Case Management Lecture #3
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Questions and Answers

What is one reason why licensing for health professionals might be restricted by legislators?

  • To reduce government spending on healthcare
  • To align with the platforms of elected officials (correct)
  • To increase the number of healthcare professionals
  • To enhance the quality of patient care

    • What advantage do pre-written letters offer to health professionals opposing new bills?

  • They provide a platform to discuss various unrelated healthcare issues
  • They simplify the process by saving time and effort for health professionals (correct)
  • They eliminate the need for health professionals to engage their legislators personally
  • They ensure that every health professional writes a unique letter for effectiveness

    • Which healthcare professional group faces opposition from ophthalmologists in Texas?

  • Optometrists (correct)
  • Nurses
  • Psychologists
  • Dentists

    • What percentage of pending bills in Texas are related to health professions?

    <p>25%</p> Signup and view all the answers

    What is the purpose of Capitol Day organized by advocates?

    <p>To talk to legislators about specific issues and bills</p> Signup and view all the answers

    What is the purpose of legal care for healthcare professionals?

    <p>To offer confidential legal counsel and guidance</p> Signup and view all the answers

    What is the primary focus of journals in the healthcare field?

    <p>To provide peer-reviewed and timely research articles</p> Signup and view all the answers

    What is the purpose of the career center in the healthcare profession?

    <p>To give access to jobs specific to healthcare professions</p> Signup and view all the answers

    How are continuing education units (c.e.u.’s) awarded during conferences?

    <p>The number of c.e.u.’s varies depending on session length and content</p> Signup and view all the answers

    What feature of legal care emphasizes confidentiality and cost-efficiency for healthcare providers?

    <p>Phone calls are confidential, unlimited, and free of charge</p> Signup and view all the answers

    What is the primary purpose of JCAHO's unannounced surveys of hospitals?

    <p>To prevent hospitals from preparing in advance</p> Signup and view all the answers

    What is a requirement for healthcare professionals applying for positions with JCAHO?

    <p>A minimum of 25 years of healthcare experience</p> Signup and view all the answers

    How does JCAHO ensure unbiased evaluations during their surveys?

    <p>By sending teams that have not worked in the region being surveyed</p> Signup and view all the answers

    What elements does JCAHO review during their hospital surveys?

    <p>Medical records, facility conditions, and patient care</p> Signup and view all the answers

    What can JCAHO do if they find discrepancies during their evaluation?

    <p>Address deficiencies individually with licensed healthcare professionals</p> Signup and view all the answers

    What is the JCAHO's approach to the size of the Survey Team?

    <p>It varies based on the size of the hospital being surveyed</p> Signup and view all the answers

    What kind of notes does JCAHO take during their surveys?

    <p>Comprehensive notes on both patient care and facility conditions</p> Signup and view all the answers

    Where is the headquarters of JCAHO located?

    <p>Chicago suburb</p> Signup and view all the answers

    What is a key reason for rotating the location of sessions in a conference?

    <p>To make the conference fair for all healthcare professionals in the state</p> Signup and view all the answers

    Which factor primarily influences the number of continuing education units (CEUs) awarded?

    <p>Novelty and complexity of submitted information</p> Signup and view all the answers

    What main benefit do vendors provide at professional conferences?

    <p>New products and job recruitment opportunities</p> Signup and view all the answers

    What misconception do many healthcare professionals have about certification's impact on their salaries?

    <p>Certification directly increases salary potential</p> Signup and view all the answers

    What aspect of professionalism is emphasized in professional schools?

    <p>Formal courses on how to behave professionally</p> Signup and view all the answers

    When are certifications typically deemed necessary for healthcare professionals?

    <p>When new technologies or treatment processes are approved</p> Signup and view all the answers

    Which is a characteristic that distinguishes professional schools from traditional universities?

    <p>Professional schools have identical cohorts with similar workloads</p> Signup and view all the answers

    How do healthcare professional associations typically handle certification training?

    <p>They organize scheduling, location, and costs for classes and exams</p> Signup and view all the answers

    What is a common misconception regarding CEUs?

    <p>CEUs can overlap with other certification requirements</p> Signup and view all the answers

    What event type may require higher fees for participation?

    <p>National conferences, especially those on cruises</p> Signup and view all the answers

    What is the primary responsibility of case managers in the healthcare system?

    <p>To oversee patient documentation and ensure it is complete</p> Signup and view all the answers

    Which of the following best describes the relationship case managers should maintain with healthcare professionals?

    <p>Professional and respectful</p> Signup and view all the answers

    How are case managers assigned their caseloads?

    <p>Geographically in the region they work</p> Signup and view all the answers

    What role do case managers play in the process of medical necessity advocacy?

    <p>They monitor patients to validate the necessity of prescriptions and procedures</p> Signup and view all the answers

    Which of the following statements about the certification of case managers is true?

    <p>Employers often cover the costs related to certification.</p> Signup and view all the answers

    'Utilization Management' in case management primarily focuses on what?

    <p>Analyzing the efficient use of healthcare resources</p> Signup and view all the answers

    Which educational background is NOT typically associated with case managers?

    <p>Human Resources Management</p> Signup and view all the answers

    What happens if the documentation needed for patient care is incomplete?

    <p>Patient care can be delayed because payers will not disburse funds.</p> Signup and view all the answers

    What is one of the primary goals of case managers in relation to patient treatment plans?

    <p>To ensure treatments align with standards and avoid excessive procedures</p> Signup and view all the answers

    How do case managers typically monitor the treatment of patients?

    <p>By reviewing patient documentation and case notes</p> Signup and view all the answers

    What is a potential consequence of trying to hide small mistakes from case managers?

    <p>It may affect patient care and treatment approval.</p> Signup and view all the answers

    What is one of the primary financial responsibilities of case managers?

    <p>To prevent double or triple payments for healthcare services</p> Signup and view all the answers

    What is a common requirement for becoming a Certified Case Manager (CCM)?

    <p>Demonstrating a certain level of employment and experience</p> Signup and view all the answers

    What is the role of the Case Management Society of America?

    <p>To oversee the certification process for case managers</p> Signup and view all the answers

    Which of the following statements accurately reflects the distribution of cases among case managers?

    <p>Each case manager has an equal number of cases assigned.</p> Signup and view all the answers

    What is patient compliance?

    <p>The degree to which a patient correctly follows their physician's medical advice.</p> Signup and view all the answers

    Which of the following terms is associated with patient compliance? (Select all that apply)

    <p>Collaboration</p> Signup and view all the answers

    The patient-centered approach focuses primarily on the goals of health professionals.

    <p>False</p> Signup and view all the answers

    What is a consequence of nonadherence?

