module 12. introduction to mental illness and developmental ...module 12. introduction to mental...

HOMECARE AIDE WORKFORCE INITIATIVE (HAWI)

Trainer’s Manual—2.1

Home Health Aide Training

Module 12. Introduction to Mental

Illness and Developmental Disabilities

Goals The goals of this module are to:

Introduce participants to the needs of clients with mental illness or developmental disabilities.

Time 2 hours

Activities Teaching Methods Time

1. Introduction to Working with Clients Who Have a Mental Illness

Interactive presentations, pairs work, and large-group discussion

1 hour

2. Introduction to Working with Clients Who Have a Developmental Disability

Interactive presentation, small-group work, and large-group discussion

1 hour

Module 12. Introduction to Mental Illness and Developmental Disabilities


Trainer’s Manual—Page 12.2

Supplies Flip chart, markers, and tape

Paper and pencils

Learner’s Book

1. Overview of Mental Health and Mental Illness 2. Myths and Truths about Mental Illness 3. Signs of Mental Illness 4. Working with Clients with a Mental Illness and Their Families 5. Introduction to Developmental Disabilities 6. Types of Developmental Disabilities 7. Working with Clients with Developmental Disabilities and Their Families

Handouts

Handout 1. Key Terms

Handout 2. Summary of Key Information

Advance Preparation

Review all the training instructions and learner’s materials for this module. Note that icons are used to remind the trainer of the following:

When you are presenting or covering Key Content in the discussion. (Key Content is also addressed in the Learner’s Book and the handouts, but we use the “key” icon only when it is covered elsewhere in the learning process.)

When it is important to ask a particular question to get participants’ input.

When it is time to refer to the Learner’s Book.

When it is time to distribute and discuss a handout.




Copy all handouts for participants. Gather all necessary supplies and equipment. Please note that the Key Content is meant to be background information for the trainer. DO NOT READ OUT LOUD TO PARTICIPANTS.

Activity 1. Introduction to Working with Clients Who Have a Mental Illness

Prepare flip chart pages for: “Learning Agenda” (Step 1) “Mental Health” (Step 2) “Mental Illness” (Step 3) “Causes of Mental Illness” (Step 4)

Activity 2. Introduction to Working with Clients Who Have a Developmental Disability

Prepare a flip chart page for “Developmental Disabilities: Using the EARS Approach” (Step 8).




Activity 1. Introduction to Working with Clients Who Have a Mental Illness

1 hour

Learning Outcomes By the end of this activity, participants will be able to:

Define “mental illness.” List three possible causes for mental illness. List two ways of treating mental illness. Explain what EARS means. Describe the role of the home health aide in assisting clients with mental illness.

Key Content Working with clients who have a mental illness can be very challenging for home

health aides in large part due to the misconceptions about these conditions that exist in our society. Learning about these conditions, what causes them, and how they affect clients and their families, can help participants to overcome stereotypes and develop empathy.

Like all the other clients who have been studied in this training, people with a mental illness sometimes need assistance with activities of daily living. A home health aide can make a difference in their lives by being there for the individuals and their families, with “EARS”—empathy, acceptance, respect, and support.




Activity Steps

Interactive Presentation15 minutes 1. Introduce module. This module introduces two new client groups—clients who have

a mental illness and clients who have a developmental disability. Post and review the prepared flip chart page with the Learning Agenda for this module.

Flip Chart

LEARNING AGENDA:

Mental Illness And Developmental Disability

Introduction to working with

clients with mental illness

Introduction to working with clients with developmental disabilities

2. Define “mental health.” Explain that in order to understand mental illness,

participants first need to understand mental health. Ask for a few ideas about how to define “mental health.” Then post and review the prepared flip chart page (see below). Note that there are many different definitions or meanings (with some differences among cultures as acknowledged by the World Health Organization). However, most definitions have the same four elements.

Teaching Tip Tell participants that their Learner’s Book has all the information that is on these flip chart pages. It will be more useful for them to listen, think, and participate in the discussions than to take notes.




