear seat belts, no drinking & driving, maintenance of breaks & tires on vehicle) Safe home environment, immunizations (Berman et al.) (see next slide) Module Competency #2: Client Needs Unit #2B: Basic Needs Middle-Aged Adult Needs Regular physical exams & screening Importance of adequate nutrition Exercise program that emphasizes skill & coordination Possibility of mid-life crisis, encourage discussion of feelings, concerns, fears Retirement planning (financial & diversional activities) with partner if appropriate (Berman et al., p. 401) (see next slide) Module Competency #2: Client Needs Unit #2B: Basic Needs Older Adult Needs Importance of adequate nutrition Be alert for symptoms of depression, risk factors for suicide, abnormal bereavement, changes in cognitive function, medications that increase risk of falls, signs of physical abuse & neglect Environment that prevents falls & injury (Ramont & Niedringhaus, p. 221) Module Competency #2: Clients Needs Recommended Learning Activities Assignments Resources Notes AS Competency #2: Interview with Middle-Late Adulthood Assignment on website Students interview an older adult and reflect on the answers to the questions AS Competency #2: Maslow’s Hierarchy of Needs Case Studies Assignment on website Students are asked to describe a patient and relate to Maslow’s Hierarchy. Module Competency #3 DESCRIBE THE TYPES OF EMOTIONAL, SPIRITUAL, MENTAL HEALTH AND SOCIAL NEEDS OF CLIENTS AND THEIR FAMILIES. Module Competency #3: Describe the types of emotional, spiritual, mental health and social needs of clients and their families. Seven units and learning activities round out the learning for this third competency: A. Define family. B. List five functions of family. C. Describe family influence on healthcare. D. Describe emotional needs of clients and their families. E. Describe spiritual needs of clients and their families. F. Describe mental health issues of clients and their families. G. Describe social needs of clients and their families. Family The family is a haven in a heartless world. ~Attributed to Christopher Lasch Families are like fudge - mostly sweet with a few nuts. ~Author Unknown When our relatives are at home, we have to think of all their good points or it would be impossible to endure them. ~George Bernard Shaw Call it a clan, call it a network, call it a tribe, call it a family. Whatever you call it, whoever you are, you need one. ~Jane Howard Module Competency #3:Various Needs of Clients Unit #3A: Define Family Recommended Content When discussing family, the question that must be asked is, “What is family?” “Basic social unit or system of two or more persons who are joined by bonds of sharing and emotional closeness & who identify themselves as being a part of the family” (Friedman) Characterized by intimacy, emotional intensity, & persistence over time Basic unit of care in the community; Two or more people who have chosen to live together & share their interests, roles, & resources (Juliar) Module Competency #3:Various Needs of Clients Unit #3A: Define Family Individuals /families define what family is for them Family is a system or unit Family members may or may not ◦ Be related ◦ Live together ◦ Have children Family is a commitment & attachment among unit members that includes future obligation Family unit care-giving functions consist of protection, nourishment, & socialization of its members (Wright & Leahey, p. 50) Who is family? Module Competency #3:Various Needs of Clients Unit #3A: Define Family Families come in many different types, colors and makeups. Nuclear Family Nuclear Dyad Single Parenting Family Cohabiting Family Step Family Extended Family Multi-Generational Family Communal Family Foster Family Skip-Generation Family Module Competency #3:Various Needs of Clients Unit #3B: Functions of Family Recommended Content The main functions of the family include developing a sense of family purpose & affiliation, adding & socializing new members, & providing & distributing care & services to its members A healthy family organizes its members & resources in meeting family goals; it functions in harmony, working toward shared goals (Berman et al., p. 429) (see next slide) Module Competency #3:Various Needs of Clients Unit #3B: Functions of Family There are 6 functions performed by families listed here (not necessarily in order of importance) 1. Economic--Growth & Development of its members 2. Protection 3. Nurturance 4. Reproduction 5. Recreation 6. Socialization & Education (Berman et al., p. 429) (see next slide) Module Competency #3:Various Needs of Clients Unit #3B: Functions of Family 1. Economic Function or provide for Growth & Development: The economic resources needed by the family are secured by the