    <p>Development of chronic conditions</p> Signup and view all the answers

    What percentage of emergency room visits is related to nonadherence?

    <p>58%</p> Signup and view all the answers

    Patients often stop taking ____________ after feeling better.

    <p>antibiotics</p> Signup and view all the answers

    Which of the following is considered the most difficult area to work with patients regarding adherence?

    <p>Lifestyle recommendations</p> Signup and view all the answers

    What type of approach should providers use to communicate effectively with patients?

    <p>Patient-centered approach</p> Signup and view all the answers

    Patient-centered teaching only involves providing patients with printed materials.

    <p>False</p> Signup and view all the answers

    What should providers assess to identify barriers to patient adherence?

    <p>Patients' strengths and limitations, social support, attitudes, and beliefs.</p> Signup and view all the answers

    What must be developed during the first appointment with a new patient?

    <p>Rapport</p> Signup and view all the answers

    What is the primary tool for assessing a patient's condition?

    <p>Skilled observation</p> Signup and view all the answers

    Pain scales from 1 to 10 are used to assess patient pain.

    <p>True</p> Signup and view all the answers

    What should healthcare providers ask before an examination?

    <p>Permission</p> Signup and view all the answers

    The ultimate goal of patient teaching is to enable patients to carry out recommendations in their _____ environment.

    <p>home</p> Signup and view all the answers

    What should be included in treatment goals?

    <p>Realistic and measurable goals</p> Signup and view all the answers

    What is an important factor when developing a treatment plan?

    <p>Patient's own words</p> Signup and view all the answers

    Fear is a useful motivator for patients.

    <p>False</p> Signup and view all the answers

    What stage comes after 'Contemplation' in the stages of change?

    <p>Preparation</p> Signup and view all the answers

    What should healthcare providers document regarding patient motivation?

    <p>All information regarding motivation factors</p> Signup and view all the answers

    Common issues in treatment planning include not addressing the patient's ______ from the initial assessment.

    <p>needs</p> Signup and view all the answers

    What are common sources of stress for young adults? (Select all that apply)

    <p>All of the above</p> Signup and view all the answers

    What lifestyle factors contribute to weight gain in young adults?

    <p>Sedentary lifestyles and lack of physical activity.</p> Signup and view all the answers

    Which issues are prevalent in middle adulthood? (Select all that apply)

    <p>Diet issues</p> Signup and view all the answers

    Most healthcare professionals focus on patient's diagnoses rather than their overall strengths.

    <p>True</p> Signup and view all the answers

    What age range is considered middle adulthood?

    <p>31-65 years</p> Signup and view all the answers

    What common issues do individuals above 65 face?

    <p>Stress related to caregiving and health management.</p> Signup and view all the answers

    The first step in discussing prevention is to address the issue and what is contributed to those issues, specifically tailored to that ______.

    <p>patient</p> Signup and view all the answers

    Why is family involvement important in patient-centered teaching?

    <p>Family members can provide support and influence patient compliance.</p> Signup and view all the answers

    It is acceptable for caregivers to be involved in patient appointments without the patient's consent.

    <p>False</p> Signup and view all the answers

    What is the first stage of the model for patient interaction?

    <p>Precontemplation</p> Signup and view all the answers

    In the __________ stage, patients are aware they have issues but may not be ready to take all actions.

    <p>Contemplation</p> Signup and view all the answers

    What psychosocial factors can affect patient teaching?

    <p>Past experience, gender, age, culture, support system, financial and physical environment.</p> Signup and view all the answers

    Which coping mechanism refers to a patient avoiding responsibilities related to their illness?

    <p>Avoidance</p> Signup and view all the answers

    Patients are always expected to function normally while ill.

    <p>False</p> Signup and view all the answers

    How can provider behavior affect patient compliance?

    <p>Providers giving too many prescriptions at once without proper education can lead to noncompliance.</p> Signup and view all the answers

    Which of the following is a common issue in patient education?

    <p>Patients forgetting key information</p> Signup and view all the answers

    Self-________ is a major component of how patients view their capability to manage their health.

    <p>efficacy</p> Signup and view all the answers

    In which age group do behavioral disorders typically emerge according to the content?

    <p>Later childhood</p> Signup and view all the answers

    Parents always trust healthcare providers without any hesitation.

    <p>False</p> Signup and view all the answers

    What must healthcare providers document when dealing with infants?

    <p>The responsible adult providing information and consent.</p> Signup and view all the answers

    What scale is used to assess patient pain?

    <p>1-10</p> Signup and view all the answers

    What must be established during the first appointment with a patient?

    <p>Rapport</p> Signup and view all the answers

    Documentation is irrelevant to payment.

    <p>False</p> Signup and view all the answers

    What is an essential tool for diagnosis according to the text?

    <p>Skilled observation</p> Signup and view all the answers

    Which of the following is a factor that can hinder a patient's motivation to follow treatment recommendations?

    <p>Sense of dependency</p> Signup and view all the answers

    What should the ultimate goal of patient teaching be?

    <p>To enable patients to manage their condition independently</p> Signup and view all the answers

    The steps to develop a treatment plan include initial assessment, additional information, and _____ treatment steps.

    <p>specific</p> Signup and view all the answers

    What are common issues related to treatment planning?

    <p>Not measurable, not addressing initial assessment, not reviewed at certain times.</p> Signup and view all the answers

    What does 'self-efficacy' refer to in the context of patient motivation?

    <p>High interest and task engagement</p> Signup and view all the answers

    What stage follows 'Preparation' in the Stages of Change model?

    <p>Action</p> Signup and view all the answers

    Match the following factors with their impact on patient motivation:

    <p>Intrinsic factors = Satisfaction from within Extrinsic factors = External rewards and encouragement Fear as a motivator = Anxiety and lower motivation Social support = Encouragement from family or friends</p> Signup and view all the answers

    Which of the following types of stress are mentioned?

    <p>Career</p> Signup and view all the answers

    Which age group is associated with middle adulthood?

    <p>31-65 years</p> Signup and view all the answers

    Young adults prioritize making appointments over other responsibilities.

    <p>False</p> Signup and view all the answers

    What lifestyle issue is noted as prevalent among young adults?

    <p>Sedentary lifestyles</p> Signup and view all the answers

    What is a significant issue faced during middle adulthood?

    <p>Career advancement</p> Signup and view all the answers

    What is the main focus that healthcare providers should adopt for patients?

    <p>Building on patients' strengths</p> Signup and view all the answers

    Caregivers can be hired for patients in late adulthood.

    <p>True</p> Signup and view all the answers

    What should healthcare professionals avoid when discussing a patient's condition?