Flip Chart

MENTAL HEALTH

Being emotionally stable

Being able to get along with others

Being able to work

Being able to cope with life’s challenges

3. Define “mental illness.” Starting with this view of mental health, mental illness can

be thought of as a condition or illness that prevents a person from being successful in each of those mental health areas. Post and review the prepared flip chart page on mental illness.

Flip Chart

MENTAL ILLNESS

A problem (illness) of the brain

that affects:

Thinking

Behavior

Emotions

Ability to carry out daily activities (over a long period of time)




4. Invite participants to share their knowledge. Ask:

What do you think causes mental illness? After a few responses, post and review the flip chart page. Note that the causes of mental illness are still being studied, since there is still a lot we don’t understand about it.

Flip Chart

CAUSES OF MENTAL ILLNESS

Chemical imbalance in the

brain

Heredity

Accident, head injury

Trauma

Drug or alcohol abuse

Isolation

Pairs Exercise10 minutes 5. Give instructions. Ask participants to form pairs with the person sitting next to them.

Ask them to close their Learner’s Books. Explain that you are going to read several statements about mental illness. They need to decide in their pairs if they think the statement is true or false. Read the first statement:

If they wanted to, people with mental illness could control their behavior. 6. Invite participants to share their responses. Give participants a few moments to

discuss in their pairs. Ask for a show of hands for those who think it is true. Then ask for those who think it is false to raise their hands. Tell them the statement is false, and briefly explain why.




Teaching Tip See 2. Myths and Truths about Mental Illness in the Learner’s Book for answers. But remind participants to keep their Learner’s Books closed during this exercise.

7. Repeat the exercise for the next three statements. [All are false.]

People with mental illness cannot work or function in social settings.

People with mental illness are dangerous or violent.

People with mental illness can never get well.

8. Wrap up pairs work. Explain that the purpose of this exercise was to bring out some of the more common myths or misconceptions about mental illness. These myths are particularly important because they relate to the fears that some people may have about working with clients who have a mental illness. Now they will consider some of the facts about mental illness.

Interactive Presentation15 minutes

9. Review 1. Overview of Mental Illness in the Learner’s Book.

10. Refer to 2. Myths and Truths about Mental Illness in the Learner’s Book. Note that this is the “quiz” that they took in pairs, with the answers.

11. Review typical signs of mental illness. Note that it is not necessary for home health aides to memorize the different types of mental illness and their specific symptoms. But it is important for them to know the general signs of mental illness and how to respond. Some people have described mental illness like a constant noise in the back of the head. It is hard to think clearly because you can’t turn it off. Review to 3. Signs of Mental Illness in the Learner’s Book.




12. Differentiate between occasional signs and repeated behaviors. Note that we ALL have shown such signs at some point in our lives. The difference for someone with a mental illness is that the signs are frequent and form a pattern of unusual behavior.

13. Explain that most mental illnesses are very responsive to treatment. The most common forms of treatment are medications and psychotherapy. If a home health aide is working with a client who has a mental illness, there will be other members of the team—therapists, psychiatrists, social workers, psychiatric nurses—who will be responsible for developing a plan of treatment with the client.

Pairs and Large-Group Discussion20 minutes 14. Invite participants to share their knowledge. Ask:

What do you think a home health aide can do to assist a client who has a mental illness?

15. Discuss “EARS.” After a few responses, review 4. Working with Clients with a Mental Illness and Their Families in the Learner’s Book. Assign one “letter” of EARS to each of the pairs who worked on the true/false quiz earlier. Ask each pair to think of an example of how to demonstrate their “letter” approach with a mentally ill client and/or family member. Note that they will have five minutes.

16. Facilitate reporting back to the large group. After 5 minutes, ask all the pairs who

worked on “Empathy” to share their example. Then continue with acceptance, respect, or support. Briefly clarify, if needed, and discuss one or two other examples.




