Liz Crowe delves into the deeper issues surrounding critical care and religion. She explores how religion influences patients and their families, why doctors can push against faith, and how the healthcare community can integrate an acceptance of faith into their care.
At the end of the presentation, you will be able to:
Identify, Describe and Discuss, How Clients and Families Come to your Practice
Identify Describe and Discuss Addiction, Mental Health, Trauma, Chronic Pain and Process Disorders
Identify how Trauma, Shame, Guilt, Humiliation, Embarrassment, Grief and Loss Effect Ones Story about themselves
Identify how Growing Up in An Alcoholic Family can effect one
Review evidence based strategies
Identify and Differentiate trauma as both objective and subjective and how it effects people over the life span
Recognize how trauma can be precipitating factor which leads to a substance use disorder and vice versa the activities one engages in the midst of a substance use disorder can be traumatic
Identify and Describe Addiction per ASAM new definition
Describe and Discuss Qualitative Methods of Inquiry and Family Mapping as a Way into Story
This was my Home Health/Home based Palliative Care Rotation Feedback; It is major part is concerned about how to take spiritual history and how to address spiritual concerns/Cues of our patients
Medicine is science. But healing is an art. The art of healing embodies our own innate ability to heal. You just need to tap into that ability to begin your own healing journey. When you are trying to heal, your thoughts have a huge impact on your success. Here are a few of my favorite healing and inspirational quotes to help you move forward on your way. Carolyn Harrington
If your teen is struggling with emotional or behavioral problems, a few weeks out in nature can make a huge difference. Surrounded by other teens and under the guidance of professionals, your child will embark on a journey of self-exploration and self-growth.
People with anxiety need to visit psychologistJohn Smith
Anxiety is a natural response to unpleasant conditions in humans. Those thoughts and worries, though, aren't natural for people with anxiety disorders. Their fear continues and, in some cases, worsens over time.
Liz Crowe delves into the deeper issues surrounding critical care and religion. She explores how religion influences patients and their families, why doctors can push against faith, and how the healthcare community can integrate an acceptance of faith into their care.
At the end of the presentation, you will be able to:
Identify, Describe and Discuss, How Clients and Families Come to your Practice
Identify Describe and Discuss Addiction, Mental Health, Trauma, Chronic Pain and Process Disorders
Identify how Trauma, Shame, Guilt, Humiliation, Embarrassment, Grief and Loss Effect Ones Story about themselves
Identify how Growing Up in An Alcoholic Family can effect one
Review evidence based strategies
Identify and Differentiate trauma as both objective and subjective and how it effects people over the life span
Recognize how trauma can be precipitating factor which leads to a substance use disorder and vice versa the activities one engages in the midst of a substance use disorder can be traumatic
Identify and Describe Addiction per ASAM new definition
Describe and Discuss Qualitative Methods of Inquiry and Family Mapping as a Way into Story
This was my Home Health/Home based Palliative Care Rotation Feedback; It is major part is concerned about how to take spiritual history and how to address spiritual concerns/Cues of our patients
Medicine is science. But healing is an art. The art of healing embodies our own innate ability to heal. You just need to tap into that ability to begin your own healing journey. When you are trying to heal, your thoughts have a huge impact on your success. Here are a few of my favorite healing and inspirational quotes to help you move forward on your way. Carolyn Harrington
If your teen is struggling with emotional or behavioral problems, a few weeks out in nature can make a huge difference. Surrounded by other teens and under the guidance of professionals, your child will embark on a journey of self-exploration and self-growth.
People with anxiety need to visit psychologistJohn Smith
Anxiety is a natural response to unpleasant conditions in humans. Those thoughts and worries, though, aren't natural for people with anxiety disorders. Their fear continues and, in some cases, worsens over time.
Looking at mental health through a wider lens to open a a deeper and more meaningful conversation that reflects the times we are in and what lies ahead.
Novus Medical Detox Center Business View Magazine FeatureNovus Medical Detox
NovusDetox is featured in the December 2018 edition of Business View Magazine, a leading industry publication providing executives and business owners across North America with the latest news about current trends and best practices.
I have the benefit of coming to the region from Hong Kong with a blank slate and have the ability to completely separate what goes on at Barossa Strong to the outside community. 100% confidentiality is always maintained and no judgements are ever made. This is a completely safe environment.For more info visit:-http://www.barossastrong.com.au/
Are you interested in becoming a counselor in your city or state? If so, check out Counselor-Education.com to learn the information that you need to start your career in professional counseling!