    <p>Using medical terminology</p> Signup and view all the answers

    What factor can influence patient adherence significantly?

    <p>Family influence</p> Signup and view all the answers

    Match the following life stages with their descriptions:

    <p>Young adulthood = 18-30 years, transitioning from dependency Middle adulthood = 31-65 years, dealing with career and family responsibilities Late adulthood = 66 years and above, potential caregiving needs</p> Signup and view all the answers

    What is patient compliance?

    <p>The degree to which a patient correctly follows their physician's medical advice.</p> Signup and view all the answers

    What is the difference between the authoritarian approach and the patient-centered approach?

    <p>The authoritarian approach places all responsibility on the physician, while the patient-centered approach focuses on the needs of patients and encourages their participation.</p> Signup and view all the answers

    What are some consequences of nonadherence?

    <p>Increase in healthcare costs</p> Signup and view all the answers

    What is a common reason for medication nonadherence?

    <p>Patients may not take medications as prescribed, such as stopping antibiotics early after feeling better.</p> Signup and view all the answers

    What factors influence patient adherence to lifestyle recommendations?

    <p>All of the above</p> Signup and view all the answers

    Patients are required to be fully informed about all aspects of their __________.

    <p>treatment</p> Signup and view all the answers

    Nonadherence impacts only individual patients and has no societal consequences.

    <p>False</p> Signup and view all the answers

    What is an effective technique to enhance patient adherence?

    <p>Using active listening and breaking information down into manageable pieces.</p> Signup and view all the answers

    What is a common barrier to effective patient-centered teaching?

    <p>Physical and cultural barriers</p> Signup and view all the answers

    How can providers assess a patient's social support?

    <p>By observing interactions and cues from the patient, including who brought them and their body language.</p> Signup and view all the answers

    What is the first stage of the patient model?

    <p>Precontemplation</p> Signup and view all the answers

    Which factors influence patient teaching?

    <p>All of the above</p> Signup and view all the answers

    What is self-efficacy?

    <p>Self-efficacy refers to a patient's belief in their own ability to succeed in specific situations or accomplish tasks.</p> Signup and view all the answers

    Patients are expected to function normally while they are ill.

    <p>False</p> Signup and view all the answers

    What is an example of a negative coping mechanism?

    <p>Self-blame</p> Signup and view all the answers

    What encompasses the coping mechanism of 'regression'?

    <p>Regression is when a patient reverts to childlike behavior in response to stress or illness.</p> Signup and view all the answers

    What is an important aspect of patient teaching through the lifespan?

    <p>Age-specific strategies</p> Signup and view all the answers

    The ______ refers to the stage in which a patient knows they have issues but are not fully ready to act.

    <p>Contemplation</p> Signup and view all the answers

    In the action stage, patients are ready to take all necessary actions to improve their health.

    <p>False</p> Signup and view all the answers

    How does the geographic location of a patient affect their treatment?

    <p>Geographic location can affect access to healthcare resources and influence environmental factors impacting treatment adherence.</p> Signup and view all the answers

    Patients are expected to seek ______ for their illness and cooperate with providers.

    <p>help</p> Signup and view all the answers

    Study Notes

    Case Management Overview

    • Case management involves patients, families, and healthcare professionals, facilitating care from entry to discharge or end of services.
    • Variances in case management exist across healthcare sectors, requiring comprehensive participation by all professionals involved.
    • Case managers oversee specific cases, handling documentation and monitoring patient care.

    Role and Responsibilities of Case Managers

    • Team advocates for patients ensuring adherence to treatment plans while preventing misdiagnosis and errors.
    • Responsible for approving care plans once documentation is complete; delays in responses can halt patient care.
    • Maintain a professional but cordial relationship with healthcare personnel to ensure efficient communication.

    Employment and Qualifications

    • Case managers often have backgrounds in nursing, physical therapy, or occupational therapy; some hold bachelor’s degrees in healthcare studies.
    • Certification as a Certified Case Manager (CCM) is common, indicating a commitment to the field and advanced knowledge and experience.
    • Positions such as directors and supervisors in case management can command high salaries, reflecting varying responsibilities.

    Utilization Management

    • Focuses on monitoring patient documentation to prevent unnecessary healthcare services and resource misuse.
    • Case managers analyze patient care for duplicative treatments and alert healthcare professionals to discrepancies.

    Advocacy and Legislative Involvement

    • Case managers actively advocate for healthcare legislation, sending pre-written letters to legislators regarding problematic bills.
    • Professional organizations help healthcare providers navigate legislative changes affecting their practice and licensure.
    • Legal Care provides support for healthcare professionals facing legal challenges, ensuring confidentiality and unlimited access to legal counsel.

    Continuing Education and Professional Development

    • Healthcare professionals are required to complete continuing education units (CEUs) to maintain licensure; annual conferences provide opportunities for education and networking.
    • The process for earning CEUs includes attending diverse sessions that reflect the professional's interests and specializations.

    Professional Certification

    • Certifications are essential for keeping up with new healthcare technologies and practices; costs can be substantial and accompanied by necessary CEUs.
    • Healthcare associations typically manage the scheduling and logistics of certification-related examinations.

    Professionalism in Healthcare Education

    • Professional schools focus exclusively on specific healthcare professions, creating stronger connections among learners and material.
    • Curriculum includes specific classes on professionalism to better prepare students for real-world healthcare challenges.

    Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

    • JCAHO oversees healthcare facilities, conducting annual unannounced surveys to ensure compliance with standards.
    • Surveys are comprehensive, examining everything from patient care to facility conditions; surveyors are independent professionals who report findings without bias.
    • Individual healthcare professionals can receive penalties for deficiencies noted during surveys, reflecting the rigor of JCAHO evaluations.

    Patient Compliance

    • Patient compliance refers to how well a patient follows their doctor's medical advice.
    • Synonyms for compliance include: comply, agree, follow through, concordance, alliance, adherence, or collaboration.
    • The term "compliance" implies a power imbalance between the patient and healthcare professional.
    • A patient-centered approach emphasizes the needs of the patient and focuses on collaboration.
    • Patient-centered care creates trust and relationships with patients.

    Nonadherence (Non-Compliance)

    • Nonadherence is a major factor in treatment failure.
    • In 1996, 58% of emergency room visits were directly related to nonadherence.
    • The average rate of nonadherence across conditions is 25%.
    • Overuse and underuse of medication are common in non-adherence, leading to increased hospitalizations and costs.
    • Types of nonadherence include:
      • Appointment keeping
      • Medication (prescription)
      • Dietary recommendations
      • Lifestyle recommendations
      • Other aspects of treatment
      • Preventive health practices

    Interventions to Increase Adherence

    • Technological devices, behavioral technique, patient contacting, reminder postcards, and patient teaching are all possible interventions to improve adherence.