adult members; may receive assistance from government programs, extended family/friends or religious and/or community organizations • 2. Protective Function Family protects physical health of its members by providing adequate nutrition, home, health care services, immunizations, use of car seats, helmets, fire alarms, etc. for safety from & prevention of injuries & illnesses (Polan, p.153) (see next slide) Module Competency #3:Various Needs of Clients Unit #3B: Functions of Family 3. Nurturance Provide unconditional love & affection, acceptance & emotional support, & companionship Family’s ability to meet physical & psychological needs of its members 4. Reproductive Function Process of individuals having children & creating new families People have options of whether to have children or not & do not need to be married to have children May be same-sex couples or single parent (Polan, p. 153) (see next slide) Module Competency #3:Various Needs of Clients Unit #3B: Functions of Family 5. o Recreation Family determines the types and frequency of leisure activities (Berman et al., p. 433) 6. Educational & Socialization Function ◦ Family is first socializing agent for teaching children society’s expectations & limitations ◦ Family is responsible for ensuring children get a formal education ◦ Family assists children’s adaptation to community’s & societal norms-teach rules, laws, expectations (Polan, p. 153) Module Competency #3:Various Needs of Clients Unit #3C: Family Influence on Healthcare Recommended Content To promote health, one must understand the health beliefs of individuals & families. Health beliefs may reflect a lack of information or misinformation about health & disease. They may include folklore & practices from different cultures. It is the family that decides about the health or illness of its members & when to seek healthcare (Cooley, p. 454) Module Competency #3:Various Needs of Clients Unit #3C: Family Influence on Healthcare Families may be the first to recognize illness in its members Families also determine the following: ◦ Whether to seek treatment ◦ What type of treatment is appropriate ◦ Who would provide that treatment or care ◦ Where the treatment should be provided (Cooley, p. 454) Module Competency #3:Various Needs of Clients Unit #3D: Emotional Needs Recommended Content The emotional needs of a client and/or their family members might be: ◦ The need for available support from the various healthcare team members ◦ Having conversations that are appropriate only to the situation ◦ Maintaining accurate information ◦ Recognizing that the patient/client has an array of emotions when dealing with a medical situation Module Competency #3:Various Needs of Clients Unit #3E: Spiritual Needs Recommended Content As with all areas of a client/patient’s life, respect of a person’s spiritual beliefs/practices are critical. It is important to make sure that students are aware of the need for respect, especially in areas that they may not understand. A client/patient’s spiritual needs might include the availability of a religious clergy. For example: Rabbi Priest Iman Native American Tribal Chief Chaplin Pastor Spiritual Director Module Competency #3:Various Needs of Clients Unit #3F: Mental Health Issues Recommended Content When a person is dealing with health issues not only are there emotional and spiritual needs, as the previous slides discussed, there are also mental health issues to be aware of and sensitive to. The curriculum lists the following as mental health issues that the patient might be dealing with. ◦ ◦ ◦ ◦ ◦ Depression Avoidance Anger Fear Isolation (see next slide) Module Competency #3:Various Needs of Clients Unit #3F: Mental Health Issues Every patient and their family members have they own way of dealing with health issues. Defense mechanisms within a patient/client are common The defense mechanisms include: ◦ ◦ ◦ ◦ ◦ Denial Projection Enable Suppression Rationalization Module Competency #3:Various Needs of Clients Unit #3F: Mental Health Issues Having introduced to the students some of the mental health issues and defensive mechanisms of a patient/client, it is important to discuss coping strategies that are available to the patient/client. Some things to keep in mind are: ◦ Family’s ability to deal with the stress of the illness depends on the family’s coping skills. If good communication skills, the family is better able to discuss how they feel about the illness & how it impacts family functioning. ◦ Social support networks provide strength, encouragement, & services to the family during the illness (Berman et al., p. 437) (see next slide) Module Competency #3:Various Needs of Clients Unit #3F: Mental Health Issues Some successful coping strategies