Uncertainty and cancer care: should primary care providers routinely screen f...Zackary Berger
Spirituality is associated with higher quality of life among cancer patients, and named by such patients among their psychosocial needs. Should primary care providers explicitly screen for and offer spirituality-oriented interventions? A talk given by Zackary Berger, MD, PhD, at Mercy Medical Center in Baltimore, Maryland.
Bibliotherapy in the Pastoral Counselling Practice during the COVID-19 PandemicDr Barbara Louw
Pastoral Counselling involves helping people to cope with the pressures and crises of life. Most of the ministry opportunities I had since the start of the COVID-19 pandemic come from people with whom I built a professional relationship via Inter Trauma Nexus and Aquilla Wellness Solutions before the lockdown started.
Treating Co-Occurring Mood & Anxiety Disorders with Substance Use DisordersGlenn Duncan
Evidence Based Treatment in the consideration of treating anxiety and depressive disorders in the substance using populations. Introduction into these disorders, DSM-5 preview with changes to substance use disorders, certain anxiety and mood disorders. Cultural and best practices treatment considerations (Mindfulness, DBT, MI, Cognitive Behavioral Therapy are in focus with mentions on other best practices such as EMDR). Issues of duty to warn and protect are covered also.
“ECO HIDEAWAY” is a 3 day Charity Benefit, an Entertainment Hospitality lounge, by-invitation-only, Exclusive to Celebrities, Film Stars, credentialed Media, Music Artists, World-class Athletes, & Industry Execs during America’s #1 Film Festival. We celebrate America’s #1 Film Festival’s international crowd by hosting Filmmakers & Music Artists with an exclusive respite, serving up all-day breakfast buffet, steaming mugs o' organic coffee & signature cocktails, music artists jammin’ LIVE with some of the hottest Artists in the biz, showcasing eco-luxury lifestyle brands, celebrity gifting, wellness & spa beauty services, complimentary hi-speed internet access, introducing the newest products for 2012, ski-in and ski-out, Film Stars, entertainment industry networking & hospitality, World Film Premiere parties, producing content for YOUR BRAND (broadcast, print, online, radio) to use for years to come to drive traffic to your business and increase your customer database. “Eco Hideaway” is a terrific way to expose your brand to tastemakers, celebrities & media, to create awareness for Charity causes, to help America make informed “green” choices while giving back. The Chateaux is in the heart of Deer Valley Resort's mid-mountain Silver Lake Village. It offers the finest amenities in the region and is the perfect way to enjoy the majesty of the Wasatch Mountains. The Chateaux’s mid-mountain location offers breathtaking views and its luxurious accommodations shape an unforgettable Deer Valley experience. Walk out the door of the Chateaux and you are just a few steps away from the legendary ski slopes of Deer Valley Resort. Or take a short, complimentary shuttle ride to Park City's Historic Main Street. The Chateaux puts you in the heart of the Park City area within minutes of a host of activities. Our PARTY BUS will also run all 3 days back & forth to Main Street hourly with designated bus stop times and locations. Utah's best ROCK STATION KBER 101FM will broadcast LIVE on Monday, Jan. 21st from the lounge.
Looking at mental health through a wider lens to open a a deeper and more meaningful conversation that reflects the times we are in and what lies ahead.
Novus Medical Detox Center Business View Magazine FeatureNovus Medical Detox
NovusDetox is featured in the December 2018 edition of Business View Magazine, a leading industry publication providing executives and business owners across North America with the latest news about current trends and best practices.
I have the benefit of coming to the region from Hong Kong with a blank slate and have the ability to completely separate what goes on at Barossa Strong to the outside community. 100% confidentiality is always maintained and no judgements are ever made. This is a completely safe environment.For more info visit:-http://www.barossastrong.com.au/
Are you interested in becoming a counselor in your city or state? If so, check out Counselor-Education.com to learn the information that you need to start your career in professional counseling!
Uncertainty and cancer care: should primary care providers routinely screen f...Zackary Berger
Spirituality is associated with higher quality of life among cancer patients, and named by such patients among their psychosocial needs. Should primary care providers explicitly screen for and offer spirituality-oriented interventions? A talk given by Zackary Berger, MD, PhD, at Mercy Medical Center in Baltimore, Maryland.
Bibliotherapy in the Pastoral Counselling Practice during the COVID-19 PandemicDr Barbara Louw
Pastoral Counselling involves helping people to cope with the pressures and crises of life. Most of the ministry opportunities I had since the start of the COVID-19 pandemic come from people with whom I built a professional relationship via Inter Trauma Nexus and Aquilla Wellness Solutions before the lockdown started.
