Psychology

Just language developmental , Several theorists how defined the various stages of grief.

the most well-known theory is the five stages of grief Elizabeth Kubler Ross defined as a result of her extensive experience in working with dying patients. Awareness of these stages can help medical assistance understand what grieving patients are experiencing, whether the loss is the death of a loved one, he lost I'll be body part or function, a financial loss, the loss I'll be home, or any number of other losses that have a strong and lasting effect on the person.

Prior to beginning medical data collection, the medical assistant can use a broad opening like,

" What would you like to talk about today?" how the patient answers will help set the tone for the remainder of the interaction.

Advance directives

A document that communicates a patient's specific wishes for end of life care should the patient become unable to do so

dementia

A progressive mental disorder characterized by decline of mental functioning and impairment of memory, judgment, and impulse control

the final step is that of self actualization

At this step, the individual has attained personal growth and reached their full potential as a human being. They have developed wisdom and wish to share their knowledge with others.

one of the most generally accepted developmental theories is the work of

Erik Erikson. his eight stages of development offer a guideline for identifying the psychosocial challenges patients face at different periods in their lives and the tasks they must master before successfully transitioning to the next stages of development.

a stressor is anything that causes anxiety or stress. Many things in the environment cause stress, as do psychological factors ( grief, depression, loss, guilt).

Even things that are positive ( taking a vacation, having and intimate experience , graduating from college) can be stressors. medical assistants should realize that coming to a healthcare facility can create a great deal of stress for a patient. this is reflected by an increase in blood pressure in the office that is not reflected in the patient's readings from home, commonly called " white coat syndrome." This is an objective indication of the patient's anxiety.

Preschoolers have an imagination and are curious about everything around them.

Eventually they will start feeling guilty for some of their actions, which is part of the natural development of moral judgment. Achieving the tasks of this stage results in assertiveness, dependability, creativity, and personal achievement. non achievement leads to feelings of inadequacy, defeat, guilt, and the belief that they deserve punishment.

General understanding of the principles of therapeutic Communication is helpful when working with all patients.

For example, medical assistants can encourage patients to Express their feelings by reflecting patient statements back to them in a way that promotes further communication. It is also helpful to make observations and offer recognition of positive changes.

Developmental theories abound, usually taking into consideration some of the most basic ideas about

Human growth and development.

Another theory used frequently in healthcare is Maslow's hierarchy of needs. This theory is based upon the

Idea that all individuals have needs ranging from basic to complex. This is usually represented as a triangle or pyramid, with each stop becoming smaller going up. This represents the fact that not all individuals will achieve the higher and more complex needs.

During this stage, toddlers begin to develop a sense of

Independence, autonomy, self control. they also acquire language skills. parents should be firm but tolerant with toddlers.

Many older patients have chronic or terminal illnesses that influence them to prepare for the end of their life.

It is not uncommon for a provider to tell you patient who has a life threatening illness, such as advanced cancer or kidney disease, that it is time to "get their affairs in order:. This means that patient should make arrangements for end of life care, funerals, burial, and cremation services.

love and belonging

Meaningful relationships and connections with others is the paramount accomplishment with this step. when met, the individual moves up to the next level of self esteem.

The development tasks for infants are to form an attachment with and develop trust in their

Primary caregiver usually the mother and then generalize those bonds to others. They also begin to trust their own body as they learn gross and then fine motor skills. Achieving the tasks of this stage results in self-confidence and optimism that caregivers will meet the infant's basic needs. non achievement leads to suspiciousness and struggles with interpersonal relationships.

self-esteem needs

Recognition of accomplishments from others gives the individual a sense of confidence and independence resulting in self-esteem. Illness can affect this by changing the individual's appearance( limb loss, disfigurement), or by role changes ( inability to perform activities of daily living, changes required for employment)

Safety: Achievement of this level means the individual feels emotionally and physically

Safe in the environment. There is a level of protection in their surroundings, and they have adequate housing and a safe work environment. Once this is accomplished, the next step is love and belonging

These techniques promote positive communication. Patient can also have specific types of problems that can require special consideration and

Techniques. The medical assistant helps build and nurture the relationship with all healthcare staff.

generativity

The concern for establishing and guiding the next generation that stems from a sense of optimism and humanity

Denial this stage,

The grieving person cannot or will not believe that the loss is happening or has happened. He might deny the existence of the illness and refused to discuss therapeutic interventions. Thought processes reflect the idea of "No, not me". the medical assistant should try to support the patient written information about the disease and treatment options.