Activity 2. Introduction to Working with Clients Who Have a Developmental Disability

1 hour

Learning Outcomes

By the end of this activity, participants will be able to: Define “developmental disability.” List three possible causes of developmental disabilities. Describe one way in which developmental disabilities differ from mental illness. Describe the role of the home health aide in assisting clients with developmental disabilities and their families.

Key Content Working with clients who have a developmental disability can be very challenging

for home health aides, in large part due to the misconceptions about these conditions that exist in our society. Learning about these conditions, what causes them, and how they affect clients and their families, can help participants to overcome stereotypes and develop empathy.

One common misconception is to confuse developmental disabilities with mental illness. Participants will learn about how developmental disabilities differ from mental illness.

Clients with developmental disabilities may be children or adults, and like all the other clients who have been studied in this training, people with a developmental disability sometimes need assistance with activities of daily living. Families are more likely to be involved in the care of people with developmental disabilities—whether children or adults. A home health aide can make a difference in their lives by being there for the individuals—and their families—with “EARS.”




Activity Steps

Interactive Presentation30 minutes 1. Introduce discussion of “developmental disabilities.” Explain that developmental

disabilities are a category of disabilities that may affect some of the clients that participants encounter in their work. Ask if they have heard of this kind of disability and what they know about it.

2. Define and discuss developmental disabilities. After a few responses, refer to 5. Introduction to Developmental Disabilities in the Learner’s Book. Discuss the definition, the areas of function that are affected, and a brief description of some of the more common types of developmental disabilities and their causes.

3. Note the differences between mental illness and developmental disability. Point out that, even though both mental illness and developmental disabilities are being discussed in this module, there are differences between them. Explain that generally, developmental disabilities happen before or at birth and continue for the client’s entire lifetime. There is no “cure.” Mental illness, by contrast, can happen at any point in a client’s lifetime, and in many cases it can be cured.

4. Review 6. Types of Developmental Disabilities and Their Families in the Learner’s Book.

5. Invite participants to share their knowledge. Ask participants:

What kind of assistance do you think a person with a developmental disability would need?

6. Refer to Learner’s Book. After a few responses, refer to 7. Working with Clients with Developmental Disabilities and Their Families in the Learner’s Book.

7. Discuss the role of the client’s family. Note that home health aides may care for either children or adults with developmental disabilities. Often, in either case, the family is very involved in the client’s life. Ask:



Trainer’s Manual—.12

Why might the family be very involved with a client who has a developmental disability, regardless of age?

What might be the impact on the family of a child who has a developmental disability?

Teaching Tip Likely responses include shame, guilt, social isolation, irritability, exhaustion, protectiveness, and worry.

Small-Group Work10 minutes 8. Give instructions for small-group work. Ask participants to work in the same

groups as they did in the previous activity. Refer them back to 4. Working with Clients with a Mental Illness and Their Families in the Learner’s Book. Explain that this time you want them to apply the “EARS” approach to working with clients with developmental disabilities and their families. Post the prepared flip chart page and ask them to take about 5 minutes to work in their small groups. Note that they can discuss any of the “EARS” letters.

Flip Chart

Developmental Disabilities: Using the “EARS” Approach

What can a home health aide do to assist a client who has a developmental disability and his or her family?

E:

A:

R:

S:




Large-Group Discussion20 minutes 9. Facilitate reporting back to the large group. Ask each group to share its example

of empathy, acceptance, respect, or support. Briefly clarify, if needed, and note their ideas on the flip chart page.

10. Summarize the module. Distribute and review Handout 1. Key Terms and Handout 2. Summary of Key Information. Ask participants if they have any questions.


Learner’s Book—Page 12.1

Learner’s Book

Module 12. Introduction to Mental Illness

and Developmental Disabilities Activity 1. Introduction to Working with Clients Who Have a Mental Illness 1. Overview of Mental Illness

2. Myths and Truths about Mental Illness 3. Signs of Mental Illness 4. Working with Clients with a Mental Illness and Their Families Activity 2. Introduction to Working with Clients Who Have a Developmental Disability 5. Introduction to Developmental Disabilities 6. Types of Developmental Disabilities 7. Working with Clients with Developmental Disabilities and Their Families




1. Overview of Mental Illness

Page 1 of 3

What is mental illness? There are also many different definitions for mental illness. Here are some basic ideas about mental illness:

Mental illness is a problem in the brain that affects how a person thinks, feels, and acts towards others.