Treating Co-Occurring Mood & Anxiety Disorders with Substance Use DisordersGlenn Duncan
Evidence Based Treatment in the consideration of treating anxiety and depressive disorders in the substance using populations. Introduction into these disorders, DSM-5 preview with changes to substance use disorders, certain anxiety and mood disorders. Cultural and best practices treatment considerations (Mindfulness, DBT, MI, Cognitive Behavioral Therapy are in focus with mentions on other best practices such as EMDR). Issues of duty to warn and protect are covered also.
“ECO HIDEAWAY” is a 3 day Charity Benefit, an Entertainment Hospitality lounge, by-invitation-only, Exclusive to Celebrities, Film Stars, credentialed Media, Music Artists, World-class Athletes, & Industry Execs during America’s #1 Film Festival. We celebrate America’s #1 Film Festival’s international crowd by hosting Filmmakers & Music Artists with an exclusive respite, serving up all-day breakfast buffet, steaming mugs o' organic coffee & signature cocktails, music artists jammin’ LIVE with some of the hottest Artists in the biz, showcasing eco-luxury lifestyle brands, celebrity gifting, wellness & spa beauty services, complimentary hi-speed internet access, introducing the newest products for 2012, ski-in and ski-out, Film Stars, entertainment industry networking & hospitality, World Film Premiere parties, producing content for YOUR BRAND (broadcast, print, online, radio) to use for years to come to drive traffic to your business and increase your customer database. “Eco Hideaway” is a terrific way to expose your brand to tastemakers, celebrities & media, to create awareness for Charity causes, to help America make informed “green” choices while giving back. The Chateaux is in the heart of Deer Valley Resort's mid-mountain Silver Lake Village. It offers the finest amenities in the region and is the perfect way to enjoy the majesty of the Wasatch Mountains. The Chateaux’s mid-mountain location offers breathtaking views and its luxurious accommodations shape an unforgettable Deer Valley experience. Walk out the door of the Chateaux and you are just a few steps away from the legendary ski slopes of Deer Valley Resort. Or take a short, complimentary shuttle ride to Park City's Historic Main Street. The Chateaux puts you in the heart of the Park City area within minutes of a host of activities. Our PARTY BUS will also run all 3 days back & forth to Main Street hourly with designated bus stop times and locations. Utah's best ROCK STATION KBER 101FM will broadcast LIVE on Monday, Jan. 21st from the lounge.
This is a company brochure of RedStar safety Pvt ltd. Our company has safety garments for various manufacturing, service industries. Our solutions are arc safe, weld safe, metal splash safe, Al safe, high-visibility and basic work wear.
Max Studio is a global corporation producing leading-edge fashion design for modern women. Sold through Max Studio stores, boutiques, web and major department stores around the world, Max Studio offers top quality fabrics and innovative styles.
Founded in 1979 by designer Leon Max, Max Studio reflects the fashion standard of today's women. In order to provide clothing of unwavering caliber Max Studio pursues superior fabrics, yarns and leather goods globally. Max Studio focuses on head-turning shapes and silhouettes creating distinguished looks for every occasion. Signature boutiques, in store instillations and website merchandise are replenished every two weeks, providing endless options for customers.
The well rounded philosophy of Max Studio permeates all aspects of our brand and business network. The Max Studio Network includes our ever-expanding web of retails, manufacturers and distributors who share the Max Studio vision and a passionate dedication to quality.
If you would like to become integrated in the global network of Max Studio, please contact us at maxmail@maxstudio.com for more information.
We support and advance the goals of our clients through customized wealth and financial planning services, investment policy creation, asset allocation and portfolio management. As a client of Cardinal Point, you can enjoy the assurance that comes with having a team of experienced professionals working with you to build a comprehensive wealth plan that is focused on creating long-term value — and delivered with a personalized approach that is tailored to your needs. www.cardinalpointwealth.com
El BoNY consideró las "amenazas" europeas pero mostró fidelidad a su país y le pidieron a Griesa que aclare qué se debe hacer con el dinero argentino, retenido desde el 26 de junio.
Marriage and fatherhood is a calling and a ministry. A husband and father is called by God to love, provide, care, guide, nurture and protect his family, as an expression of God, who is the ultimate Husband and Father. Discover the importance and what it takes to fulfill this call and ministry.
Antivirus Scanning Performance and System Resource Utilization ComparisonGFI Software
IT system administrators need to balance the security requirements of the enterprise with usability of PCs. As the threat landscape evolves, PC security solutions have become resource hungry to the point that the PC becomes unusable during periods of security scanning. Tests show that VIPRE Business endpoint security solution offers better scanning performance with minimal system resource usage.
We at Thrillophilia want to thank all of you for writing back to us. We work really ahrd to create great travel experiences for you and this pushes us even more.
