Adult Apgar Test. 1. I am satisfied with the ACCESS I have to my emotions -- to laugh, to be sad, to feel pleasure or even anger.

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Transcription:

Adult Apgar Test Score 0=hardly ever 1=sometimes 2=almost always 1. I am satisfied with the ACCESS I have to my emotions -- to laugh, to be sad, to feel pleasure or even anger. 2. I am satisfied that my life's PRIORITIES are mine and clearly reflect my values. 3. I am satisfied with my commitment to personal GROWTH, to initiate and embrace change. 4. I am satisfied with the way I ask for ASSISTANCE from others, professionally and personally, when in trouble. 5. I am satisfied with the RESPONSIBILITY I take for my wellbeing -- physically, emotionally and spiritually. ƕ0 Å 1 Å 2 ƕ0 Å 1 Å 2 ƕ0 Å 1 Å 2 ƕ0 Å 1 Å 2 ƕ0 Å 1 Å 2

Adult Apgar Wellness Score

Adult Apgar Wellness Score 9 or 10 indicates a high level of wellness.

Adult Apgar Wellness Score 9 or 10 indicates a high level of wellness. 6 to 8 indicates imbalances and stresses that need attention.

Adult Apgar Wellness Score 9 or 10 indicates a high level of wellness. 6 to 8 indicates imbalances and stresses that need attention. 5 or less indicates significant trouble or pain, requiring crucial changes to achieve wellness. Professional counselling, a therapeutic support group or individual work is strongly recommended.

Professional Caregiver Health Taking Care of Us

Professional Caregiver Health Taking Care of Us Rob Rutledge MD FRCPC

Professional Caregiver Health Taking Care of Us Rob Rutledge MD FRCPC Oncologist, Associate Professor

Professional Caregiver Health Taking Care of Us Rob Rutledge MD FRCPC Oncologist, Associate Professor www.healingandcancer.org

Agenda

Agenda Introduction

Agenda Introduction Overview of burnout

Agenda Introduction Overview of burnout Healthy lifestyle assessment

Agenda Introduction Overview of burnout Healthy lifestyle assessment Discussion of burnout

Agenda Introduction Overview of burnout Healthy lifestyle assessment Discussion of burnout Relaxation exercise

TAKE HOME POINTS

TAKE HOME POINTS Take care of yourself

TAKE HOME POINTS Take care of yourself Use what works for you

TAKE HOME POINTS Take care of yourself Use what works for you Emotional distress is normal

TROUBLED TIMES

TROUBLED TIMES Medical oncology workers in Ontario, CMAJ

TROUBLED TIMES Medical oncology workers in Ontario, CMAJ 71% response rate to questionnaire, n=681

TROUBLED TIMES Medical oncology workers in Ontario, CMAJ 71% response rate to questionnaire, n=681 Physicians, allied health, support staff

TROUBLED TIMES Medical oncology workers in Ontario, CMAJ 71% response rate to questionnaire, n=681 Physicians, allied health, support staff Emotional exhaustion in 53, 37, 30%

TROUBLED TIMES Medical oncology workers in Ontario, CMAJ 71% response rate to questionnaire, n=681 Physicians, allied health, support staff Emotional exhaustion in 53, 37, 30% Depersonalization 22, 4, 5%

TROUBLED TIMES Medical oncology workers in Ontario, CMAJ 71% response rate to questionnaire, n=681 Physicians, allied health, support staff Emotional exhaustion in 53, 37, 30% Depersonalization 22, 4, 5% Low personal accomplishment 48, 54, 31%

TROUBLED TIMES Medical oncology workers in Ontario, CMAJ 71% response rate to questionnaire, n=681 Physicians, allied health, support staff Emotional exhaustion in 53, 37, 30% Depersonalization 22, 4, 5% Low personal accomplishment 48, 54, 31% One third of each group considered leaving cancer care

Stress and burnout in oncology Kash et al, Beth Israel Hospital

Stress and burnout in oncology Kash et al, Beth Israel Hospital N=261 house staff, nurses, med oncs in academic hospital and clinical practice