The result is behavior that is not appropriate for the life situation. It is a disability because it can affect how a person gets along in life.

What causes mental illness? No one knows for sure. It is probably a combination of many factors. Here are some possible causes:

Chemical imbalance in the brain Heredity Accident; head injury Emotional trauma Drug or alcohol abuse Isolation from other people for a long time

Can mental illness be treated? Yes. The most common forms of treatment are medications and psychotherapy.





Page 2 of 3 TYPES OF MENTAL ILLNESS Anxiety-related disorders

Anxiety means fear or uneasiness (worry). Sometimes we all have good reasons to be afraid or worried. But generally that doesn’t last, after the reason has been addressed. Anxiety-related “disorders” are when the fear or worry don’t go away. It can lead to muscle aches or shaking, sweating, dizziness, feeling tired, racing heart, a choking feeling, cold or hot flashes, and a dry mouth.

Phobias: fear of specific things (for example, spiders = arachnophobia) or situations (for example, riding in an elevator = claustrophobia)

Post-traumatic stress disorder (PTSD): caused by a traumatic experience, like being a victim of a violent crime or being in a military combat situation

Obsessive-compulsive disorder (OCD): when you can’t stop doing certain things or thinking about certain things (for example, constantly washing hands because of fear of germs)

Depression

Everybody feels “depressed” (sad) every now and then. But “clinical depression” is when the feelings become so strong that the person is not able to function in life. The person may have no interest in doing anything (apathy), may have a hard time sleeping, and may feel guilt or hopelessness. There may be intense mental, emotional, and physical pain. Depression can occur when someone is ill, but it can also make other illnesses worse. Depression is also linked to suicide for older people.





Page 3 of 3 Bipolar disorder

This is a kind of depression where the person may be very depressed for a while, and then becomes extremely active. It used to be called “manic-depressive disorder.”

Schizophrenia

This is a brain disorder that affects a person’s ability to understand reality, to think, and to communicate clearly. A person with schizophrenia may have hallucinations (where they hear and see things that are not real). They may have delusions (firm beliefs about things that aren’t true). They may also have slow, repeated movements (such as rocking back and forth).




2. Myths and Truths about Mental Illness

Myth: People with mental illness can control their behavior.

The Truth: People with mental illness cannot control their thoughts, feelings, or behavior. The lack of control is part of the illness.

Myth: People with mental illness cannot work at a job.

The Truth: People with mental illness can work at a job, depending on how severe their illness is. Also, they may be able to take a less stressful job.

Myth: People with mental illness are violent.

The Truth: People with mental illness usually do not hurt themselves or others.

Myth: People with mental illness can never get well.

The Truth: It depends on the illness and how severe it is. However, with treatment, many people with mental illness can live normal lives and sometimes get well.




3. Signs of Mental Illness

It is important to know the basic signs that you might see in clients who have a mental illness. It is also important to remember that these signs could indicate other problems or illnesses. That is why you must report what you see, and not decide for yourself what it means. Physical signs:

Not able to sleep Tired and sleeping more than normal Headaches Diarrhea Nausea General pain

Emotional signs:

Mood swings Anxious all the time Sadness Hopelessness Fears Not knowing where they are Imagining people or events

Social signs (around other people):

Aggression Withdrawal (lack of interest in people or activities) Overdependent on others Suspicious of others (paranoia) Acting like a child (regression)




4. Working with Clients with a Mental Illness and Their Families

Working with mentally ill clients and their families is a big job. There’s a lot to remember. It helps to think of the word EARS:

Empathize Accept Respect Support

Empathize with the client and their family.

Think about how each person feels. Show that you care. Try to make the person feel better.