D'Amico Kitchen in Le Meridien Chambers Hotel in Minneapolis, MN.
Located in the Theater District near Target Center and the new Twins Baseball Stadium.
Follow us on twitter at @DAmicoKitchen
www.damico-kitchen.com
Modelos de mejora del performance de los negociohernan.corso
Todos las empresas tienen procesos que necesitan mejorar, en este presentación explicamos explica como mejorar el perfomance de las empresas a través de incrementar la eficiencia y efectividad de los procesos de negocio.
Being Present: A Spiritual Care Workshop for Healthcare ProfessionalsJoel High
This is a presentation I delivered to healthcare staff at Alegent Health a few years ago. Alegent Health is a large regional healthcare system based in Omaha, NE and affiliated with CHI. The primary message here is that all staff that interact with patients can impact a patient's spiritual care.
The Power of Spiritual Counseling with Angelicare Hospice.pptxangelicarehospice
Incorporating spiritual care into healthcare practices acknowledges the holistic nature of healing. Just as physical and emotional needs are addressed, spiritual needs must also be recognized and attended to for comprehensive care. Research has shown that spiritual well-being is closely linked to improved health outcomes, including better pain management, enhanced quality of life, and increased resilience in the face of illness. By integrating spiritual counseling into patient care, organizations like Angelicare Hospice can better support individuals in their healing process, promoting a sense of wholeness and comfort.
OBJECTIVES
- Identify, Describe How Clients and Families Come to your
Practice
- Identify , Describe and Discuss Addiction, Mental Health ,
Chronic Pain and Process Disorders
-Identify how Trauma, Shame ,Guilt, Humiliation, Embarrassment , Grief and Loss Effect Ones Story about Themselves
-Identify how we as clinicians, behavioral health care professionals identify our clients
OBJECTIVES:
Identify, Describe How Clients and Families Come to your Practice
Identify , Describe and Discuss Addiction, Mental Heath , Trauma , Chronic Pain and Process Disorders
Identify how Trauma, Shame ,Guilt, Humiliation, Embarrassment , Grief and Loss Effect Ones Story about Themselves
Meeting People Where They Are: Taking Spiritual Assessment - Tessie Mandevill...wwuextendeded
Meeting People Where They Are: Taking Spiritual Assessment – Tessie Mandeville, Reverend & Bobbi Virta, Reverend
Presented at the 2015 Palliative Care Summer Institute conference at Bellingham Technical College
An overview of Lay counseling Equipping Christians fo.docxnettletondevon
An overview of
Lay counseling: Equipping Christians
for helping ministry
By Siang-Yang Tan
Contents
• The Need for Lay Counseling Ministries
• Biblical Basis for Lay Counseling
• A Biblical Model for Effective Lay Counseling
• Basic Principles of Effective Counseling
• Reasons to Refer
• The Literature of Lay Counseling
• Building a Ministry of Lay Counseling
• Selection of Lay Counselors
• Training of Lay Counselors
• Supervision of Lay Counselors
• Evaluation of Lay Counselors
• Potential Pitfalls
• Conclusions
Introduction
• Is lay Christian counseling helpful or dangerous?
• Can we expect an average person without a master’s
or doctoral degree in counseling to be able to meet
the needs of someone plunged into depression or
wracked with indecision by some complex problems
in life?
• Lay counselors are “individuals who lack the training,
educational experience, or credentials to be
professional counselors, but who nevertheless are
involved in helping people cope with personal
problems” (Gary Collins, cited p. 14)
• Lay counseling is present in churches, para-church
organizations, mental health settings, Christian, and
secular
The Need for Lay Counseling
Ministries
• Psychological problems are
increasingly evident
• Christians are not trained to
handle difficult problems (i.e.
typical answer is “you’re a sinner,
just pray about it”)
• There are Scriptural texts that
support the use of lay counseling
Biblical Basis for Lay
Counseling
• Conservative circles are concerned about the
“seduction of Christianity by secular psychology”
• Every ministry must begin with Biblical and
theological basis, including lay counseling
• Two categories of Scriptural reference provide
biblical support for lay counseling ministries in
churches
– Calling of all Christians to be involved in ministry
(priesthood of all believers)
– All believers are called to be involved in ministry to one
another (i.e. people-helping by non-professionals and
para-professionals)
The Call to Ministry in General
(Priesthood of Believers, I Peter 2:5,9)
• Eph. 4:1-16 demonstrates God’s will for all
saints to be equipped for ministry or
service
– Unity of Calling: no clergy-laity distinction
– Unity of Ministry: each member of the body is
indispensable. We don’t have a ministry; we
are one.