    Misconceptions about Nonadherence

    • Patients with serious or chronic illnesses are not necessarily more compliant.
    • Nonadherence isn't limited to certain healthcare settings or environments.
    • It's incorrect to assume that giving patients more information will lead to better adherence.

    What Healthcare Seeks in Providers

    • Initiative: Healthcare professionals are expected to take initiative to address patient needs.
    • Leadership: Healthcare professionals need to initiate and plan interventions, not just follow the patient's lead.
    • Critical thinking: Providers should approach patient care with a detailed and organized understanding of the situation and their role.

    Patient-Centered Teaching

    • Patient-centered teaching involves a deliberate problem-solving approach.
    • It's more than just providing information.
    • It requires gathering information about the patient's needs, beliefs, and abilities.
    • Identifying potential barriers (physical, psychological, social, or cultural) is crucial.
    • Active listening is a key component of patient-centered teaching.

    First Appointment with a New Patient

    • The first appointment is crucial for establishing a rapport and partnership with a new patient.
    • Skilled observation is an important tool for diagnosing patient concerns.
    • Open-ended questions can help elicit valuable information from patients.

    Patient Teaching and Treatment Planning

    • Provider Stress and Emotions: Provider stress and emotions can affect patient interaction and their understanding of treatment plans.
    • Patient Assessment and Goal Setting:
      • Goals: Incorporate patient goals with the health professional's goals.
      • Progression: Set small, achievable goals for patient progress.
      • Nonjudgemental Approach: Avoid judgment when working with patients.
    • Treatment Plan Development:
      • Needs Assessment: Gather information about the patient's needs, wants, and potential barriers to learning or following recommendations.
      • Alternatives: Explore alternative management strategies, if necessary.
    • Ongoing Patient Assessment: Regularly assess patients for changes, progress, and new symptoms.
    • Avoid Assumptions: Do not rush to conclusions or assume patient understanding.
    • Documentation of Patient Teaching:
      • Prevent Redundancy: Clearly communicate what has been taught and what still needs to be addressed.
      • Patient Understanding: Document the patient's level of understanding and areas needing reinforcement. -Evaluation of Patient Teaching:
      • Goals: Monitor progress towards short-term and long-term goals established in the treatment plan.
      • Realism: Ensure long-term and short-term goals are realistic and measurable.
      • Common Phrases: Be prepared for patients using phrases like:
        • "I want to return to my goal." or "I want to be able to..."
      • Adjustments: If no progress is observed, adjust short-term goals to promote progress.
      • Example Goals:
        • "Patient will ambulate 50 feet down the hallway."
        • "Patient will remove contact lenses every night."
        • "Patient will wear a hand brace 6 hours every day, except while sleeping."
    • Treatment Planning Issues:
      • Reflection of Patient Words: Ensure the treatment plan accurately reflects the patient's own words and goals.
      • Timely Review: Treatment plans need to be regularly reviewed and updated.
      • Measurability: Establish measurable goals that allow for progress tracking.
      • Address Initial Assessment: The treatment plan must address information gathered during the initial assessment.

    Steps in Treatment Plan Development

    1. Initial Assessment: Conduct a thorough assessment of the patient's condition.
    2. Additional Information: Gather additional information about the patient, beyond the initial assessment, such as:
      • Work and Occupation: Travel, schedule, etc.
      • Skills and Abilities: Vocabulary, compliance level, etc.
    3. Treatment Steps:
      • Diagnosis: Explain the diagnosis to the patient clearly.
      • Goal Setting: Collaborative goal setting with the patient.
      • Documentation: Document the patient's stated goals.
    4. Evaluate Outcomes: Monitor the patient's progress and responses to the treatment plan.
    5. Adjustments: Adjust the treatment plan as needed, based on patient progress.
    6. Timeline: Define realistic timelines for achieving goals.
    7. Monitoring: Continuously monitor the patient’s response to treatment.

    Treatment Planning Issues and Common Errors

    • National Issue: A significant percentage (62%) of treatment planning across the nation lacks consistency and accurate implementation.
    • Education Gap: Education in treatment planning is insufficient in many health care programs.
    • Consequences: Incorrect treatment planning can lead to payment issues and other complications.
    • Common Errors:
      • Lacks Patient Voice: The plan does not reflect the patient's concerns, goals, and priorities.
      • Lack of Review: The plan is not reviewed or updated regularly.
      • Lack of Measurable Goals: Progress is not tracked or evaluated, making it difficult to assess treatment effectiveness.
      • Ignores Initial Assessment: The plan fails to address key points from the initial assessment.

    Enhancing Patient Motivation and Adherence

    -Provider Responsibility: Enhancing patient motivation is a critical aspect of the healthcare provider's role.

    • Reasons for Lack of Motivation:
      • Lack of Understanding: The patient may not understand how information or recommendations contribute to their health status.
      • Misaligned Goals: The patient's goals may not align with the health professional's goals.
      • Perception of Outcomes: The patient may not share the same positive perception of treatment outcomes as the health professional.
    • Intrinsic Factors in Motivation:
      • Internal Satisfaction: The patient is motivated by the inherent satisfaction of engaging in the treatment plan.
      • Challenges: The patient is motivated by the challenge itself, rather than external rewards or pressures.
      • Psychological Factors: Psychological factors, such as a desired outcome (attending a daughter's wedding), can drive motivation.
      • Negative Effects: Lack of perceived benefits, anxiety, or lack of confidence can negatively impact motivation.
    • Extrinsic Factors in Motivation:
      • External Support: Social encouragement, family support, or external rewards can motivate patients.
      • Negative Factors: Factors such as dependency, inadequacy, or external pressures can hinder motivation.
    • Examples of Extrinsic Factors:
      • Work Conditions: Environmental factors at work can influence a patient's motivation to follow treatment plans.(pain, family influence or economic issues)
      • Family Influence: Family members, especially those living with the patient, can significantly impact their motivation.
      • Economic Factors: Financial constraints can be a barrier to motivation.
      • Environment: The patient's physical environment can have a significant impact on their motivation.
    • Motivation to Gain Information:
      • Recognized Need: The patient recognizes the need for knowledge to enhance their understanding.
    • Goals as Motivators:
      • Personal Goals: Patients are more likely to be motivated when treatment plans align with their own personal goals.
    • Motivation to Learn:
      • Comfort Levels: Physical and psychological comfort levels can impact a patient's willingness to engage with learning.
    • Fear as a Motivator:
      • Ineffective Strategy: Fear tactics are often ineffective motivators.
      • Anxiety Reduction: Helping patients recognize and address fears and anxieties can enhance their motivation to learn and receive information.
    • Motivation to Follow Recommendations:
      • Cost-Benefit Analysis: The patient considers the perceived cost of following recommendations versus its potential benefits.
      • Social Support: Support from family, friends, and community can significantly enhance motivation.
      • Environmental Factors: Factors such as accessibility of resources, transportation, and housing can influence motivation.
    • Enhancing Patient Motivation to Change:
      • Behavior Change: It is essential to focus on strategies that promote behavior change and enhance motivation to commit to the treatment plan.
    • Stages of Change Model:
      • Precontemplation: The patient is unaware of the problem or the need for change.
      • Contemplation: The patient recognizes the problem but may not have decided to take action.
      • Preparation: The patient is ready to take action but may not have all the necessary information or resources.
      • Action: The patient is actively engaged in the treatment plan and making changes.
      • Maintenance: The patient has made changes and is working to sustain them.
      • Relapse: The patient relapses back into old behaviors but is often able to regain motivation and re-engage with the treatment plan.
    • Self-Efficacy:
      • Confidence: Self-efficacy refers to a patient's confidence in their ability to successfully implement change.
      • Importance of High Self-Efficacy: A patient with high self-efficacy is likely to be more motivated and actively engaged in their treatment plan.
      • Low Self-Efficacy: Patients with low self-efficacy may experience difficulty making necessary changes and feel overwhelmed.
      • Factors that Increase Self-Efficacy:
        • Social Influence: Observing others who successfully manage their condition can boost self-efficacy.
        • Mastery Experiences: Successful experiences with the treatment plan can increase self-confidence.
        • Coping Skills: Developing coping skills to manage challenges and setbacks can improve self-efficacy.