Stress and burnout in oncology Kash et al, Beth Israel Hospital N=261 house staff, nurses, med oncs in academic hospital and clinical practice House staff greatest risk of burnout

Stress and burnout in oncology Kash et al, Beth Israel Hospital N=261 house staff, nurses, med oncs in academic hospital and clinical practice House staff greatest risk of burnout Emotional exhaustion and poorer sense of self accomplishment

Stress and burnout in oncology Kash et al, Beth Israel

Stress and burnout in oncology Kash et al, Beth Israel Nurses reported more physical symptoms but less emotionally distant from patients

Stress and burnout in oncology Kash et al, Beth Israel Nurses reported more physical symptoms but less emotionally distant from patients Women lower sense of accomplishment and more distress

Stress and burnout in oncology Kash et al, Beth Israel Nurses reported more physical symptoms but less emotionally distant from patients Women lower sense of accomplishment and more distress Perceiving oneself as religious decreased reported burnout

PHYSICIAN HEALTH Duxbury 1999

PHYSICIAN HEALTH Duxbury 1999 Ottawa cohort study. 5 depts.

PHYSICIAN HEALTH Duxbury 1999 Ottawa cohort study. 5 depts. In preceding 3 months:

PHYSICIAN HEALTH Duxbury 1999 Ottawa cohort study. 5 depts. In preceding 3 months: 1 in 4 felt really stressed

PHYSICIAN HEALTH Duxbury 1999 Ottawa cohort study. 5 depts. In preceding 3 months: 1 in 4 felt really stressed 1 in 5 had poor emotional health

PHYSICIAN HEALTH Duxbury 1999 Ottawa cohort study. 5 depts. In preceding 3 months: 1 in 4 felt really stressed 1 in 5 had poor emotional health 12% had thought about suicide

PHYSICIAN HEALTH Duxbury 1999 Ottawa cohort study. 5 depts. In preceding 3 months: 1 in 4 felt really stressed 1 in 5 had poor emotional health 12% had thought about suicide 7% had planned suicide

WHAT IS BURNOUT?

WHAT IS BURNOUT? Christina Maslach, UCLA

WHAT IS BURNOUT? Christina Maslach, UCLA A prolonged response to chronic emotional and interpersonal stressors on the job

WHAT IS BURNOUT? Christina Maslach, UCLA A prolonged response to chronic emotional and interpersonal stressors on the job Physical and emotional exhaustion, depersonalization/cynicism and inefficacy

WHAT IS BURNOUT? Christina Maslach, UCLA A prolonged response to chronic emotional and interpersonal stressors on the job Physical and emotional exhaustion, depersonalization/cynicism and inefficacy Erosion of engagement with job

BURNOUT

BURNOUT In the middle of life s journey I found myself in a dark forest the way ahead obscured. Dante

Consequences of burnout

Consequences of burnout Emotional exhaustion related then to anxiety and depression

Consequences of burnout Emotional exhaustion related then to anxiety and depression Related to absenteeism, high staff turnover and diminished productivity

Consequences of burnout Emotional exhaustion related then to anxiety and depression Related to absenteeism, high staff turnover and diminished productivity Negative impact on colleagues

Consequences of burnout Emotional exhaustion related then to anxiety and depression Related to absenteeism, high staff turnover and diminished productivity Negative impact on colleagues Burnout makes it harder to work with people who are dying

LOSS OF SOUL

LOSS OF SOUL Sometimes I feel as though I am little by little disappearing. The phones keep ringing. The requests for help keep coming in. I feel as though I am not here. I get scared that I ll screw up Social worker

WARNING SIGNS OF BURNOUT

WARNING SIGNS OF BURNOUT Poor health: headaches, irritability, fatigue, hypertension, anxiety, depression, sleep disturbances, myocardial infarction