– Unity in Common Life: (Eph. 2:5, 6, 19, 22, 3:6;
4:16); we are interdependent
– Unity in Purpose: ultimate goal is maturity in
Christ; ordained pastors should equip the
saints for ministry or service
The Call to Lay Counseling as a
Specific Ministry
• Mandate to show Christ-like love to one another (John
13:34-35) and carry each other’s burdens (Gal. 6:2)
• All believers are to admonish, encourage, or help one
another (Rom. 15:14; Col. 3:16; I Thess. 5:14)
• Some believers specially gifted with exhortation, or
paraklesis (Rom. 12:8)
• Jay Adams developed nouthetic (from nouthesia)
counseling, “change through co.
Kidsablity provides clinical psychology and Psychological Assessment services to improve your mental health Our goal is to provide love and support to kids.
Responding to Cancer | Tips for Anxiety, Stress | ThymicUK & Dimbleby Cancer ...OliverNeely1
Responding to Cancer. An information session helping us to understand our response to cancer diagnosis, ongoing treatment etc..
Advice and tips for dealing with anxiety, stress and emotions for cancer patients, friends and family.
This presentation was done for Central Valley Recovery, Awareness, Preventing Strokes (“CVRAPS”). In attendance were stroke survivors, caregivers, clinicians, therapists and others related to stroke recovery and prevention.
The Good News, newsletter for June 2024 is hereNoHo FUMC
Our monthly newsletter is available to read online. We hope you will join us each Sunday in person for our worship service. Make sure to subscribe and follow us on YouTube and social media.
The PBHP DYC ~ Reflections on The Dhamma (English).pptxOH TEIK BIN
A PowerPoint Presentation based on the Dhamma Reflections for the PBHP DYC for the years 1993 – 2012. To motivate and inspire DYC members to keep on practicing the Dhamma and to do the meritorious deed of Dhammaduta work.
The texts are in English.
For the Video with audio narration, comments and texts in English, please check out the Link:
https://www.youtube.com/watch?v=zF2g_43NEa0
HANUMAN STORIES: TIMELESS TEACHINGS FOR TODAY’S WORLDLearnyoga
Hanuman Stories: Timeless Teachings for Today’s World" delves into the inspiring tales of Hanuman, highlighting lessons of devotion, strength, and selfless service that resonate in modern life. These stories illustrate how Hanuman's unwavering faith and courage can guide us through challenges and foster resilience. Through these timeless narratives, readers can find profound wisdom to apply in their daily lives.
Why is this So? ~ Do Seek to KNOW (English & Chinese).pptxOH TEIK BIN
A PowerPoint Presentation based on the Dhamma teaching of Kamma-Vipaka (Intentional Actions-Ripening Effects).
A Presentation for developing morality, concentration and wisdom and to spur us to practice the Dhamma diligently.
The texts are in English and Chinese.
In Jude 17-23 Jude shifts from piling up examples of false teachers from the Old Testament to a series of practical exhortations that flow from apostolic instruction. He preserves for us what may well have been part of the apostolic catechism for the first generation of Christ-followers. In these instructions Jude exhorts the believer to deal with 3 different groups of people: scoffers who are "devoid of the Spirit", believers who have come under the influence of scoffers and believers who are so entrenched in false teaching that they need rescue and pose some real spiritual risk for the rescuer. In all of this Jude emphasizes Jesus' call to rescue straying sheep, leaving the 99 safely behind and pursuing the 1.
Lesson 9 - Resisting Temptation Along the Way.pptxCelso Napoleon
Lesson 9 - Resisting Temptation Along the Way
SBs – Sunday Bible School
Adult Bible Lessons 2nd quarter 2024 CPAD
MAGAZINE: THE CAREER THAT IS PROPOSED TO US: The Path of Salvation, Holiness and Perseverance to Reach Heaven
Commentator: Pastor Osiel Gomes
Presentation: Missionary Celso Napoleon
Renewed in Grace
The Book of Joshua is the sixth book in the Hebrew Bible and the Old Testament, and is the first book of the Deuteronomistic history, the story of Israel from the conquest of Canaan to the Babylonian exile.
2 Peter 3: Because some scriptures are hard to understand and some will force them to say things God never intended, Peter warns us to take care.
https://youtu.be/nV4kGHFsEHw
What Should be the Christian View of Anime?Joe Muraguri
We will learn what Anime is and see what a Christian should consider before watching anime movies? We will also learn a little bit of Shintoism religion and hentai (the craze of internet pornography today).