    Individual Factors Influencing Teaching and Adherence

    • Psychosocial Factors: These factors can influence the effectiveness of teaching and adherence to treatment recommendations.
      • Past Experiences: Patients with negative past experiences with healthcare systems may be less likely to trust and comply with care.
      • Gender: Gender differences can exist in terms of health beliefs, seeking medical care, and adherence to regimens.
      • Age: Age can affect how patients process information, interact with health professionals, and comply with treatments.
      • Culture: Different cultures have varying beliefs about health, illness, and appropriate treatment practices, needing to be sensitive to cultural considerations when providing care.
      • Support System: Patients with strong social support systems are more likely to adhere to treatment plans.
      • Finances: Financial constraints can limit access to care, medication, and resources needed for successful treatment.
      • Environment: The physical environment (access to transportation, safe neighborhood, etc.) can impact a patient's ability to comply with treatment recommendations.
    • Patient as an Individual:
      • Unique Characteristics: Patients vary in their level of knowledge, skills, beliefs, and experiences with illness.
      • Coping Mechanisms: Patients have individual coping mechanisms, lifestyles, and perspectives that influences their health journey.
    • Social Influences:
      • Social Support: A patient's circle of social support, including family, friends, and community members, can significantly impact their adherence to treatment.
      • Cultural and Religious Influences: Cultural and religious beliefs can affect health practices, treatment preferences, and adherence to medical recommendations.
    • Environmental Factors:
      • Location: Geographical location can influence the availability of healthcare services, transportation, and support networks.
      • Living Arrangement: Housing conditions, living arrangements, and the surrounding environment can impact a patient's ability to follow treatment plans.
      • Financial Status: Limited financial resources can create barriers to accessing healthcare.
      • Schedule: A demanding work schedule or lack of flexibility with time commitments can make it difficult to adhere to treatment regimens.
    • Nature of Treatment Recommendations:
      • Frequency and Complexity: Treatment recommendations that require frequent visits, multiple medications, or complex regimens can contribute to non-compliance.
    • Influence of Personality Styles:
      • Interaction with Others: How a patient interacts with others and their responses to stress and emotions can affect their motivation and adherence.
    • Patient Self-View: Patient's perceptions of themselves impact their engagement with treatment.
      • Self-Identity: How a patient perceives their own identity can influence their approach to illness.
      • Self-Esteem: Patients with low self-esteem may be less likely to prioritize their health or believe they can manage their condition.
      • Self-Efficacy: A patient's belief in their ability to manage their condition is crucial to success.
      • Self-Concept: How a patient sees themself within the context of their illness can impact their coping and adherence.
    • Patient Adjustment to Illness:
      • Coping Strategies: Patients develop strategies for coping with illness, which may vary from person to person.
      • Sick Role: This concept describes the expectations associated with being sick, such as being reliant on others for care and having a reduced capacity for typical roles.

    Coping with Illness

    • Strategies for Adapting to Illness: Patients develop different ways to cope with their illnesses.
      • Denial: Ignoring or refusing to acknowledge the illness.
      • Compensatory Strategies: Using methods to compensate for limitations caused by the illness.
      • Benign Forgetfulness: Forgetting to take medications or follow recommendations.
      • Avoidance: Evasion of situations related to the illness.
      • Role Modeling: Copying behaviors of others who have successfully managed similar conditions.
      • Regression: Reverting to child-like behaviors.
      • Blaming Others: Attributing responsibility for the illness to external factors.
      • Self-Blame: Taking personal responsibility for the illness.
      • Rationalization: Justifying unhealthy behaviors.
      • Hiding Feelings: Supressing or concealing emotions.
      • Redirecting Emotions: Shifting feelings to other areas.
      • Excess Activity: Engaging in excessive activity to mask feelings.
      • Diverting Feelings: Distracting oneself from negative thoughts and emotions.
    • Importance of Support: Helping patients develop healthy coping mechanisms and providing support is important to their overall well-being.

    Provider Behavior and Non-Compliance

    • Multiple Prescriptions: Prescribing multiple medications at the same time can lead to confusion and reduced adherence, particularly if proper education is not provided.

    • Patient Education: It’s crucial to explain the purpose and timing of medications clearly.

    • Follow-up Assessments: During subsequent visits, ask patients about their medication adherence and clarify any confusion.

    • SCENARIOS FROM LECTURE*

    • Lack of Explanation: Healthcare providers sometimes fail to adequately explain the rationale behind treatment interventions.

      • **Example: ** An OT makes the patient pedal cycle without explaining the purpose or benefits, leading to a decrease in motivation.

    • Motivation and Noncompliance: Patients may not be motivated to follow through with treatment plans if they don't understand the importance of specific interventions.

    • Unclear Connections: Patients may have difficulty understanding the link between different components of their treatment plans, especially when addressing multiple complex conditions.

    • Patient Questions & Assumptions: Just because a patient does not ask questions does not mean they fully understand what is being discussed.