Accept the client and their family.

Accept the personeven if you don’t like the way the person acts.

Accept the personeven if the person’s ideas don’t seem right. Respect the client and their family.

Avoid arguing and giving advice. Help the client stay part of their family.

Support the client and their family.

Assist the client with daily tasks and personal care. Keep the client safe. Store things that could hurt them out of their

reach. Share what you have learned about mental illness with family

members. Write down and report any changes you see in how the client acts

(ORR).




5. Introduction to Developmental Disabilities

What is a developmental disability? It develops before age 22. There may be mental or physical problems, or both. It is a lifelong condition.

Having a developmental disability means that a person will be challenged in at least 3 of these areas:

Independent living Being able to earn money to support oneself Learning Walking and moving around Communicating with words Taking care of oneself Making decisions for oneself

What can cause developmental disabilities?

Brain injury or infectionbefore, during, or after being born Abnormal genes or chromosomes Very premature birth Poor diet and health care Drug use by the mother during pregnancy (includes drinking alcohol

and smoking)




6. Types of Developmental Disabilities Autism

Autism is when a person has problems communicating and interacting with others. It usually appears before a child turns three and it affects more boys than girls. It can cause a range of problems, including repeating body movements, being aggressive, and not being able to relate to people. Cerebral palsy

Cerebral palsy is caused by brain damage before or during birth. There can be physical or mental disabilities, or both. It affects muscle control and nerves. Movements may be stiff or sudden (“spastic”). A person with cerebral palsy may have problems with speaking.

Down syndrome

This is an intellectual disability caused before birth. Physical signs of Down syndrome include a smaller skull, flatter nose, and short fingers.

Intellectual disability

This used to be called “mental retardation.” It is the most common developmental disability. People with an intellectual disability have mental functioning that is below average. They may experience difficulty learning, communicating, moving, and interacting socially. There are different levels of intellectual disability—mild, moderate, severe, and profound. Spina bifida

This is when part of the backbone is not fully developed at birth and part of the spinal cord bulges out. Some people with spina bifida have no lasting disability. Others may have to use a wheelchair for their whole life and may have bladder or bowel problems.




7. Working with Clients with Developmental Disabilities and Their Families

Clients with developmental disabilities live in many places:

With their families Independently in apartments or houses In group homes with supervision In institutions

Home health aides who work with clients with developmental disabilities may be called “direct support professionals” (DSP). They may work in the client’s home or in the community. They may work directly with the client, or with the family. The goal of at-home support is to promote independence for the client, as much as possible. How can a home health aide assist clients with developmental disabilities and their families?

Assist with ADLs Help the client to explain their needs and goals (being the client’s

“advocate”)

Assist with managing the homecooking, cleaning, shopping, paying bills

Assist the client to go to work

Assist the client to participate in community activitieseducation, training, social events, recreation (fun!)



Handouts

Handout 1. Key Terms

Page 1 of 3

Anxiety-related disorders [1]

Anxiety-related “disorders” are when extreme fears or worries don’t go away and make the person unable to cope with normal situations. These include phobias, post-traumatic stress disorder, and obsessive-compulsive disorder.

Autism [6]

A developmental disability that starts in childhood, where a person has problems communicating and interacting socially with others. It can cause problems with not being able to relate to people, repeating body movements, and being aggressive.

Bipolar disorder [1]

A kind of depression where the person may be very depressed for a while, and then becomes extremely active. It used to be called “manic-depressive disorder.”

Cerebral palsy [6]

A developmental disability caused by brain damage before or during birth. It affects muscle control and nerves. Movements may be stiff or sudden. A person with cerebral palsy may have problems with speaking clearly.

Depression [1]

“Clinical depression” is when the feelings of sadness or hopelessness become so strong that the person is not able to function in life. Depression is common among older people and is linked to suicide.



Handouts

Handout 1. Key Terms Page 2 of 3

Developmental disability [5]

A mental and/or physical disability that develops before age 22 and is a lifelong condition.