are: ◦ Relaxation techniques such as massage, visualization, reflexology ◦ Prioritization – do the tasks that are only important and need to be done ◦ Time management – Control your time, life, stress and energy levels ◦ Self-Care – get plenty of sleep, eat a healthy diet, exercise, read a good book Module Competency #3:Various Needs of Clients Unit #3G: Social Needs Recommended Content Just as all people have social needs, patients/clients are no different. Social needs of a patient/client include: ◦ ◦ ◦ ◦ Being included in activities such as a book club, a game of bridge Having an active role in their own care Participating in their own care conferences Attending support groups, if possible Module Competency #3: Emotional, Spiritual, Mental Health, and Social Needs Recommended Learning Activities Assignments Resources Notes AS Competency #3: Making Sense of Mental Health-Past and Present Assignment on website This is an assignment from the National Institute of Health on the history of mental health AS Competency #3: Mental Health Assignment on website Students reflect on 3 YouTube videos on actual mental health patients Module Competency #4 EXPLAIN HOW DIFFERENT DISEASES CAN INFLUENCE THE FUNCTIONING, BEHAVIORS, AND ATTITUDES OF INDIVIDUALS INCLUDING DEMENTIA/ALZHEIMER’S DISEASE. Module Competency #4: Explain how different diseases influence the functioning, behaviors, and attitudes of individuals including dementia/Alzheimer’s disease. Two units and learning activities round out the learning for this fourth competency: A. Describe how chronic illness affects individual coping and behaviors B. Describe how acute illness affects coping and behaviors. Module Competency #4: Diseases Unit #4A: Chronic Illness Recommended Content Chronic Illness: Health problem of long duration in which the disease shows little or no change or slowly gets worse. Affect a person’s ability to meet their need for selfactualization Includes stressors that impact the client and their family These stressors are discussed on the following slide. Module Competency #4: Diseases Unit #4A: Chronic Illness Stressors that impact the patient and their family are: ◦ Emotional- stress over a period of time can lead to other chronic conditions (depression) ◦ Physical-depending on the body systems that are affected by illness, this may be a major stressor to the family and client (chronic pain, limited mobility) ◦ Social- as the client may be isolated from peers and others ◦ Financial- healthcare costs impact the client’s financial resources or in some cases their ability to work for resources Module Competency #4: Diseases Unit #4B: Acute Illness Recommended Content Although acute illness is by nature short-lived, it can be a crisis & stress families, especially if it involves hospitalization; it can impact families’ financial & time resources It is important for the healthcare worker to realize that the person in crisis may act in ways that are not his/her normal behavior, because he/she feels a loss of control due to the illness Many of the stressors for chronic illness may still apply to acute illness. Module Competency #4: Diseases Unit #4B: Acute Illness At this point in the module, the curriculum asks the instructors to discuss with the students the following: ◦ Discuss the impact of Dementia/Alzheimer’s on the client and their loved ones ◦ Discuss appropriate behavior modification for those suffering from Dementia/Alzheimer’s ◦ Recognize personal feelings when providing care to clients with Dementia/Alzheimer’s Module Competency #4: Influences of Diseases Recommended Learning Activities Assignments Resources Notes AS Competency #4: Coping with Alzheimer’s Part 1 Assignment on website Students watch the movie, “Forgetting” and focus on the difficulties that arise in caring for a loved one with Alzheimer’s and the coping strategies that caregivers and family members must make. Module Competency #5 DESCRIBE SELECTED CLIENT SERVICE STRATEGIES INCLUDING CUSTOMER SERVICE, THEIR IMPACT ON QUALITY CLIENT CARE AND THE IMPORTANCE OF CLIENT PARTICIPATION IN GROUP/FAMILY ACTIVITIES. Module Competency #5: Describe selected client service strategies including customer service, their impact on quality client care and the importance of client participation in group/family activities. Four units and learning activities round out the learning for this fifth competency. A. Identify ways that healthcare workers can promote client services. B. Discuss ways that quality client care can be enhanced in the health care setting. C. List common expectations for service. D. Discuss importance of client/family inclusion in group activities. Module Competency #5: Customer/Client Services Unit #5A: Promoting Client Services