If the person has a dependent, such as a partner, the dying person will want to make financial or caregiving arrangements for the dependent.

The person also needs to have advance directives in place, as well as a will and a durable power of attorney for healthcare document available. These participations bring the reality of the end of life into sharp focus, and generally put the patient and loved ones into a state of anticipatory grief. this means that they are feeling the emotions and reactions that grief causes before the loss actually occurs.

stagnation

The result of stopping progress or forward movement

Medical assistants must realize that older adults are a unique population because

They face so many challenges towards the end of life. The physical challenges are real, and the feelings of grief can be overwhelming. This leads to a major health concern for older adults; depression

After age 60, many people start to think about their own mortality.

They realize that so much of their life is behind them, and they begin to wonder how many "good years" they have left .

this is the psychosocial crisis for infants ( birth to 18 months)

Trust is the successful outcome of this stage; mistress is the unsuccessful outcome.

It is important to understand that not everyone grieves in the same way.

Well one person might navigate through the stages of grief one by one and in a sequence, others can be in more than one stage simultaneously. Some might keep skip one of the stages. The duration of the process is also highly variable. there is no " right way" to grieve. the stages of grief that Kubler ross defined are as follows.

Those who capacity for independent living has diminished can become victims of elder abuse,

Which can involve neglect or physical abuse, often perpetrated by caregivers or family members who are overwhelmed with the burden of caring for the aging individual.

ego

a part of the mind that senses and adapts to reality

psychologist

a person who specializes in the study of the structure and function of the brain and related mental processes

psychiatrist

a physician with additional medical training and experience in diagnosis, prevention, treatment of mental disorders

ultraviolet

a type of radiation the sun produces

achieving the tasks of this stage ( identity vs. role confusion) results in emotional stability,

ability to form committed relationships, and sound decision making. non achievement leads to a lack of personal goals and values, rebelliousness, self consciousness, and a lack of self confidence

(ego integrity vs despair) many will volunteer to retain a feeling of usefulness. Their bodies succumb to

age related changes, and health problems become a major concern, especially as friends and love ones die. Achieving the tasks of the stage results and wisdom, self acceptance, and a sense of self worth as life draws to a close. Not achievement leads to dissatisfaction with one's life, feelings of worthlessness, helplessness to change, depression, anger, and the inability to accept that death will occur.

create enough gaps between the chairs in the waiting areas and

along walls for safe wheelchair access, maneuvering, and parking.

this is the psychosocial crisis for toddlers ( 2 to 3 years)

autonomy is the successful outcome of this stage; shame and doubt are the unsuccessful outcome.

a psychologist is a healthcare professional who conducts evaluations of

behavior and practices individual, group, and family therapy.

individuals who have chronic or terminal illness are under an extreme amount of stress.

casual, routine opening lines like an excessively cheerful " How are you doing today?" can provoke defensive responses like, " how do you think i'm doing? i'm dying." Even if the patient doesn't say that, he might think it. instead, medical assistants should welcome these patients warmly and respect their dignity. Treat them with kindness and caring at all times.

achieving the tasks of this stage ( intimacy vs isolation) results in the ability for mutual self-respect and love, intimacy, and

commitment to others and to a career. Non Achievement leads to social isolation and withdrawal; multiple job changes or lack of productivity and fulfillment in one job; and an inability to form long term, intimate relationships

empathy

conveyance of an objective awareness and understanding of the feelings, emotions, and behavior of patients, including trying ti envision what it must be like to be their situation.

( ego integrity vs despair) this is the psychosocial crisis for older adults ( 65 years and older). ego integrity is the successful outcome of this stage,

despair is the unsuccessful outcome. During this stage, most adults retire; their children, if they have any, no longer live at home.