WARNING SIGNS OF BURNOUT Poor health: headaches, irritability, fatigue, hypertension, anxiety, depression, sleep disturbances, myocardial infarction Withdrawal, isolation, neglecting patient care or other duties,

WARNING SIGNS OF BURNOUT Poor health: headaches, irritability, fatigue, hypertension, anxiety, depression, sleep disturbances, myocardial infarction Withdrawal, isolation, neglecting patient care or other duties, Paradoxical workaholic phenomenon

WARNING SIGNS OF BURNOUT Poor health: headaches, irritability, fatigue, hypertension, anxiety, depression, sleep disturbances, myocardial infarction Withdrawal, isolation, neglecting patient care or other duties, Paradoxical workaholic phenomenon Alcoholism, drug addiction

WARNING SIGNS OF BURNOUT Poor health: headaches, irritability, fatigue, hypertension, anxiety, depression, sleep disturbances, myocardial infarction Withdrawal, isolation, neglecting patient care or other duties, Paradoxical workaholic phenomenon Alcoholism, drug addiction Relationship dysfunction

LOSS OF SOUL

LOSS OF SOUL I feel like I ve been turned into a liquid from a solid. Everyone has had a turn sucking me up into a syringe and I m trapped inside a barrel. My potency has weakened and I m leaking out the needle, absorbed into nowhere. Nurse

WHY DO WE BURNOUT?

WHY DO WE BURNOUT?

WORKING IN PALLIATIVE CARE IS STRESSFUL

WORKING IN PALLIATIVE CARE IS STRESSFUL You are expected to be source of strength

WORKING IN PALLIATIVE CARE IS STRESSFUL You are expected to be source of strength You deal with breaking bad news

WORKING IN PALLIATIVE CARE IS STRESSFUL You are expected to be source of strength You deal with breaking bad news You provide patients with emotional support

WORKING IN PALLIATIVE CARE IS STRESSFUL You are expected to be source of strength You deal with breaking bad news You provide patients with emotional support Treating dying patients, especially if can t relieve suffering, is stressful

WORKING IN PALLIATIVE CARE IS STRESSFUL You are expected to be source of strength You deal with breaking bad news You provide patients with emotional support Treating dying patients, especially if can t relieve suffering, is stressful Exposure to disability and disfigurement

WORKING IN PALLIATIVE CARE IS STRESSFUL You are expected to be source of strength You deal with breaking bad news You provide patients with emotional support Treating dying patients, especially if can t relieve suffering, is stressful Exposure to disability and disfigurement Seeing injustice of young people dying

WORKING IN PALLIATIVE CARE IS STRESSFUL You are expected to be source of strength You deal with breaking bad news You provide patients with emotional support Treating dying patients, especially if can t relieve suffering, is stressful Exposure to disability and disfigurement Seeing injustice of young people dying Working with difficult or special patients

STRESS FROM MODERN MEDICINE

STRESS FROM MODERN MEDICINE Increased cognitive demands

STRESS FROM MODERN MEDICINE Increased cognitive demands Increased choices and complexity

STRESS FROM MODERN MEDICINE Increased cognitive demands Increased choices and complexity Iatrogenic complications

STRESS FROM MODERN MEDICINE Increased cognitive demands Increased choices and complexity Iatrogenic complications Increased patient expectation

STRESS FROM MODERN MEDICINE Increased cognitive demands Increased choices and complexity Iatrogenic complications Increased patient expectation Increased regulation

STRESS FROM MODERN MEDICINE Increased cognitive demands Increased choices and complexity Iatrogenic complications Increased patient expectation Increased regulation Increased workload

A STRAINED HEALTH CARE SYSTEM

A STRAINED HEALTH CARE SYSTEM

COMMON PERSONALITY TRAITS IN PHYSICIANS

COMMON PERSONALITY TRAITS IN PHYSICIANS Overly conscientious

COMMON PERSONALITY TRAITS IN PHYSICIANS Overly conscientious People pleasing

COMMON PERSONALITY TRAITS IN PHYSICIANS Overly conscientious People pleasing Sense of responsibility and guilt

