Psychological First Aid

Bob - May 19, 2021

https://relief.unboundmedicine.com/relief/view/PTSD-National-Center-for-PTSD/1230010/all/Introduction_and_Overview#:~:text=Psychological%20First%20Aid%20includes%20basic,activities%20in%20a%20flexible%20manner.

Good morning,

Link above is a comprehensive intro to psychological first aid. It’s responder-oriented but the principles and concepts mentioned can be used for one’s family, for self, for “stranger” disaster “victim” who appears out of nowhere into your immediate environment.

Some misc comments;

One of the best government agencies – my opinion only – with real good publications (no-cost to requester) is SAMHSA, a small agency of Dept of HHS. They have an A+ pocket size Field Manual titled “Field Manual For Mental Health and Human Service Workers In Major Disasters”. A favorite line I photocopied:

“Disaster mental health assistance is often more practical than psychological in nature.”

…….

For your psychological first aid research do learn about the topic called “compassion fatigue”.

……

Keep notes and understand that they’re restricted health care information. 

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Good morning Bob,

Thank you for a great link – I have bookmarked it in my emergency preparedness section.

Compassion fatigue is an important part of psychological first aid. It is something that can affect people with or without a disaster present.

For example, caregivers are susceptible. They put another person or person(s) needs before their own and become progressively more exhausted.

In many families, it is often left up to one sibling to assume the responsibility for the care of ageing family members because the rest of the family deems that the caregiver “is good at it”.

In reality, the other family members don’t want the work or the responsibility of caregiving.

If family members don’t want to help directly, then they can chip in and hire regular respite care for the caregiver. There must be care for the caregiver and they should be encouraged to practice regular self care, free of any guilt.

If a caregiver is on the verge of burnout and then a disaster occurs, the result could be very bad.

Protecting our physical and psychological health is part of prepping. We want to be as healthy as possible going into a disaster.

I found a wiki explanation of compassion fatigue and here is the link for anyone who might like more info:

https://en.wikipedia.org/wiki/Compassion_fatigue#:~:text=Compassion%20fatigue%20is%20a%20condition,secondary%20traumatic%20stress%20(STS).

 

https://www.samhsa.gov/about-us

Good morning Ubique,

It’s good that you posted the above Wike link on compassion fatigue. Am hoping forum participants will go through this stuff.

At the initial like I posted above on psychological first aid, did you notice that at “Working With Survivors With Disabilities”, at second dot: “… address the person directly rather than the caretaker …”. This sometimes depends.

Above is SAMHSA link. Surfing around their website gets to their “Store” where there’s the list of publications.

 

Good afternoon Bob,

Glad it could help. I hope preppers here read through this info also. Now is the time to do it before a disaster or crisis.

I wonder if some people are not comfortable discussing these issues openly? If so, that’s okay. They can still read about it.

Yes, I did notice that phrase “address the person directly rather than the caretaker…” and I agree that sometimes depends. Sometimes caregivers have to advocate for themselves.

The doctors here ignored how much “I was taking for the team” while caregiving until I sat the family doctor and his psychiatrist down and told them point blank: “I have high blood pressure and an assortment of my own health issues, I cared for my Mom, my Aunt and husband all at once while I was sick myself.”

“Now Mom and Aunt have passed and I am left to care for him. Despite his episodic rages and your inability to diagnose him until after he passes, I am still his friend. If I, who am not a psych nurse, wasn’t here to run the gauntlet with husband’s rages and help manage them, all of you involved in his care would just throw him into a psych ward and sedate him.”

It was then, finally, that my family doctor began to see me differently. I had no idea what I was in for when I got involved with him and became his caregiver. It has taken a toll, but, sometimes we have to step up and do the right thing when no one else will do it. We just get on with it when no one else wants to help.

I advocated for med changes and a re-diagnosis for him. One of the meds he was on caused his glaucoma and he was on his way to vision loss. His eye sight has now stabilized to the point where he no longer has to have regular checks to retain his driver’s license.