( identity vs role confusion) this is the psychosocial crisis for adolescents ( 12 to 20 years ). Identity is the successful outcome of the stage; role confusion is the unsuccessful outcome.

during this stage, adolescents try to figure out where they fit in and what direction their life should take. if role confusion sets in , adolescents become followers, which can lead to poor decisions making.

the first step when working with patients who have mental or emotional challenges is determine how they can communicate and what level of communication they can understand.

family members and caregivers can assist with this.

achieving the tasks of this stage( autonomy vs shame and doubt) results in self control and voluntary delaying of

gratification. non achievement leads to anger with self, a lack of self confidence, and sense of pride in the ability to perform tasks.

acceptance, during the grieving person comes to terms with loss and starts making plans for moving on with life despite the loss or impending loss.

he is willing to try to " make the best of it" and formulate new goals and enjoy new relationships. if death is imminent, he will start making funeral and burial arrangements and might reach out to friends and family who have not been a part of his recent years of life. there might still be some depression, but there might also be humor and friendly interaction. thought processes reflect the idea of " yes, ,me , and i'm ready". the medical assistant should offer encouragement, support, and additional education to the patient and his family and friends during this time.

( industry vs. inferiority) this is the psychosocial crisis for school age children ( 7 to 12 years)

industry is the successful outcome of this stage inferiority is the unsuccessful outcome. During the stage, children need to receive recognition for accomplishments to provide reinforcement and build self confidence. If the treatments are met with a negative response, inferiority can be established. Children require acknowledgement of their successes. Achieving the tasks of this stage results in feelings of competence, self satisfaction, and trustworthiness in addition to increased participation in activities and taking on more responsibilities at school, home, and the community. non achievement leads to feelings of inadequacy and the inability to compromise or cooperate with others.

(initiative vs guilt) this is the psychosocial crisis for preschoolers ( 3 to 6 years )

initiative is the successful outcome of this stage; guilt is the unsuccessful outcome.

development, however, encompassess physiological , emotional, mental, social,

interactive, spiritual, and physical or maturational changes. these theories take into account the activities of the conscious mind the thoughts, beliefs, and emotions people are aware of and the unconscious mind the emotions that lie beneath the surface and beyond awareness but profoundly affect the conscious mind.

(intimacy vs isolation) this the psychosocial crisis for young adults ( 20 to 35 years).

intimacy is the successful outcome of this stage; isolation is the unsuccessful outcome. during this stage, young adults begin to think about partnership, marriage,family, and career. lack of fulfillment in this key area of life can lead to isolation and withdrawal.

For many, their adult children live long distance away and have families and careers of their own.

it gradually becomes more difficult for older adults to continue to work, maintain their home, and depending on what health conditions they have participate in activities they enjoy ( gardening, tennis) as well as activities of daily living. They worry that minor issues, like forgetting to buy an item they need at the grocery store or misplacing their keys, means they are developing dementia.

medical assistants should offer support and empathy and allow the patient to set the tone of the conversation.

it is crucial that the medical assistant never say they know how the patients feels. all feelings are unique to the individual, so to express this belittles the person and shows a lack of respect for their individuality and uniqueness. Medical assistants should listen carefully to the patient, maintain eye contact, and always ask how they may help.

when communication begins and a patient becomes agitated or confused,

it is crucial to be remain calm. Avoid showing impatience or speaking louder, which can increase the patient's agitation. any time the medical assistant cannot understand something the patient says, asks for clarification.

Depression, during this stage, the reality of the situation takes hold, and the grieving person feels sad,

lonely, and helpless. for example, he might have feelings of regret and self blame for not taking better care of himself. he might talk openly about it or might withdraw and say nothing about it. thought processes reflect the idea of " yes, it's me". the medical assistant should sit with the patient and not put any pressure on him to share his feelings but instead convey support and understanding. referrals to a support group or for counseling can be helpful.

just like patients with physical challenges, there are sometimes noticeable indications in appearance,

mannerisms, behavior that patients have developmental, or psychosocial challenges. Medical assistants must advocate for these patients and treat them with respect and empathy at all times. they should make sure to meet their immediate needs and ask their caregivers what they can do to improve their comfort and calm their anxieties.

psychology is the study of the

mind and behavior.

events in the environment ( death of a loved one, theft, vandalism,

motor vehicle crashes, physical assault, job or school problems) can also cause stress. Major disasters ( fires, floods, tornadoes, earthquakes, hurricanes, war) can result in post traumatic stress disorder ( PTSD), which is a mental health condition that causes anxiety, insomnia, anger, loss of interest in daily activities, and flashbacks to the traumatizing event.

many older adults deal with constant grief, as older friends,

neighbors, and family members die. They may also grieve for themselves for their younger, healthier days and for the abilities they are losing or have lost. They hear many clichés, such as "just take one day at a time", " don't worry about what hasn't happened yet", and " you're only as old as you feel." But the reality is that these platitudes offer little comfort to older adults grappling with the grim realities of aging.