Recommended Content At times is seems as though adequate customer service is dying. Within healthcare, the patient is always the #1 focus and providing patients with competent customer/patient service is critical. Some things to keep in mind with providing customer service to patients is: ◦ Stay focused on the client’s/patient’s needs ◦ Avoid allowing personal feelings to enter into a situation ◦ Recognize the stage of development of the client and how this impacts client needs ◦ Recognize the impact of family in the client’s receipt of healthcare services Module Competency #5: Customer/Client Services Unit #5B: Enhancing Quality Client Care Recommended Content When providing quality care to a client, it is important to remember that the client may have feelings of vulnerability and may be in a crisis. Being aware of this will aid in the healthcare provider delivering quality care. The following list provides a few suggestions for the enhancement of client care: ◦ Come to work ready to focus on the client ◦ Take care of self physically, emotionally, and mentally so that you are able to meet the needs of those you serve ◦ Leave personal problems at home ◦ Seek professional development opportunities that assist in continuing in your own development Module Competency #5: Customer/Client Services Unit #5C: Expectations for Service Recommended Content Common expectations for services received are: ◦ Service should be completed in a timely way ◦ Service is client centered ◦ Service in health care includes compassion Module Competency #5: Customer/Client Services Unit #5D: Importance of Client/Family in Group Activities Recommended Content Often times, clients/patients are lonely and as a result can suffer from depression. The inclusion in group activities can provide many benefits, such as: ◦ ◦ ◦ ◦ ◦ Loneliness may be reduced Provides a means of socialization Increases self worth Refocuses negative thoughts to positive thoughts Promotes a feeling of acceptance Module Competency #5: Client Service Strategies Recommended Learning Activities Assignments Resources Notes AS Competency #5: Importance of Participation on Group-Family Activities Assignment on website Students review several webpages on elderly and activities and then answer questions. Module Competency #6 DEFINE THE STAGES AND PROCESSES OF DEATH AND DYING AND THE INFLUENCE THOSE STAGES HAVE ON CLIENTS AND THEIR FAMILIES. Module Competency #6: Define the stages and processes of death and dying and the influence those stages have on clients and their families. This competency consists of three units and their learning activities. A. List the stages of grief that occur in death and dying. B. List the needs of the dying client and their family. C. List the different causes of death and describe how this may affect the client and families ability to progress through the stages of death. Module Competency #6: Death and Dying Unit #6A: Emotional Stages of Grief Grief: “The total response to the emotional experience to loss” “Grief is manifested in thoughts, feelings, & behaviors associated with overwhelming distress or sorrow” Everyone experiences loss, grieving, & death at some time during his/her life. People may suffer loss of: Valued relationships through moving from one city or state to another, separation, divorce, or the death of a family member (parent, grandparent, sibling, spouse) or friend Changing life roles, as they watch grown children leave home or retire from lifelong work (Berman et al.) (see next slide) Module Competency #6: Death and Dying Unit #6A: Emotional Stages of Grief Healthcare workers interact with dying clients & their families or caregivers in a variety of settings: ◦ from a death of an unborn child, to the adolescent victim of an automobile collision, to the elderly client who dies from a chronic illness There are many influences on the dying process: legal, ethical, religious, spiritual, biological, personal It is important that the healthcare worker provides sensitive, skilled, & supportive care to all those affected (Berman et al.) (see next slide) Module Competency #6: Death and Dying Unit #6A: Emotional Stages of Grief Recommended Content Any discussion about death and dying can be uncomfortable; however, the more that it is discussed, the less taboo it becomes. Such a discussion with students can make a powerful impact on many people especially given the fact that so many students have suffered numerous forms of loss and/or death. Elizabeth Kubler-Ross was responsible for introducing the five stage of dying and death. (see next slide) Module Competency #6: Death and Dying Unit #6A: Emotional Stages of Grief Kübler-Ross (1969) describes five stages of dying and although these stages are listed in order, grieving people do not experience them in any particular order for any length of time & often move back & forth between stages Five Stages of Dying Denial Stage Anger Stage Bargaining Stage Depression Stage Acceptance Stage (Potter & Perry, p. 464) (see next slide) Module Competency #6: Death and Dying Unit #6A: Emotional Stages of Grief 1. 