    • SCARY TACTICS:*

    • **Ineffective: ** Using fear-based tactics ("if you don't do this, more issues will happen") is rarely an effective motivational strategy.

    • Acknowledge Anxiety: It is important to acknowledge and address patients' anxiety, as healthcare environments can be stressful.

    • MOTIVATION FACTORS:*

    • Cost-Benefit Analysis: Patients weigh the perceived costs (time, effort, financial burdens) and potential benefits of following treatment recommendations.

    • Outcome Perception: A patient's perception of their ability to achieve desired outcomes influences their motivation.

    • Social Support: Family, friends, and co-workers can have a significant impact on a patient's motivation and adherence.

    • Environmental Factors: Accessibility to resources, transportation, and safe environments can influence motivation.

    • DOCUMENTATION:*

    • Motivation Factors: Document the patient's concerns and motivation factors to inform the treatment plan.

    • Patient Words: Use the patient's own words to describe their goals and concerns.

    • PRE-DETERMINED BELIEFS:*

    • Helplessness: Some patients have a belief that their health outcomes are predetermined or beyond their control, which can hinder motivation.

    • "It Doesn't Matter" Attitude: Patients with this mindset may not see the value in changing their behaviors.

    • HIDDEN AGENDA:*

    • Secondary Gain: Patients may manipulate providers by claiming symptoms to gain benefits such as time off work, attention, or access to resources.

    • CHRONIC CONDITIONS:*

    • Training: Patients with chronic conditions often need training to adapt and manage their limitations.

    • Demotiviation: Refusing a patient's requested activities, even if not medically advisable, can be demotivating and contribute to a decline in mental health.

    • Cognitive Reasons: Patients may resist changing their behaviors because they want to maintain their sense of control and autonomy, despite their limitations.

    • ILLNESS AND UNPREDICTABILITY:*

    • Coping with Uncertainty: Illness often involves a level of unpredictability, making it difficult for patients to fully adjust and cope.

    • MODELS:*

    • Stages of Change Model: This framework helps understand why patients may not immediately engage with their treatment plan.

      • Precontemplation: The patient is unaware or in denial about the need for change.
      • Contemplation: The patient recognizes the need for change but is unsure about taking action.
      • Preparation: The patient is ready to change but may lack the information and resources.
      • Action: The patient is actively engaged in making changes.
      • Maintenance: The patient is working to maintain their positive changes.
      • Relapse: The patient experiences a setback but may be able to regain motivation and continue with their treatment plan.

    • Importance of the Model: The Stages of Change Model helps healthcare providers understand a patient’s readiness for change and tailor interventions accordingly.

    Coping Mechanisms for Non-Compliance

    • Patients can develop coping mechanisms that may hinder their participation in treatment.
    • Providers should identify these and document them.
    • Some common coping mechanisms include:
      • Denial: Patient may not accept their diagnosis or treatment plan.
      • Compensatory Strategy: Patient finds a positive way to cope with limitations.
      • Benign Forgetfulness: Patient claims to forget instructions or appointments.
      • Avoidance: Patient avoids treatment settings or activities.
      • Role Modeling: Positive or negative role modeling in group settings.
      • Regression: Patient reverts to childlike behavior.
      • Blaming Others: Patient attributes their condition to external factors.
      • Self-Blame: Patient internalizes responsibility for their condition.
      • Rationalization: Patient provides explanations for their non-compliance.
      • Excess Activity: Patient engages in excessive activities to avoid dealing with their condition.

    Patient Teaching Through the Lifespan

    • Neonatal:
      • Family medicine, OBGYN
      • Focus on education for the mother and developing child
      • Many questions about health, finances, housing, and postpartum depression.
    • Prenatal:
      • Family medicine, OBGYN
      • Continue patient education for parents and the developing child.
      • Frequently answer questions related to diet, formula, and infant nourishment.
    • Infancy (1 day to 12 months old):
      • Family medicine or pediatrics
      • Develop rapport with the parents.
      • Document details about responsible adults and information provided.
      • Address parent anxieties about infant growth, development, and safety.
      • Educate about diet, formula, and introduction of solid foods.
    • Immunization:
      • Determine and communicate infant immunization schedules to parents.
      • Use standardized forms to document immunization refusals and potential legal issues.
    • Sibling Rivalry:
      • Educate parents about potential sibling rivalry and its impact on infant safety.
      • Recommend proactive strategies to manage sibling behaviors.
    • Toddlers (1-3 years old):
      • Family medicine or Pediatrics.
      • Significant increase in safety concerns related to toddler mobility and curiosity.
      • Continue diet education and address questions on solid food introduction.
      • Assess walking, standing, and other mobility skills.
      • Ensure language development is on track (comprehend 400 words by age 2).
      • Start engaging directly with the toddler for greetings and interaction.
      • Recognize cognitive awareness and independence, adapting teaching techniques, as needed.
      • Address toilet training questions.
    • Preschool (3-5 years old):
      • Family medicine or Pediatrics.
      • Increased potential for patient non-compliance.
      • More alert and reactive patients.
      • Continue to monitor language development (comprehend 2,500 words by age 5).
      • Use humor, stories, and visual aids to communicate.
      • Recognize and address potential fear of healthcare settings by age 5.
    • Later Childhood (6-12 years old):
      • Family medicine or Pediatrics.
      • Patients are more independent and cooperative.
      • Greater vocabulary and ability to comprehend instructions.
      • Parents are still involved, but children take cues from adults.
      • Positive reinforcement and direct communication are effective for engagement.
      • Be aware of potential behavioral disorders and conditions like autism spectrum disorder.
      • Address substance abuse concerns and provide referrals.
      • Continue to provide diet education and address nutritional concerns.
      • Manage and document sports physicals.
    • Adolescents (13-18 years old):
      • Family medicine or Pediatrics.
      • Communicate directly with the patient.
      • Report findings to parents, as teenagers are minors.
      • Address substance abuse concerns.
      • Manage sports physicals.
      • May experience more non-compliance due to increased risk-taking behaviors.
    • Young Adults (19-30 years old):
      • May not seek health care often.
      • Focus on prevention and address a range of physical and mental health issues.
      • Provide specific advice regarding prevention measures.
      • Encourage healthy lifestyles, including maintaining a balanced diet and regular physical activity.
      • Address stress management concerns and provide guidance.
      • Focus on movement and exercise.
      • Address potential health risks associated with sedentary lifestyles.
      • Recognize common health concerns, such as joint issues, cardiovascular risks, hypertension, cholesterol, and obesity.
    • Middle Adulthood (31-65 years old):
      • Focus on career-related stress.
      • Address issues like diet, weight management, and exercise.
      • Provide information about disease prevention.
      • Manage complex health concerns.
      • Handle a greater workload, potentially including Saturday appointments.
    • Late Adulthood (65+ years old):
      • Similar issues as middle adulthood, including career concerns.
      • May have a caregiver.
      • Healthcare professionals may need to make decisions about appointments.
      • Address potential caregiver issues and ensure patient safety.
      • Focus on strengths rather than limitations.
      • Emphasize disease prevention strategies.

