CH 1: Mental Health, Accessibility, End-of-Life

What are the factors that contribute to the development of mental health disorders?

biological factors, environmental factors, combination of both

White-Coat Syndrome

common sign of anxiety in a medical setting characterized by a temporary rise in blood pressure during an appointment

Environmental Stressors

factors in a person’s surroundings that can cause emotional or physical strain

What determines the impact a trauma has on a person?

how their mind interprets the stressor and responds to it

What are some of the most common causes of stress?

financial and social pressures

Active Listening

paying attention to verbal and nonverbal cues

Empathy

understanding and compassion for the patient

Respect

treat with dignity regardless of background, condition, or attitude

Clarity

simple, clear language

Patience

not rushing patients to answer

Reflection

repeat/rephrase patient’s statement to show understanding and encourage elaboration

Observation

point out behaviors and changes you notice

Recognition

acknowledge the patient’s progress and effort

According to the American with Disabilities Act (ADA)…

medical offices must have marked accessible parking spaces, wheelchair-accessible entrances/ramps, and bathrooms with large stalls and handrails

What are some general accessibility things you can do to help patients with disabilities?

arrange waiting room chairs to make room for wheelchairs, avoid rugs and floor mats that can make movement difficult or could cause tripping, keep pathways clear, etc.

What are some things you can do to help patients with vision loss?

provide Braille and large-print reading materials, use clear descriptive language when giving directions, avoid touching patients without letting them know

What are some things you can do to help patients with hearing loss?

offer online appointment scheduling to reduce phone-related barriers, face patient directly when speaking to them to let them read your lips, do not shout, speak clearly at a normal pace, provide sign language interpreter if requested (legally required if asked)

What are some things you can do to help patients with service animals?

remind others not to touch, feed, or distract the animal, let it remain with the patient at all times

What is the first priority when communicating with patients with developmental delays?

determine how the patient communicates and what level they understand

Defense Mechanisms

unconscious coping strategies people use to protect themselves from negative emotions; two types

Adaptive

defense mechanism type that helps a person adjust and cope as they process stress in a healthy way

Maladaptive

prevent personal growth and interfere with emotional adjustment and problem-solving

Apathy

indifference; lack of concern or emotion

Compensation

balancing a weakness with an achievement

Conversion

turning anxiety into a physical symptom

Denial

refusing to accept reality

Displacement

redirecting emotions to a less threatening object

Dissociation

detaching emotions from thoughts/events

Identification

adopting traits or behaviors of someone else

Intellectualization

focusing on facts instead of feelings

Introjection

absorbing the ideas or beliefs of others

Projection

attributing one’s own faults to others

Rationalization

justifying unacceptable behaviors

Reaction Formation

acting opposite of true feelings

Regression

reverting to childlike behavior

Sublimation

channeling negative impulses into positive actions

Suppression

intentionally avoiding unpleasant thoughts

Undoing

making up for a mistake with a symbolic act

Verbal Aggression

attacking someone verbally instead of addressing the issue

Sarcasm

using irony or mockery to make emotions

What should MAs discuss with patients and their families to help with end-of-life preparation and care?

discuss advanced directives, wills, health care power of attorney, making burial/funeral arrangements, ensuring loved ones have financial and care-giving support

Anticipatory Grief

the process of grieving before a loss actually occurs

What are the five stages of grief?

denial, anger, bargaining, depression, acceptance

Denial

patient refuses to belief the loss/illness is real

Anger

patient feels anger toward the situation, loved ones, or staff

Bargaining

patient tries to make deals (e.g. if I can live long enough to see my grandchild graduate…)

Depression

sadness and withdrawal occur as reality sets in

Acceptance

patient acknowledges the loss and begins to find peace