Note that each module in the Qualification - Certificate in Care (Care Professionals) is a short course in its own right, and may be studied separately.
EFFECT OF STRESS ON HEALTH AND WELLBEING
It is crucial that people learn to effectively and not destructively cope with the everyday stresses around them. Chronic high levels of stress is linked to reduced immune system function, leaving you open to infections, flu’s, viruses etc, and there is increasing evidence that serious diseases such as cancer and heart disease occur more frequently in highly stressed people. Digestive problems can also occur, because when you are fighting or fleeing, the energy your body produces is diverted to the muscles that you will need, and withdrawn from the digestive tract. If you are constantly on edge, your digestion will suffer. Negative behaviours in response to stress, such as high alcohol consumption, prescription and illegal drug abuse and smoking all have their own obvious effects on a person’s health and wellbeing. Inability to cope with stress can result in psychological illnesses, such as anxiety disorders, paranoia and most commonly, depression. A complete inability to deal with stressors any longer can result in a nervous breakdown, which is a state of complete mental exhaustion often accompanied by serious physical illness.
It is important to have coping mechanisms and a realistic attitude when it comes to stress. Low levels of stress appear to aid our immune system to respond better and become stronger. Acknowledging stress and being aware of our comfortable zone is an important step in dealing with stress and the affects of it. We can acknowledge that we are under stress, what it is from, and how to successfully deal with it. In doing so, each time we deal with a certain stress, we build our capacity and system to enhance it for the next time we need to undertake that task. Attempting to ignore a stressful situation will generally lead to an increasing build up of tension and anxiety and as stress levels rise, the ability to rationally cope with the issue will tend to diminish, fuelling a further increase in stress; a vicious cycle. The results of unrelenting high stress can be catastrophic, life threatening diseases, family breakdowns, chronic illness and addiction.
Insecurity, boredom and frustration at work can erupt into "stress sickness" which can, in extreme situations lead to depression, anxiety and other mental illnesses, other chronic illnesses, family breakdowns, alcoholism and drug abuse. There is anecdotal evidence linking life-threatening conditions such as heart attack and some forms of cancer with high stress. Unrelenting high stress can seriously compromise a person’s feeling of control in their life and work and can lead to a complete mental breakdown. It is always important to ensure a person has a time/space that is stress-free or as low stress as possible. If you are working in a professional setting, as a counsellor, life coach, fitness trainer or similar, stress management training and coaching for your client should be a top priority.
Stress and the Immune System
There are a variety of white blood cells in the circulation which function in our immune response.
• Neutrophils
Primarily recognise fungi and bacteria and there activity and subsequent death in large numbers will result in inflammation and pus.
• Eosinophils
Recognise parasites and destroy them
• Basophils
Involved in allergic responses where they produce chemicals called histamines. In people with allergies, they will ‘over-react’ to the perceived threat, and with each exposure, the over-reaction will get more severe and the high histamine levels will result in a dangerously excessive inflammation, which can cause severe breathing difficulty (due to bronchospasm), swelling in the glands and adjacent tissues (face will look puffy for example) and causes blood vessels to dilate, which will reduce blood pressure, combined, these effects can be lethal. Epi Pens are carried by people with severe allergic reactions, and contain epinephrine, which stops and counteracts the effects of histamines. You should always check whether a client has allergies, and how they need to be treated.
• Leukocytes
There are three main leukocytes:
• B Cells
Mature in the bone marrow. The general mechanism of these cells is to recognise, through the antibodies they express on their surface, anything pathogenic in the body.
They will attach to the invading fungi/bacterium/parasite/foreign or mutated cell using their antibodies (the foreign body or part of the foreign body they recognise is called the antigen) and destroy it, by ingesting it and breaking it down chemically.
These are the ‘memory’ of the immune system. Once they have recognised and destroyed a foreign body, they will be able to (more rapidly) recognise and destroy it if it again enters the body.
• T Cells
Mature in the thymus. Helper T cells stimulate the B cells, killer T cells will destroy cells in the body that have been invaded by bacteria or viruses.
• Natural Killer Cells
These also fight viruses and tumours by killing infected or cancerous cells.
Both acute and chronic stress deplete the efficiency of these cells and hence the body’s ability to stave off disease (O’Leary 1990). It has also been shown that stressed people are more likely to acquire infectious diseases (Hinkle & Plummer 1952) than their non-stressed counterparts. Research is ongoing to understand the specific effects of high stress levels on the immune system and specifically these key components of it.
THE STAGES OF GRIEVING
1) Denial
In the denial stage people refuse to believe what has happened. They try in their mind to tell themselves that life is as it was before the loss. They literally deny that anything has changed. They can even make believe to an extent by re-enacting rituals that they used to go through with their loved one. These could be such things as making an extra cup of tea for the loved one who is no longer there, or rushing back to tell them that they have just met an old friend. Other manifestations of denial could include flashbacks to times and conversations from the past as though the deceased were here with us now.
2) Anger
Anger can manifest itself in many ways. Individuals may blame others for their loss. Alternatively they may blame themselves. Typically, more introverted people will direct their anger inwards and more extraverted people will direct their anger outwards, though obviously some people will direct their anger in both directions. People may become easily agitated culminating in emotional outbursts.
3) Bargaining
Bargaining can take place within the individual or if they are religious with their god. Often the person will offer something to try to take away the reality of what has happened. They may try to make a deal, to have their loved one back as they were before the tragic event occurred. It is only human to want things as they were before.
4) Depression
Depression is a very likely outcome for all people that grieve for a loss. There can be a feeling of listlessness and tiredness. Often sleep patterns are interrupted and routines broken. The person may be bursting helplessly into tears and have little control over such outbursts. They may feel as though there is no purpose to life any more. They may have unreasonable feelings that they are a failure. They may also feel guilty and believe that everything is their fault. They may also experience feelings that they are being punished, and why do these things not happen to anyone else?
Clearly these sorts of things happen to everyone at some time or other but the depressed person cannot see this to be the case. Pleasure and joy can be difficult to achieve even from activities which have always given delight. Lethargy, disinterest and a general lack of motivation may prevent the individual from getting on with their life. Decision making and confidence in one’s convictions may prove too difficult.
There may also be thoughts of suicide. Any reference to suicide should be taken seriously. Obviously there are many different permutations of depression and not all people will experience the same feelings, or with the same intensity.
5) Acceptance
This is the final stage of grief. It is when the person realizes that life has to go on. At this point the person can accept their loss and come to terms with it. They should now be able to regain their energy and goals for the future. Some people will go about this slower than others, but the important thing is that they are back in the land of the living.
People do not always follow these phases in a set, linear way. They may move through them, then backwards, then forwards again, or they might miss some stages completely. This is just a “typical” process of grieving.
The Tasks of Mourning
Knowing that a person who is grieving will move through the stages discussed may not help us to be with the bereaved person.
There are tasks of mourning – that is, what needs to happen at the different stages or phases. If there is denial, the person needs to accept reality. If there is anger or sadness, that needs to be experienced and so on. So the tasks of mourning are:
Stage 1 To accept the reality of loss
Stage 2 To experience the pain of grief
Stage 3 To adjust to the new situation
Stage 4 To withdraw emotional energy from the loss and put it into a new situation or relationship.
If you pay in full on enrolment, the fees are discounted.
If you pay in 2 parts, the first half of the course is supplied initially; and the second part payment is not made until you have completed the first half (at which time the second half of the course is supplied).
If you pay in 4 parts, the first half is still supplied; you are then billed a second payment (due 2 months later). The third payment becomes due when you commence the second half of the certificate.The fourth part is due 2 months after that.