    Family-Centered Teaching and Patient Adherence

    • Engage with the family, recognizing their influence on the patient's decisions.
    • Family members can either positively or negatively influence patient compliance.
    • Incorporate family members into treatment plans, especially in fields like PT, OT, and rehab centers.

    Family Training

    • Involve family in training to care for patients.
    • Identify a consistent family member for training.
    • Ask the patient's permission first.
    • Document who you trained for and the training details.

    Long-Term Illness Impact on Family

    • Long-term illness can affect responsibilities, attention, finances, stress, and restrictions.
    • Family members may experience anger or frustration.
    • You may need to manage family issues, even if they are not your patient.
    • Maintain professional boundaries and refer to counseling if needed.

    Communication with Families

    • Use regular language, avoiding medical terminology.
    • Assess understanding through questions and demonstrations.
    • Provide information in small manageable chunks.
    • Repeat information and check understanding.
    • Emphasize their support role rather than a complete care plan.
    • Encourage independence and avoid over protection of the patient.

    Family Follow-up

    • Address family concerns and clarify misconceptions.
    • Provide accurate information by gathering data from the environment and patient.
    • Set realistic expectations for the patient's progress.
    • Be prepared for families who consistently request to be involved in care.
    • Remind them that you are the primary healthcare provider, and they are not required to be present at all appointments.

    Patient Compliance

    • Compliance is the degree to which a patient follows their physician's medical advice.
    • Compliance can also be referred to as:
      • Comply
      • Agree
      • Follow through the treatment
      • Concordance
      • Alliance
      • Adherence
      • Collaboration
    • Compliance implies a power differential between the patient and the healthcare provider.
    • Patient-centered focuses on the needs of the patient over the goals of the health professional.
    • Patient-centered approaches focus on:
      • Increased patient satisfaction and better health outcomes
      • Patients being fully informed about all aspects of their treatment
      • Patients being more involved in treatment planning and decision-making
      • Patients being encouraged to accept more responsibility for their healthcare
    • Benefits of a Patient-Centered Approach
      • Decrease in liability issues
      • Create trust and relationships
      • Patients ask more questions about their treatments
      • Patients become more honest and providers gain more information
      • More realistic expectations

    Nonadherence (Non-Compliance)

    • Nonadherence is a significant factor in treatment failure.
    • Nonadherence can lead to development of chronic conditions and unhealthy habits.
    • Types of Nonadherence
      • Appointment keeping
      • Medication (prescription)
      • Dietary recommendation
      • Lifestyle recommendations
      • Other aspects of treatment (home treatment)
      • Preventive health practices
    • Consequences of Nonadherence
      • Individual: Increase risk of chronic diseases and recurrence
      • Societal: Increase morbidity, mortality, disability and infection spread
      • Economic: Increase in healthcare costs due to hospitalizations and additional visits

    Interventions to Increase Adherence

    • Technological devices
    • Behavioral techniques
    • Patient contacting
    • Reminder postcards
    • Patient teaching
      • Health professionals need to be effective communicators and explainers
      • Patient-centered teaching is about tailoring teaching based on the patients' learning needs, the best way to present information and the patient's specific needs and circumstances at home.

    Misconceptions About Nonadherence

    • That patients with serious illness or chronic issues are more compliant.
    • That noncompliance only occurs in certain healthcare settings or environments.
    • That certain patient backgrounds cause them to be more noncompliant.
    • That providing more information will lead to better compliance.
    • That patients will automatically comply if they are given more referrals and forms.

    Approaches to Working With Patients

    • It is important to acknowledge patient limitations, use active listening, and provide details about how the treatment will work.
    • The patient-centered approach should involve working closely with the patient and providing information in a way that is clearly explained.
    • Providers should be proactive in assessing patient needs and setting realistic expectations.
    • Avoid a "cookie cutter" approach, which assumes every patient will respond to treatment in the same way.
    • It is important to identify and address any potential barriers to compliance.

    Key Points about Patient-Centered Teaching

    • Passive patient: The patient plays a passive role in their care and may not fully understand the information provided.
    • Documenting patient interactions: Providers should document all interactions with the patient, including questions, concerns, understanding, etc.
    • Importance of patient-centered teaching: It involves gathering information, individualizing information, and planning treatment.
    • Identify patient needs: This involves identifying the patient's level of knowledge, attitudes, beliefs, social factors, and cultural values.
    • Assess strengths and limitations: This helps providers provide customized information and support.
    • Active listening: This is essential for understanding the patient perspective.

    First Appointment With New Patient

    • First appointments are crucial for building rapport and partnership with the patient.
    • It is essential to go above and beyond to show the patient that you care.
    • A first assessment is required by law before any treatment can be provided.
    • Providers should ask for permission before examining the patient.
    • Use skilled observation to gather information about the patient.

    Additional Key Points

    • The USA has a high rate of misdiagnosis.

    • Payer sources are not favorable to providers who use language like "uncooperative" or "difficult" when documenting about patient interactions.

    • Treatment is a process, not a one-time thing.

    • Providers should not ask yes or no questions about medication adherence.

    • Technology should be used as a tool to assist providers, not replace them.### Patient Teaching and Motivation

    • Provider's stress can affect patient care.

    • Patient teaching plans should be developed with patients' goals and preferences in mind.

    • Effective patient teaching involves clear communication, non-judgmental approach, and patient-centered care.

    • Assessment is crucial for patient teaching.

    • Document patient teaching to track progress, avoid redundancy, and identify areas needing reinforcement.

    • Evaluation of patient teaching includes assessing achievement of goals, both short-term and long-term.

    • Long-term goals should be broken down into specific, measurable short-term goals.

    • Issues in treatment planning can include lack of reflection, inconsistent reviews, and unmeasurable goals.

    • Treatment plans should be individualized and tailored to the patient's needs, goals, and circumstances.

    Patient Motivation

    • Motivation is a crucial factor in patient adherence to treatment recommendations.
    • Lack of motivation can be due to lack of understanding of information, misaligned goals between patients and providers, or differing perceptions of treatment benefits.
    • Factors influencing motivation include intrinsic factors like physical and psychological conditions, and extrinsic factors like social support and environmental influences.
    • Fear can be a motivator but should be handled carefully to avoid discouraging patients.
    • Enhancing patient motivation involves identifying patients' goals, helping them understand the benefits of treatment, and addressing their concerns and anxieties.
    • Stages of change can be used to understand a patient's readiness to change their behavior.
    • Self-efficacy plays a vital role in motivation.