Down syndrome [6]

An intellectual disability caused before birth. Physical signs of Down syndrome include a smaller skull, flatter nose, and short fingers.

EARS [4]

“Empathy, Acceptance, Respect, and Support”—an approach to working with clients who have mental illness or developmental disabilities and their families

Intellectual disability [6]

People with an intellectual disability have mental functioning that is below average. It is the most common developmental disability; it used to be called “mental retardation.” There are different levels of intellectual disability—mild, moderate, severe, and profound.

Mental illness [1]

Mental illness is a problem in the brain that affects how a person thinks, feels, and acts towards others.

Obsessive-compulsive disorder (OCD) [1]

An anxiety-related disorder when you can’t stop doing certain things or thinking about certain things (for example, constantly washing hands because of fear of germs)



Handouts

Handout 1. Key Terms Page 3 of 3

Phobia [1]

Fear of specific things (for example, spiders) or specific situations (for example, riding an elevator)

Post-traumatic stress disorder (PTSD) [1]

An anxiety-related disorder caused by a traumatic experience, like being a victim of a violent crime or being in a military combat situation

Schizophrenia [1]

A brain disorder that affects a person’s ability to understand reality, to think, and to communicate clearly. A person with schizophrenia may have hallucinations, delusions, and slow, repeated movements (such as rocking back and forth).

Spina bifida [6]

A developmental disability caused when part of the backbone is not fully developed at birth and part of the spinal cord bulges out. Some people with spina bifida have no lasting disability. Others may have to use a wheelchair for their whole life and may have bladder or bowel problems.



Handouts

Handout 2. Summary of Key Information Page 1 of 3

Mental illness is a problem in the brain that affects how a person thinks, feels, and acts towards others. No one knows for sure what causes mental illness. It is probably a combination of many factors, including chemical imbalances in the brain, head injury, and emotional trauma. Mental illness can be treated and people can live normal lives. Types of mental illness include:

Anxiety-related disorders (such as phobias, post-traumatic stress disorder, and obsessive-compulsive disorder)

Depression Bi-polar disorder Schizophrenia

It is important to know the basic signs that you might see in clients who have a mental illness. Remember--these signs could indicate other problems or illnesses. That is why you must report what you see, and not decide for yourself what it means.

Physical signs of mental illness: Not able to sleep Tired and sleeping more than normal Headaches or general pain Diarrhea or nausea

Emotional signs of mental illness: Mood swings Anxious all the time Feeling sad, hopeless, or afraid Not knowing where they are Imagining people or events



Handouts


Social signs of mental illness: Aggression Withdrawal (lack of interest in people or activities) Overdependent on others Suspicious of others (paranoia) Acting like a child (regression)

EARS is an approach to working with mentally ill clients and their families. The letters stand for:

Empathize Accept Respect Support

Developmental disability is a mental and/or physical disability that develops before age 22 and is a lifelong condition. Types of development disabilities include autism, cerebral palsy, Down syndrome, intellectual disability, and spina bifida. A person with a developmental disability will be challenged in several of these areas:

Independent living Being able to earn money to support oneself Learning Walking and moving around Communicating with words Taking care of oneself Making decisions for oneself



Handouts


What can cause developmental disabilities?

Brain injury or infectionbefore, during, or after being born Abnormal genes or chromosomes Very premature birth Poor diet and health care Drug use by the mother during pregnancy (includes alcohol and

smoking)

Home health aides who work with clients with developmental disabilities may work in the client’s home or in the community. They may work directly with the client, or with the family. The goal of at-home support is to promote independence for the client, as much as possible. A home health aide can assist clients with developmental disabilities and their families by:

Assisting with ADLs Helping the client to explain their needs and goals (being the client’s

“advocate”)

Assisting with managing the homecooking, cleaning, shopping, paying bills

Assisting the client to go to work Assisting the client to participate in community

activitieseducation, training, social events, recreation (fun!)

module 12. introduction to mental illness and developmental ...module 12. introduction to mental...

Documents