The Chakra System in our body - A Portal to Interdimensional Consciousness.pptxBharat Technology
each chakra is studied in greater detail, several steps have been included to
strengthen your personal intention to open each chakra more fully. These are designed
to draw forth the highest benefit for your spiritual growth.
2. Our purpose
Inspired by the message of Christ, our mission is to serve all
Australians in practical and tangible ways. Each of us has a heart for
people - a deep and powerful need to care for others. We understand
accepting care is an emotional and challenging time. We welcome,
support and guide all people and their families through - to become part of
our family – where they have freedom and can be themselves.
The care we provide goes beyond the physical to ensure our residents
and clients are healthy, comfortable and above all, loved. We respect
each individual and the rich lives that they have led, so our care is centred
around their needs and preferences, not ours.
3. For the love of Christ
Compels us
2 Corinthians 5:14
4. We have an
uncompromising commitment
to all Australians –
to create a loving home and
family environment
which enhances their
health and spiritual well-being.
5. Uncompromising Commitment
Focuses on what is important for the individual in respect to
their journey past, journey present and journey future.
Shared Journey – we are all part of a community
Celebrates individuality, purpose, meaning and fosters the
uniqueness that is who we are as people
9. Presenting Circumstances
Frequent re-admission to Acute Psychiatric Hospital
Failed attempt at long term Psychiatric rehabilitation
Failed admission to mainstream aged care facility
Estrangement from family
Case study of model in action: Peter
Causal
Factor
Regressive
Experience
Feeling Strategy Outcome
• Delusion
he is being
beaten by
“others”
inside him
• Unable to
stop the
assault
• Verbal
Aggression
• Screaming
• Pacing
• Fear
• Disempower-
ment
• Staff
respond to
fear
• Staff assist
with
identification
of emotional
response
• Staff ask
how they can
help
• Decreased verbal
aggression
• Screaming has
stopped
• Pacing has
decreased
• Decreased
occurrence of
delusion
• Increased self control
• Increased emotional
awareness
• Increased dignity
• Peter has regained
power over “the
others” (fear)
10. A hope for a new tomorrow
Your true self is pure, infinite spirit. Spirit isn’t something
outside you, but intertwined in everything you feel, think
and do (Chopra: 2013)
Ultimately meaning in life is central to who we are as
individuals It includes finding intimacy with the concept of
“god”, people around us, it transcends loss and disability,
focuses on finding meaning and hope within our everyday
existence. (MacKinlay: 2001)
11. If we are to better the future,
we must disturb the present.
(Catherine Booth)
Aged Care Plus is part of The Salvation Army within Australia and provides aged care services across the Australian Eastern Seaboard.18 Residential Aged Care Centres which provide a mixture of High Care, Low Care and Dementia Care Services. There are over 1300 Residential Aged Care Beds in our Centres combined.8 Retirement Villages for independent livingWe currently have 50 Community Aged Care Packages providing care services into the homes in local communities and have recently been successful in acquiring an additional 31 Community based care packages.2 Day Therapy CentresHACC Counselling Service for Carers caring for their loved ones in the home environment.TSAACP provides a unique and diverse service to our community and our demographic at some Centres is very different to the profile mostly associated with aged care services in Australia. Our mission is to meet the needs of persons practically and without prejudice. Many of our consumers come from backgrounds such as alcohol recovery services, homeless lifestyle and persons from a low socioeconomic background. Whilst this shapes some of our internal demographics our care centres are available to all persons from all walks of life.The freedom to be oneself is fundamental to our ethos, we value the individuality and the life experience of each person who comes into our care and we foster this as a part of community which focuses not only on inclusion but belonging. The value of each individuals experience is what makes our care environments unique
The Australian StoryLike most countries, Australia has an ageing population. Older people (those aged 65 years and over) currently make up 13.6 per cent of the population. Compared with 8.3 per cent in 1971, it is estimated that by 2015 older people will comprise 16.4 per cent of the population, increasing to 26 per cent in 2050. Over the next two decades, Australia’s population is expected to rise by 29 per cent, with the number of people aged 65 and over rising by 90 per cent. Our ageing population is diverse and varied and the needs are only going to continue to change particularly as we span the generations.There is a distinct change in the ageing profile entering into residential aged care services. The Australian Government focus in part has been about promotion of wellness and care services in the community setting for as long as possible and considerable federal funding has been put into community based aged care services for care provision within the home setting. As a result of this the admission profile to residential services has changed dramatically:Increased frailty and higher physical dependence – this has had implications for what were typically known as low care environments and has resulted in specialisation of service types within TSAACP (this will be discussed in more detail shortly)Palliative CareIncreased need for high and low care dementia servicesPsychogeriatric needs / Mental HealthCare provision is continually changing and not one size fits all. This provides us with challenges and we are continually required to reinvent ourselves in order to meet the needs of our changing consumer cohort. The importance of individuality, connectedness and the comfort of being a community is paramount in ensuring we meet the wellbeing and spiritual needs of our residents.Definition of Healthy ageingThere are many definitions of healthy ageing, a term which is often used interchangeably with terms such as active ageing, successful ageing, positive ageing and productive ageing. Although there is no universal definition, there is general acceptance that healthy ageing involves more than justphysical or functional health. Quality of life is fundamental to ensuring our individual stories continue to be heard, considered and respected for the uniqueness they provide. In essence these stories are the fabric of who we are.WHO defines active ageing as ‘the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age’ allowing people to ‘realize their potential for physical, social and mental well-being throughout the life course’.