Erikson believed that Society and culture affect how the personality

of an individual develops and that successful completion of each stage supports the healthy development of the person's ego

Achieving tasks of this stage ( generativity vs stagnation) results in professional and

personal achievements and active participation in serving the community and society. Non-achievement occurs when development ceases which leads to self preoccupation without the capacity to give and share with others.

Growth generally refers to physical growth from infancy to adulthood and then the

physiological changes that take place as people age.

a psychiatrist is a physician who assesses behavior, conducts and prescribes interventions,

provides ongoing therapy, and can prescribe medications.

medical assistants can ensure these patients are comfortable and able to function well in their surroundings by organizing common areas.

psychologically, the patients will feel more at ease; as a result, it will be easier to build therapeutic relationships with them. they will see the office staff has anticipated their needs and facilitated their navigation throughout the office. helpful office organization strategies are as follows.

psychosocial

referring to the relationship between and interplay of mental health and interpersonal relations

during this stage ( initiative vs guilt) , children look for new experiences but will hesitate when adults

reprimand them or restrict them from trying new things.

As people age and their physiologic abilities and reserves dwindle, they tend to

seek more health care services. with the exception of pediatric settings, many of the patients who medical assistants will encounter in their daily practice will be in their last few decades of life.

instead of thinking patients who have physical challenges as disabled, medical assistants

should consider them as having special needs.people who live with physical challenges do many things others without those challenges do. they just do them differently.

( generativity vs stagnation) this is the psychosocial crisis for middle adults (35 to 65 years) generativity is the successful outcome of this stage;

stagnation is the unsuccessful outcome. during this stage. During the stage, adults continue to raising children and some become grandparents. They want to help mold future generations, so they often involve themselves in teaching, coaching, writing, and social activism.

the physiological needs

such as food, air, water, homeostasis, reproduction, rest, and physical activity are at this level. All individuals who have an illness or health issue are at the step. Once all these needs are met, the individual can move to the next level.

it is also important to make sure the patient has all the services he needs,

such as hospice referrals, meal delivery services, and home health assistance. support groups and community services can also help; these services can provide social experiences and an outlet for dying patients and their familites

Bargaining , during this stage, the grieving person attempts to avoid the loss by making some kind of deal,

such as wanting to live long enough to attend a particular family occasion. the patient might also be searching for alternative solutions. He is still hoping for his previous life, or life it's self, or at least a postponement of death. thought processes reflect the idea of " yes, me, but " the medical assistant should listen with attention and encourage the patient to continue expressing his feelings

initiative

the ability and tendency to start an action

anger, during this stage

the grieving person might aim feelings of hostility at others, including health care staff ( because they cannot fix or cure the disease). thought processes reflect the idea of " why me" ? the medical assistant should not take the patient's anger personally but should instead help him understand that becoming angry is an expected response to grief.

Maslow's hierarchy of needs begins with

the needs that sustain life

autonomy

the right to make one's own personal decisions, even when those decisions might not be in that person's own best interest

psychology

the study of behavior and of the functions and processes of the mind

when working with patients, it is important to understand

their physical challenges as well as their developmental, emotional, socioeconomic, and psychological challenges. understanding the interplay of all these factors that affect a patient's personality and behavior can help medical assistants adjust the style and content of their communication to best meet that patient's need.

Medical offices and facilities are legally required to have appropriate access for patient who use wheelchairs or other assistive devices.

these include marked parking spaces, ramps and wheelchair accessible bathrooms with large stalls and hand rails,.

a major focus of psychology is communication

this occurs with patients who have wide variety of problems and communication barriers.

environmental or physical stressors include situations that cause enough stress

to become obstacles to achieving goals or having positive experiences. Things in the environment ( air pollution, ultraviolet rays from excessive sun exposure, overcrowding, language and cultural barriers, racial or ethnic discrimination) cause the body physical stress.