and this understanding can enhance interpersonal relationships with the older adult. Rapport and trust are assembled or hindered from the initial client meeting and transform/shift at every subsequent interaction. Other ways to increase rapport and trust are with the use of interpersonal warmth and a nonjudgmental attitude (Boyd, 2017). The healthcare worker should prepare for positive interactions prior to the first interaction with the client and Cultural care To understand the older adult more completely, the healthcare provider must enter the therapeutic relationship with the understanding that cultural beliefs and practices impact care. The older adult client may identify with a particular culture, and the healthcare provider needs to assess that identification in order to provide quality mental health services. The healthcare worker needs to understand the definition of culture, its application, and how to extend cultural acceptance. Definition of culture (American Psychiatric Association, 2022c): 1. The distinctive customs, values, beliefs, knowledge, art, and language of a society or a community. These values and concepts are passed on from generation to generation, and they are the basis for everyday behaviors and practices. 2. The characteristic attitudes and behaviors of a particular group within society, such as a profession, social class, or age group. The healthcare provider must assess each older adult client with openness using cultural competence and cultural humility. Cultural competence is the knowledge, skill, and awareness the healthcare provider possesses (Boyd, 2017). Cultural humility Empathy In the healthcare profession, empathy has nineteenth-century historical beginnings. Florence Nightingale is the most notable advocate as a result of her role in bringing compassion and empathy to patients. She is credited with unifying science and skill with compassion and empathy (Magpantay-Monroe, 2015). Exhibiting empathy can be thought of as an individualistic portion of healthcare with artistic freedom. There is more than one correct and therapeutic way to connect with older adult clients when assessing, intervening, and delivering treatment— especially when meeting mental health needs. The healthcare worker addressing mental health concerns can utilize and modify
work at strengthening the bond whenever possible. Healthcare organizations can also strive to decrease ageism by offering educational activities that dispel misconceptions and prejudices while addressing intergenerational concerns of the older adult (WHO, 2021). Ultimately, the healthcare worker must foster a therapeutic relationship nurtured in rapport and trust in order to meet the mental health needs of the older adult. is the healthcare provider’s ability to self-reflect on potential bias and possible factors that could interfere with providing mental healthcare (Stubbe, 2020). It places emphasis on a continuous learning process for the healthcare worker. Both concepts are defined and designed to aid the healthcare worker in their interactions with older adult clients and provide cultural acceptance. Techniques for the healthcare worker to extend cultural acceptance (Stubbe, 2020) include: ● Review your agency’s policies and practices toward culture. ● Find out if your agency provides accommodations for language. ● Simply ask the client how they identify their culture. ● Take notes on specific practices, customs, and beliefs the client discusses. ● Avoid assumptions. ● Ask about discrimination, bullying, or possible harassment related to culture. ● For validation, reword and repeat what is being shared. ● Give the client permission to speak up when they are feeling misunderstood. various approaches to communication to elicit trust and rapport that enrich the environment for information exchange, often of a sensitive nature. The healthcare worker can use originality with the empathetic approach, with the goal of maximizing the dialogue with the older adult client. This is important for the older adult client because the WHO (2021) notes empathy as a method for combatting ageism. With trust and empathy, the healthcare worker can increase interpersonal connection enveloped in empathy with the older adult client, making it easier to assess, intervene, and treat mental healthcare needs. else onto the healthcare worker (Boyd, 2017). This can be heard when a client says things such as “You remind me so much of my son/daughter” or “You look like a girl/boy a grew up with.” While these comments are not infallible indicators, they should prompt the healthcare worker to follow up on the association the client is making. The association can be favorable—or an obstacle to overcome. Countertransference is when a healthcare worker knowingly or unknowingly places their own feelings or attitudes onto the client (Boyd, 2017). This term can present in a positive or negative connotation. If the elderly client reminds you of your loving grandparent, then you might take great care in meeting needs or risk breeching professional boundaries. If the older adult client reminds you of your abusive grandparent, then the client is at risk for decreased objectivity in assessment and possible degradation of care rendered. Both transference and countertransference can be combatted with awareness. The practice of self-awareness and the review of extenuating factors that contribute to ageism, as discussed above, can also be applied to transference and countertransference. Trust, empathy, and a focus on professionalism place the healthcare worker in the appropriate space for communicating and enhancing mental healthcare needs of the older adult.
Professional boundaries for the mental healthcare worker While meeting the needs of the older adult mental health client, the healthcare worker is cautioned to maintain professional boundaries. Ethical topics such as abuse can be of concern with older adult mental healthcare, and they warrant a review of appropriate interaction. The National Council of State Boards of Nursing (2018) defines professional boundaries as the area between the healthcare worker’s “power and the client’s vulnerability.” Mental healthcare assessments and interactions depend on the healthcare worker’s aptness within this delicate scope. The focus during the interview should always be the client. Keeping the perspective of the client’s recovery goals can guide the healthcare worker to maintain appropriate balance. The healthcare worker should avoid self-disclosure whenever possible. Self-disclosure is defined as personal information a healthcare worker shares with a client (Boyd, 2017). Using honesty and redirection can give the healthcare worker the ability to shift questions or comments about themselves back in line with the therapeutic relationship. Remember, the goal is to help the older adult client through professional interactions and work to improve their quality of life. Transference and countertransference are two sides of the same coin. The healthcare worker meeting mental healthcare needs for the older adult should use acute recognition/awareness for the hindrance of either element. Transference is a client placing the thoughts, feelings, or behaviors they associate with someone
Page 194
Book Code: PYFL4024
EliteLearning.com/Psychology
Powered by FlippingBook