Being part of a community contributes to well-being throughout our lives. People living in residential aged care are recognised as being at greater risk of social isolation and disconnection from their experience of community. Our aim is to inspire hope which in turn promotes well-being and quality of life. This can be a challenge as our resident demographic often comes from an environment where there is hopelessness, particularly those with homeless backgrounds and where life’s circumstances have resulted in some tragic and negative outcomes. The literature indicates Social inclusion strategies are essential to ensure that people living in residential aged care services are supported to be involved and connected. Many people who come from a homeless background or suffer with mental illness can feel isolated. This isolation results in significant outward displays of what is perceived by many as “difficult behaviour”Our approach aims to improve and integrate connectivity in a community setting by:adopting a strong person-centred approachbetter understanding the complexity of older people’s health care needs, specifically the relationship between the physical and the emotional components of a persons illness; andimproving outcomes by fostering individuality and providing hope in individual circumstances.Each of our Centres provide a unique service to a unique group of older Australians. Our staff and residents frequently tell us of the importance of a family environment in our care settings. We have realised that to foster this type of environment is essential in achieving a person centeredness and wellness.
Uncompromising Commitment is our Person Centred Care Approach within TSAACP. It is based upon our values and provides a framework for our individual service types. It is based around the definition articulated by the Victorian Department of Health Services which states that the aim of a person centred care framework is“Treatment and care provided by health services [that] places the person at the centre of their own care and considers the needs of the older person’s carers.” (Victorian Department of Human Services: 2003)Uncompromising Commitment’ – focuses on the person’s capabilities, not their deficits;fosters a shared understanding about what is important to the person in their day-to-day life and in the future they desire; and seeks to develop a better, shared understanding of the person and their situation. A person-centred plan is developed which will describe the balance between what is important to the person, their aspirations, and what supports they require.A collaborative and respectful relationship between the consumers and care provider.The framework is not a prescriptive model of care for centres as one size does not fit all. The Framework is applied practically based upon the individual needs of the care service and the people who are a part of that community.We have three very specific services within our group that cater for the needs of people with mental illness and people from homeless backgrounds. One of our greatest challenges in this area is achieving contentment in a group of individuals that often have significant behavioural challenges as a result of their mental illness. Carpenter Court is one of our services that meets the needs of this unique group of individuals and succeeds in achieving wellness and ultimately providing a hope, meaning and purpose for residents.
Traditional behaviour management strategies are focussed on the actual behaviour being presented by the person. Traditional methodologies are not usually focussed on the underlying emotional and well-being factors associated with the outward demonstration of the behaviour. The focus in main stream behaviour management approaches is to identify the trigger and resolve this for the individual rather than with the individual. This is focussed on the physical components of health.There is often a lack of recognition for emotional or spiritual awareness and interventions are focussed on the exhibiting problem often stereotyped as a behaviour. The intervention is reactive and often focussed on the behaviour being exhibited with the ultimate aim of modification– often there is little insight to the underlying impacts that result in the behaviour being exhibited initially. This results often in frequent recurrence and an increase in anxiety, agitation and decreased spiritual well-being for the individual. Feedback from our resident cohort indicates this typical approach results in the reinforcement of feelings with a negative impact, specifically “I’m a bad person”. A traditional approach does not necessarily focus on the wellbeing of the individual – rather it is focussed on ceasing the behaviour being exhibited. This does not foster a person centred approach where spiritual contentment and well-being is enhanced, the focus is on the trigger for the demonstrated behaviour.