2. 3. Denial & Isolation Stage: a person acts as though nothing has happened & refuses to accept the fact of the loss; person shows no understanding of what has occurred. Anger Stage of adjustment to loss; a person expresses resistance & sometimes intense anger at God, other people, or the situation. Bargaining Stage: cushions & postpones awareness of the loss by trying to prevent it from happening. Grieving or dying people make promises to self, God, or loved ones that they will live or believe differently if they are spared the dreaded outcome. (Potter & Perry) (see next slide) Module Competency #6: Death and Dying Unit #6A: Emotional Stages of Grief Depression Stage: occurs when a person realizes the full impact of the loss. Some feel an overwhelming sense of sadness, hopelessness, & loneliness; resigned to the bad outcome, they sometimes withdraw from relationships & life. 5. Acceptance Stage: the person incorporates the loss into life & finds ways to move forward. Resolved to the fact that death is imminent and finds peaceful acceptance & positive feelings. 4. (Potter & Perry) Module Competency #6: Death and Dying Unit #6B: Needs of the Dying Client & Family Recommended Content The needs of clients and their family members when dealing with dying and death correspond to those of Maslow’s Hierarchy of Needs. As stated state earlier in the power point, Maslow’s Hierarchy of Needs are: ◦ ◦ ◦ ◦ ◦ Physiological needs – providing basic needs Safety and security – promoting comfort Love and belonging – support by the family Self-esteem – learning needs Self-actualization – being at their best in spite of the disease or illness Module Competency #6: Death and Dying Unit #6C: Types of Death Recommended Content Having a discussion about various types of death also lends itself to various types of loss. The various types of loss are briefly introduced here: 1. 2. Actual Loss: Loss that can be recognized by others Perceived Loss: Loss experience by one person, but cannot be verified by another ◦ Example: A woman who leaves her employment to care for her children at home may perceive a loss of independence & freedom Both actual & perceived losses can be anticipatory loss (see next slide) Module Competency #6: Death and Dying Unit #6C: Types of Death 3. 4. 5. Anticipatory Loss: Loss that is experienced before the loss actually occurs. Example: A woman whose husband is dying may experience the actual loss in anticipation of his death. (Berman et al., p. 1082) Developmental Losses: Losses that occur during the process of normal development, such as grown children leaving home, retirement from a career, death of aged parents (these generally can be anticipated & prepared for). Situational Losses: Loss of one’s job, death of a child, or loss of functional ability because of acute illness or injury. (see next slide) Module Competency #6: Death and Dying Unit #6C: Types of Death Types of Death Unexpected death leaves families feeling shocked & bereaved (Examples might be death due to a heart attack) Traumatic death can lead to complicated grief: (Examples: suicide or homicide) Anticipated death from a chronic or prolonged illness; families may be physically & emotionally exhausted from caring for the family member prior to death (Berman et al.) (see next slide) Module Competency #6: Death and Dying Recommended Learning Activities Assignments Resources Notes AS Competency #6: Morrie and ALS Assignment on website Students watch the movie ”Morrie” about a man dying from Lou Gehring’s disease. AS Competency #6: Death & Dying Obituary Assignment on website Students write their own obituary Module Competency #7 DESCRIBE HOW TO CARE FOR THE CLIENTS’ ENVIRONMENT. Module Competency #7: Describe how to care for the clients’ environment. Two units and their learning activities are embedded in this competency. A. Discuss the importance of a clean environment. B. Describe proper care of client’s personal items Module Competency #7: Clients’ Environment Unit #7A: Clean Environment Recommended Content In the busy-ness of the career of a healthcare provider, some important tasks might be overlooked. A clean and organized environment for clients/patients can provide the person with safety, health and comfort. When caring for a patient’s environment keep in mind to: ◦ Clean surface items appropriately ◦ Reduce allergens ◦ Promote infection control Module Competency #7: Clients’ Environment Unit #7B: Client’s Personal Items Recommended Content At times it is necessary to assist the client/patient with proper caring of their personal belongings. In doing so, it is important not to move their personal items to a new location. ◦ Doing so could cause confusion and/or anxiety for the client. Also, when cleaning their environment, ask the client for any suggestions that they may have. This will promote a feeling of inclusion and encourage pride in their surroundings. Module Competency #7: Describe How to Care for the Clients’ Environment Recommended Learning Activities Assignments Resources Notes AS Competency #7: Care of George’s Environment Assignment on website Students review a picture of a patient’s room and identify 20 problems with his environment. Module Competency #8 USING A PROBLEM SOLVING PROCESS APPLIED TO HEALTHCARE SITUATIONS, DESCRIBE HOW HEALTHCARE WORKERS CAN BE AWARE AND SENSITIVE TO THEIR CLIENTS’ NEED/BEHAVIORS. Module Competency #8: Using a problem solving process applied to healthcare situations, describe how healthcare workers can be aware and sensitive to their clients’ needs/behavior One unit is included in this competency and its learning activities. A. Discuss the problem solving process as applied to awareness and sensitivity to clients utilizing a team approach. Module Competency #8: Problem Solving Unit #8A: Problem Solving Process Recommended Content 1. Identify the problem 2. Analyze the problem 3. Generate and analyze solutions – brainstorm for possible solutions, evaluate the best solution 4. Implement the best solution 5. Evaluate the solution’s effect, plan the next steps Module Competency #8: Problem Solving Process Recommended Learning Activities Assignments Resources Notes AS Competency #8: Aging Suits Assignment on website Students compare normal movement to what it feels like to be aged with arthritis, cataracts, limited movement by putting on an aging suit. This completes the curriculum for Awareness & Sensitivity to Clients Needs. (see next slide) What to do now? You’ve now been introduced to Awareness and Sensitivity to Clients’ Needs.. Presented were key points found on the instructor resource outline and several possible learning activities to use. You received tips on teaching the material, along with areas to be sensitive to with students. Now, click on the “Survey” tab and complete the Awareness & Sensitivity to Clients’ Needs Survey. You are invited to go to the website to preview additional learning activities, PowerPoints, assessments, etc. You are encouraged to use the instructor learning resource module outline to make notes on which online resources would benefit you and your teaching style. Accessing HealthForce Minnesota To access the HCCC curriculum go to: 1. www.healthforceminnesota.org/curriculum 2. Click on Healthcare Core Curriculum 3. Click on Curriculum (Password Required) A. Password: HCCC 4. Select desired module to view “This workforce solution was funded by a grant awarded by the U.S. Department of Labor’s Employment and Training Administration. The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership.” This work by the Health Professions Pathways (H2P) Consortium, a Department of Labor, TAACCCT funded project is licensed under a Creative Commons Attribution 3.0 Unported License. Power point created by: Dede Carr, BS, CDA, LDA Pat Reinhart, RN References Berman, A., Snyder, S.J., Kozier, B., & Erb, G. (2008). Promoting family health. In A. Berman, S.J. Snyder, B. Kozier, & G. Erb (Eds.). Kozier & Erb’s Fundamentals of nursing: Concepts, process, and practice (8th ed.) (pp.428441). Upper Saddle River, NJ: Prentice Hall Cooley, M. L.(2009). A family perspective in community/public health nursing. In F. Maurer & C. Smith (Eds.). Community/public health nursing practice: Health for families and populations (4th ed.) (pp. 327-344). St. Louis, MO: Elsevier. Friedman, M.M. (1998). Family nursing:Theory & Practice (3rd ed.). Norwalk, CT: Appleton & Lange References Juliar, K. (2003) Minnesota Healthcare Core Curriculum (2nd ed.). Clifton Park, NY: Delmar Publishers Maurer, F., & Smith, C. (2009). Community/public health nursing practice: Health for families and populations (4th ed.). St. Louis, MO: Elsevier. Ramon, P.R. & Niedringhaus, D. M. (2008). Promoting culturally proficient care. Fundamental nursing care (2nd ed.) (pp. 16-26). Upper Saddle River, NJ: Person Prentice Hall Wright, L.M. & Leahey, M. (2009). Nurses and families: A guide to family assessment and intervention (5th ed.). Philadelphia, PA: F.A. Davis You have completed Health Care Core Curriculum Awareness & Sensitivity to Clients’ Needs. Congratulations!! Complete the “Self Assessment” found under “Assessments”