He has quality of life, despite whatever is wrong in his brain (lots of head injuries). As we were taught in palliative care: “You matter because you are…”

Regarding meds and vision loss: I had a med review done for him when he turned 65 and one of the meds that he took that was causing the glaucoma. It wasn’t even proven to have efficacy at his age. That is preventable vision loss.

This is why psychological first aid is so important. We need to know how to care for ourselves when we are isolated and alone as much as we need to know how to care for others, because many times, we have to do both at once.

The SAMHSA information and other organizations can help us create sound psychological first aid for ourselves and others in need.

I have SAMHSA bookmarked and it is a wonderful resource. So many great publications and info.

 

Good evening Ubique,

Of course, some are not comfortable discussing this subject. 

From my veterans’ work, it’s difficult, due to comfort range, to get someone to prep their final papers and, I suggest, a recent photo and a draft obit.

Here, the new batch of doctors are slowly shedding the loftness. 

You have placed heaps of psychological pressure on yourself with the car-giving role and can see you’ve mastered the use of the needed techniques.

Once we truly understand that life is difficult – and really understand this – the difficulty fades away. The difficulty is now viewed as the routine. Thus, the difficulties are the daily routines of living.

 

Good morning Bob,

I found this info on the American Psychological Association website. The suggestions are in an article directed toward caregivers, however, the article states that the suggestions are what they suggest to their clients.

The suggestions are quite good and well written with links for relaxation techniques and other resources. Sometimes, suggestions are listed without fully explaining them or how they can be helpful. 

https://www.apa.org/monitor/2020/07/self-care

I believe I mentioned before that drafting an obit was part of our Palliative Care course. Our instructor made us look at our own attitudes toward the subject and that was one method of doing so.

Glad to hear new doc are shedding the loftiness. I partner with my health care providers. They do not dictate my care. They make suggestions, but I make the decisions. I ensure that I fully understand what they are doing at all times.

Caregiving is something that is part of my family culture. People weren’t turfed off into a long term care facility. I started caregiving when my Mom got sick and went through years of misdiagnosis. I was around five. The experience taught me empathy.

And, it was a good lesson in what you wrote about understanding that life is difficult.

If we are to be fully prepared for life and the scope of the reality of life, not just the fun parts, we can accept it as part of life and it ceases to be difficult.

“Life is a zoo in a jungle.” Peter DeVries, American novelist 1910-1993, served WWII as a marine attaining rank of Captain, and then seconded to the OSS.

 

Good morning Ubique,

Just read the Rebecca Clay APA article.  Good info.  Appreciated reading at “Limit News Consumption” explicitly mentioning “checking reliable sources”.

Yes, remember your mention of obit prep for course. It is a rehabilitive process just to prep a draft. This works as self-therapy when written by pen on paper and not the transitory word processor. Once the initial exposure to the unpleasant is converted into the pleasant … after all, a task is being accomplished … life gets easier.

Here by an assembly of events, the health care providers are no longer sovereigns in their fiefdoms. One of the big events is that govenment funds much of health care here. The organization Disabled American Veterans – DAV – is one of the watchdogs. I worked 10 rural counties in re VA’s mobile clinics.  Once a big spending bill was being finalized in Congress and at time was visiting a mobile clinic out in the sticks here. Now I was treated like a sovereign. Not me personally – just symbolically – because of my DAV hat.  My reports are written and personally delivered (pre-COVID) back to DAV. My second home is Hong Kong and I did oversight re the VA clinic in Manila, RP.  It’s a clinic treating the WWII veterans and the post WWII vets until RP became independent.  It’s a small place but good. 

Pete DeVries books are main features in Veterans org bookshelves.

 

That must be so hard on you to have been a caregiver for so long. Especially when your husband goes through those rages. It would be hard to tell myself that it is just his head injuries and not take it personal. 

You are an angel and a saint!