In order to achieve wellbeing and spiritual contentment within the resident cohort at Carpenter Court an experiential model has been implemented based on the emotional awareness behind the behaviour being exhibited by the individual resident.Emotional Awareness – A persons experience will often dictate their outward expression – Experience is based upon an individuals emotions and how they interpret the situation or circumstance they are in. Persons with a mental Illness are unable to identify or be aware of the links between their actions (or the behaviour) and their emotional and spiritual state.Emotional Connectivity – When we focus on the expression of the individuals experience this allows the care giver to identify specific interventions to address the emotional and spiritual component based on the experience. It is a focus not on the management of the behaviour, but the emotional connections that provides significance to the person. Contentment – the outcome is not focussed on a specific behaviour strategy, but rather on their contentment. The interventions implemented results in achieving contentment for the individual and this in turn increases their spiritual and emotional awareness.The model gives the person a supportive framework to address their feelings and emotions. The focus is on providing a dignified environment to address underlying aetiology of emotional disturbances which often results in significant internal turmoil for the individual. Behavioural support planning allows the person the opportunity to respond to their feelings in a way that provides meaning which is specific to their individual needs.Deepak Chopra states that ones spirit can be altered by the “continuous cascade of thoughts, sensations and emotions. The mind can get mired in a conditioned pattern of thinking, returning again and again to thoughts of anxiety, stress, depression and limitation”
In 2005 it was recognized that referrals for people with Mental Illness plus/minus homelessness (of all levels) were increasing. It was also noted that referring agencies were having increasing difficulties placing these people into aged care. Aged Care was and is experiencing a surge of aged applicants and consequently the marginalized were/ are the least attractive to accommodate. In response to the changing resident community it was decided to change the service profile, this involved all internal and external stakeholders. Focus groups were held with staff which led to a comprehensive literature reviews.This reflected our experience that Challenging behaviors are increasing and that these are mostly associated with dementia. However older people with long term mental illness present with behaviors not associated with cognitive decline. The challenge of providing care and accommodation to this population is immense, as implications/ repercussions of behavior impact care and the workforce- as well as the person themselves.It was obvious that whilst approaching this issue from WHS, social, medical and clinical models The overwhelming expressed need by residents was a need for them to understand their place in the world- they had a desire to develop self-awareness and self-control, the residents saw us as partners in assisting this to occur. Underpinning this was a feeling that they were not good enough, and had never been recognized as a whole person throughout their entire lives- that is a physical, social and spiritual part of society and the core community.
In 2012 Peter was admitted to Carpenter Court on a trial basis. Peter was immediately assessed and a BSP was initially developed.The aim was to address the emotional discord rather that the presenting behavior.Peter was diagnosed with Schizophrenia- chronic treatment resistant in 1973. Peter had repeated admissions into the regions Acute Mental Health Unit every year to late 2010 with length of stay ranging from 4- 18 weeks. In 2010 Peter was admitted into a long term rehabilitation facility which was unsuccessful resulting in admission to a locked psychiatric facility. In 2012 Peter was transferred into a locked aged care dementia unit which also failed and was again admitted into the acute Mental Health Facility. Peter has long standing fixed delusions which are resistant to treatment, many of the delusions have significant impact on how he is viewed publicly. Some Peters delusions are: there a people inside of him who beat him, he is a 15 year old girl, he frequently receives electric shocks from outer space, he owns an orphanage, He has been kidnapped and is held against his will, he is in goal. The resultant behavior ranges from verbal aggression, physical aggression, screaming, threatening to kill people, refusal to speak to his mother who is still alive. Response to one delusionThe most apparent presenting emotion was fear- when I discussed this with Peter he was immediately taken aback and could be seen to be re-evaluating . The delusions remained however recognition of his feeling allowed him freedom to take action to resolve the fear. We simply provide the environment and support for this to occur. For example Peter is fearful of “others” inside of him as they beat him regularly 2-3 time a week. When asked how we can help he asked that they be told they must not beat him. I asked Peter if I could speak to one of the others and proceeded to tell them they are not to beat Peter any more- Peter now tells staff he has been beaten by the “others” inside of him, but not like before- in fact he asked a staff member to put a bandage on his hand as he had hurt it defending himself. We have noticed that the frequency of the beating is now 1-2 month, and Peter is beginning to develop his own strategies to manage this fear- one of those being he will tell the others not to beat him himself. This slide represents the background work completed with Peter, this forms the basis for a joint development of the Behavior support plan.
Meaning is centric to all individuals. The Model presented in action at Carpenter Court identifies that the individualised approach to each person is critical in ensuring their individual meaning, purpose and hope in life is identified and actualised. When the causal factors that result in an outward expression as a behaviour are identified and individuals are provided with the opportunity to explore these in a safe environment, there is a hope and freedom that is found ultimately resulting in improved well-being and quality of life. Spirituality is the personal quest for understanding answers to ultimate questions about life, meaning and about relationships. Contentment is key to achieving spiritual well-being.