COMMON PERSONALITY TRAITS IN PHYSICIANS Overly conscientious People pleasing Sense of responsibility and guilt Unrelenting perfectionism

COMMON PERSONALITY TRAITS IN PHYSICIANS Overly conscientious People pleasing Sense of responsibility and guilt Unrelenting perfectionism Need to control don t like change

COMMON PERSONALITY TRAITS IN PHYSICIANS Overly conscientious People pleasing Sense of responsibility and guilt Unrelenting perfectionism Need to control don t like change Chronic self doubts

COMMON PERSONALITY TRAITS IN PHYSICIANS Overly conscientious People pleasing Sense of responsibility and guilt Unrelenting perfectionism Need to control don t like change Chronic self doubts Uncomfortable with love, approval

COMMON PERSONALITY TRAITS IN PHYSICIANS Overly conscientious People pleasing Sense of responsibility and guilt Unrelenting perfectionism Need to control don t like change Chronic self doubts Uncomfortable with love, approval Ability to delay gratification

YOU ARE MORE THAN YOUR JOB

YOU ARE MORE THAN YOUR JOB

INDIVIDUAL RISK FACTORS FOR BURNOUT

INDIVIDUAL RISK FACTORS FOR BURNOUT Younger is higher chance (<30-40)

INDIVIDUAL RISK FACTORS FOR BURNOUT Younger is higher chance (<30-40) Unmarried (single > divorced)

INDIVIDUAL RISK FACTORS FOR BURNOUT Younger is higher chance (<30-40) Unmarried (single > divorced) Higher education, high job expectation

INDIVIDUAL RISK FACTORS FOR BURNOUT Younger is higher chance (<30-40) Unmarried (single > divorced) Higher education, high job expectation Low levels of hardiness LESS: Involved, sense of control, openness to change

INDIVIDUAL RISK FACTORS FOR BURNOUT Younger is higher chance (<30-40) Unmarried (single > divorced) Higher education, high job expectation Low levels of hardiness LESS: Involved, sense of control, openness to change Perceive locus of control is external

INDIVIDUAL RISK FACTORS FOR BURNOUT Younger is higher chance (<30-40) Unmarried (single > divorced) Higher education, high job expectation Low levels of hardiness LESS: Involved, sense of control, openness to change Perceive locus of control is external Passive, defensive coping style

INDIVIDUAL RISK FACTORS FOR BURNOUT Younger is higher chance (<30-40) Unmarried (single > divorced) Higher education, high job expectation Low levels of hardiness LESS: Involved, sense of control, openness to change Perceive locus of control is external Passive, defensive coping style Poor self-esteem

INDIVIDUAL RISK FACTORS FOR BURNOUT Younger is higher chance (<30-40) Unmarried (single > divorced) Higher education, high job expectation Low levels of hardiness LESS: Involved, sense of control, openness to change Perceive locus of control is external Passive, defensive coping style Poor self-esteem Emotionally unstable, type A personality, feeling more than thinking type

BIOLOGICAL STRESSES

BIOLOGICAL STRESSES Lack of sleep

BIOLOGICAL STRESSES Lack of sleep Poor eating habits

BIOLOGICAL STRESSES Lack of sleep Poor eating habits Poor level of fitness

HIERARCHY OF SOCIAL DEMANDS

HIERARCHY OF SOCIAL DEMANDS Work and career demands

HIERARCHY OF SOCIAL DEMANDS Work and career demands Household responsibilities

HIERARCHY OF SOCIAL DEMANDS Work and career demands Household responsibilities People in our lives

HIERARCHY OF SOCIAL DEMANDS Work and career demands Household responsibilities People in our lives Personal needs and wants

Discussion question

Discussion question How do you know when you re burnt out? Physical symptoms Emotional Behavioural Social

Discussion question How do you know when you re burnt out? Physical symptoms Emotional Behavioural Social (Tell a story about the last time you were really hurting)