 

Hi Liz, 

Thank you for the kind words. 

I don’t take it personally because he is the one who must live inside his body and whatever is wrong in his brain. And, he is cognizant of it. It’s hard to hear him say “I wasn’t always like this.”

We cope together by developing strategies to cope with triggers. He has low frustration tolerance and we have ways to deal with that. He enjoys puttering in the shed with his new tools. This activity works his brain and motor skills. He also likes doing yard work. These activities help him find joy in doing something he enjoys.

Some days and weeks are very hard, but I believe that love always finds a way. My Dad did this for my Mom when she was very ill and mis-diagnosed. She presented with psych symptoms, but had two underlying medical conditions that affected her brain. Dad fought for twelve years to get her help. He did everything out of love and compassion. Mom reciprocated many years later when he had bypass surgery and later, cancer.

I was very blessed to have them both as examples of unconditional love and compassion.

 

https://www.nami.org/About-Mental-Illness/Mental-Health-by-the-Numbers/Infographics-Fact-Sheets

Good morning,

NAMI = National Alliance For Mental Illness is another good source for developing one’s psychological first aid program.

Glance at the fact sheets.  On the link’s left vertical bar is a list of categories to explore.

Couldn’t readily find something super I wanted to post – but it’s somewhere on the NAMI site. NAMI titles it “holiday blues”. It involves a major issue that’s a building block for disaster matters. This is from my 3X5 index card used to teach this stuff:

“Stressors – ‘Family relationships are complicated’”. Family reunions: highlights what’s changed in a person’s life – or what hasen’t changed”.  “We set ourselves up for disappointment; daily struggles don’t disappear”.

 

Good morning Bob,

Great link for NAMI and thank you! I used to have the link years ago for a health support group I belonged to. They have excellent resources.

Yes, “holiday blues” are a big one and I can see the linkage between covid or other routine disruption turning life into one big “holiday” with all the associated stress of a bad Thanksgiving dinner or family reunion.

There are some family dinners where “pass the gravy please” causes people to duck.

 

Good evening Ubique,

Had guess you’re familiar with NAMI. They do, indeed, have premier resources.

Family dinners and reunions are avoided to the max. Life’s rough enough without “holiday blues”. Plus, let’s not forget, someone is doing much work during these events.

 

Good “wee hours of the morning” Bob,

Some of the nicest family dinners are pot luck where everyone brings something or cooks together. Shore dinners where the fishing lines go in and the walleye is fresh. Add a camp fire and there is no better time.

 

Good morning Ubique,

Good morning also during the early-riser wee morning hours.

Shore dinners around a campfire are some of the best events I attend. They provide healthy foods, quality relaxation, and refinement of social relationships.

We also use term “pot luck” for our events.  This term is augmented by the term/expression “Bring a covered dish”. Of course you know me and the “covered dish course” of the shore dinner is also the learning/class session. At one shore dinner I brought 2 of the flimsey, wavy type paper plates (Second one was the cover) with samples of the recently researched eel grass – some fresh, some prepared, etc. After the theatrics of my covered dish -held together by 3 of the small silver paper clamps – brought out some larger quantity of eel grass for camp fire cooking. Also distributed some photocopies of preparation, consumption of the marine botany.

Time for another coffee … not due to early, early AM but rather the COVID vaccination fatigue. 

 

Good morning Bob,

Great shore dinner story! What a great way to present a covered dish with a side dish of education 🙂

That could be a really fun way to organize a pot luck or shore dinner. Everyone brings a dish that can help expand preparedness knowledge.

Did you get your second dose of vaccine or is the fatigue from the first dose?

I am supposed to be going for the second shot of Pfizer soon.

 

Good morning Ubique,

The fatigue is from the second shot/jab. 

 

Good morning Bob,

I have heard that the second shot can carry more effects. I hope you recover from the jab soon and feel better.

Did they mix your shots or did you get the same vaccine both times? They keep changing their minds here.