    Individual Factors in Patient Teaching and Adherence

    • Psychosocial issues like past experiences, gender, age, culture, support system, financial situation, and physical environment can influence patient teaching and adherence.
    • Patients are individuals with unique knowledge, skills, and beliefs about their illnesses.
    • Social influences including social support, attitudes, beliefs, and cultural and religious influences play a role.
    • Environmental factors like location, living arrangements, financial status, and daily schedule all impact patient participation in their healthcare.
    • The nature of treatment recommendations can influence adherence, with more complex or demanding treatments posing challenges.
    • Personality styles can influence patient-provider interactions and affect adherence.
    • Patients' self-views including self-identity, self-esteem, self-efficacy, and self-concept are important in patient education and motivation.
    • Patient adjustment to illness can impact their self-perception and adherence to treatment.
    • Teaching patients coping mechanisms is essential to help them navigate the challenges of illness and treatment.
    • Provider's behavior can influence patient adherence, with clear communication, empathy, and tailored approaches contributing to better patient education and motivation.

    Coping Mechanisms

    • Patients may employ various coping mechanisms to deal with anxiety.
    • Denial: Patients may reject a diagnosis and deny the need for treatment, often claiming to have followed instructions or lying about compliance.
    • Compensatory Strategy: Patients can use this coping mechanism to find positive outlets or alternatives. For example, a dancer who can no longer dance might find fulfilment in supporting or training other dancers.
    • Benign Forgetfulness: Patients may exhibit memory lapses, often saying, "I forgot, I will do it later."
    • Avoidance: Patients may actively avoid situations or tasks related to their treatment.
    • Role Modeling: Patients in a group setting can have a negative or positive influence on others. This can involve taking legal action against a provider or encouraging participation and reassurance.
    • Regression: Patients may regress to childlike behaviors, requiring more assistance.
    • Blaming Others: Patients may externalize responsibility for their condition, placing blame on others.
    • Self-Blame: Patients might internalize blame, often stating, "If I wasn't so stupid" or "I'm forgetful."
    • Rationalization: Patients often find reasons or explanations for not following treatment recommendations.
    • Excess Activity: Patients may engage in excessive activities to distract themselves from their condition, such as excessive physical activity, commonly seen in individuals with eating disorders.

    Lifespan Development and Patient Teaching

    • Neonatal: The patient is both the mother and the developing child. Health professionals must consider both their status, including potential postpartum depression. Questions regarding financial stability and housing are important to address.
    • Prenatal: Patient education continues for the infant and the adults involved in their care. This includes answering questions about diet, formula, food stages, and the effects of specific foods. Ensuring adequate nutrition is crucial and requires addressing related inquiries.
    • Infancy: Healthcare professionals need to build a rapport with the parents since they are the primary caretakers. Understanding the parents' level of maturity, their anxiety, and their understanding of "normal" development is important.
    • Immunization: Parents sometimes hesitate to provide their children with immunizations. Healthcare providers have developed standard forms for parents who decline immunizations, which are important for liability purposes.
    • Sibling Rivalry: Parents should be informed about potential sibling rivalry and advised on how to manage negative behaviors from siblings towards the infant.
    • Toddler: Patient safety becomes a greater concern during this stage due to increased mobility and curiosity. This is also the stage when language development is crucial, and any delays may warrant evaluation for underlying issues.
    • Preschool: Patient non-compliance can begin to emerge. Preschoolers are more alert and demonstrate more reactions. As their vocabulary develops, they begin to understand the concept of fear, which is essential to consider when providing care.
    • Later Childhood: Children in this age group are more independent and have a greater vocabulary. They may also exhibit behavioral disorders or Autism Spectrum Disorder, which requires timely referral.
    • Adolescents: Healthcare professionals can communicate directly with adolescents, but parental involvement is still required as they are minors. They are more susceptible to substance abuse and may engage in risk-taking behaviors.
    • Young Adults: Young adults may have an inconsistent health care record and prioritize less on health. This is a crucial period for preventative measures, as they are often exposed to new stressors and lifestyle changes.
    • Middle Adulthood: Healthcare professionals should recognize the importance of career-related stresses on middle-aged individuals, which can impact their health. They may be managing their own families and caregiving responsibilities.
    • Late Adulthood: The same issues as middle adulthood persist, but healthcare professionals should avoid age-based bias and focus on individual strengths. Caregivers may play a significant role in accessing healthcare.

    Family-Centered Teaching and Patient Adherence

    • Families can significantly influence patients' adherence to treatment plans. They can contribute positively to the patient's well-being.
    • Healthcare providers can enlist family members to assist in care.
    • Family members should be educated on transferring patients safely and effectively.

    Family Training

    • Family Involvement: When training family members, choose a consistent and involved member.
    • Patient Permission: Always ask the patient for permission before training family members.
    • Documentation: Document the family member trained, the skills demonstrated, and the date of training.

    Impact of Long-Term Illness

    • Family Impact: Long-term illness impacts all family members, affecting responsibilities, attention, finances, stress levels, and restrictions.
    • Financial Stress: Financial concerns are a significant impact of long-term illness.
    • Managing Family Members: Family members may have different perspectives on the illness. Healthcare providers should manage interactions with them, acknowledging their impact but setting boundaries when necessary.
    • Communication: Use straightforward language when communicating with family members, avoiding medical jargon.

    Skill: Checking for Understanding

    • Active Listening: Use open-ended questions to encourage family members to ask questions and demonstrate their understanding. For example, "Do you have any questions? Okay, show me…."
    • Confidence Building: Checking for understanding allows family members to feel confident and identify mistakes.
    • Gradual Information: Provide information in small chunks, stopping to assess understanding before proceeding.
    • Preventing Overdependence: Ensure that family members do not take on all care tasks, allowing the patient to maintain their independence.

    Subsequent Encounters

    • Family Questions: When family members return with questions, get accurate information from the patient and relevant sources.
    • Realistic Expectations: Convey realistic expectations about the patient's progress and limitations.
    • Family Visitation: Reassure families that they do not have to attend all appointments; the healthcare provider is responsible for the patient's care.

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    Description

    This lecture focuses on the system of case management, emphasizing its effects on patients, families, and healthcare professionals. It covers the process that impacts patients from entry into care until the discontinuation of certain healthcare services. Understand the critical components of case management in various healthcare settings.

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