TAKING CARE OF US

TAKING CARE OF US The department

TAKING CARE OF US The department The individual

MOST IMPORTANT ADVICE:

MOST IMPORTANT ADVICE:

JUST SAY NO

JUST SAY NO

GET BACK INTO YOUR BODY

GET BACK INTO YOUR BODY

EXERCISE Empowering ourselves

EXERCISE Empowering ourselves

How much do you exercise each week? Empowering ourselves

How much do you exercise each week? = Getting heart rate to 65% of max Empowering ourselves

How much do you exercise each week? = Getting heart rate to 65% of max < 3 times per week Empowering ourselves

How much do you exercise each week? = Getting heart rate to 65% of max < 3 times per week 3 times for 30min Empowering ourselves

How much do you exercise each week? = Getting heart rate to 65% of max < 3 times per week 3 times for 30min 3 times for 60 min Empowering ourselves

How much do you exercise each week? = Getting heart rate to 65% of max < 3 times per week 3 times for 30min 3 times for 60 min 6 times for 30 min Empowering ourselves

How much do you exercise each week? = Getting heart rate to 65% of max < 3 times per week 3 times for 30min 3 times for 60 min 6 times for 30 min 6 times for 60 min Empowering ourselves

NUTRITION Empowering ourselves

NUTRITION Empowering ourselves

How many servings of fruits / vegetables do you eat daily? Empowering ourselves

How many servings of fruits / vegetables do you eat daily? Empowering ourselves

How many servings of fruits / vegetables do you eat daily? Less than five Empowering ourselves

How many servings of fruits / vegetables do you eat daily? Less than five 5-10 servings Empowering ourselves

How many servings of fruits / vegetables do you eat daily? Less than five 5-10 servings 5-10 serv. + low fat Empowering ourselves

Maintaining a Empowering ourselves

Maintaining a Empowering ourselves

Empowering ourselves

Empowering ourselves

Calculate your Body Mass Index BMI > Height 20 22 24 26 28 30 32 34 36 38 Weight in pounds 60 inches 102 112 123 133 143 153 164 174 184 195 62 in 109 120 131 142 153 164 175 186 196 207 64 in 116 128 140 151 163 174 186 197 209 221 66 in 124 136 148 161 173 186 198 210 223 236 68 in 131 144 158 171 184 197 210 223 236 249 70 in 139 153 167 181 195 209 223 236 250 264 72 in 147 162 177 191 206 221 235 250 264 279 74 in 155 171 186 202 218 233 249 264 280 296

SLEEP Empowering ourselves

SLEEP Empowering ourselves

SLEEP 7-8 HOURS PER NIGHT Empowering ourselves

SLEEP 7-8 HOURS PER NIGHT Empowering ourselves

SLEEP 7-8 HOURS PER NIGHT YES Empowering ourselves

SLEEP 7-8 HOURS PER NIGHT YES Empowering ourselves

SLEEP 7-8 HOURS PER NIGHT YES Empowering ourselves

SLEEP 7-8 HOURS PER NIGHT YES NO Empowering ourselves

RELAXATION Empowering ourselves

RELAXATION Empowering ourselves

How often do you practice a relaxation technique each week? Empowering ourselves

How often do you practice a relaxation technique each week? = slowing down your mind meditation, yoga, tai chi etc Empowering ourselves

How often do you practice a relaxation technique each week? = slowing down your mind meditation, yoga, tai chi etc Never Empowering ourselves

How often do you practice a relaxation technique each week? = slowing down your mind meditation, yoga, tai chi etc Never Once per week Empowering ourselves

How often do you practice a relaxation technique each week? = slowing down your mind meditation, yoga, tai chi etc Never Once per week 2-5 times Empowering ourselves

How often do you practice a relaxation technique each week? = slowing down your mind meditation, yoga, tai chi etc Never Once per week 2-5 times 6 or more times Empowering ourselves

WHAT TO DO - BODY Empowering ourselves

WHAT TO DO - BODY Take care of your body! Empowering ourselves

WHAT TO DO - BODY Take care of your body! Love your body Empowering ourselves

DO YOU HAVE FUN? Empowering ourselves

DO YOU HAVE FUN? Empowering ourselves

Schedule a fun activity weekly Empowering ourselves

Schedule a fun activity weekly Empowering ourselves

Schedule a fun activity weekly YES Empowering ourselves

Schedule a fun activity weekly YES Empowering ourselves

Schedule a fun activity weekly YES Empowering ourselves

Schedule a fun activity weekly YES NO Empowering ourselves

Do you feel supported in your life? Empowering ourselves

Do you feel supported in your life? Empowering ourselves

DO YOU HAVE A CONFIDENTE AT WORK? Empowering ourselves

DO YOU HAVE A CONFIDENTE AT WORK? Empowering ourselves

DO YOU HAVE A CONFIDENTE AT WORK? YES Empowering ourselves

DO YOU HAVE A CONFIDENTE AT WORK? YES Empowering ourselves

DO YOU HAVE A CONFIDENTE AT WORK? YES Empowering ourselves

DO YOU HAVE A CONFIDENTE AT WORK? YES NO Empowering ourselves

HOME / WORK BALANCE Empowering ourselves

HOME / WORK BALANCE Empowering ourselves

DO YOU HAVE A HEALTHY HOME / WORK BALANCE? Empowering ourselves

DO YOU HAVE A HEALTHY HOME / WORK BALANCE? Empowering ourselves

DO YOU HAVE A HEALTHY HOME / WORK BALANCE? YES Empowering ourselves

DO YOU HAVE A HEALTHY HOME / WORK BALANCE? YES Empowering ourselves

DO YOU HAVE A HEALTHY HOME / WORK BALANCE? YES Empowering ourselves

DO YOU HAVE A HEALTHY HOME / WORK BALANCE? YES NO Empowering ourselves

Nurturing a spiritual life Empowering ourselves

Nurturing a spiritual life Empowering ourselves

DO YOU NURTURE A SPIRITUAL LIFE? Empowering ourselves

DO YOU NURTURE A SPIRITUAL LIFE? Empowering ourselves

DO YOU NURTURE A SPIRITUAL LIFE? YES Empowering ourselves

DO YOU NURTURE A SPIRITUAL LIFE? YES Empowering ourselves

DO YOU NURTURE A SPIRITUAL LIFE? YES Empowering ourselves

DO YOU NURTURE A SPIRITUAL LIFE? YES NO Empowering ourselves

We in this together Empowering ourselves

We in this together Empowering ourselves

IN THE LAST MONTH HAVE YOU ASKED A COLLEAUGE HOW THEY ARE REALLY DOING? Empowering ourselves

IN THE LAST MONTH HAVE YOU ASKED A COLLEAUGE HOW THEY ARE REALLY DOING? Empowering ourselves

IN THE LAST MONTH HAVE YOU ASKED A COLLEAUGE HOW THEY ARE REALLY DOING? YES Empowering ourselves

IN THE LAST MONTH HAVE YOU ASKED A COLLEAUGE HOW THEY ARE REALLY DOING? YES Empowering ourselves

IN THE LAST MONTH HAVE YOU ASKED A COLLEAUGE HOW THEY ARE REALLY DOING? YES Empowering ourselves

IN THE LAST MONTH HAVE YOU ASKED A COLLEAUGE HOW THEY ARE REALLY DOING? YES NO Empowering ourselves

ADD UP YOUR SCORE Empowering ourselves

ADD UP YOUR SCORE Eat 5-10 fruits and veggies daily Empowering ourselves

ADD UP YOUR SCORE Eat 5-10 fruits and veggies daily Exercise - 3 times a week Empowering ourselves

ADD UP YOUR SCORE Eat 5-10 fruits and veggies daily Exercise - 3 times a week Maintain a reasonable weight Empowering ourselves

ADD UP YOUR SCORE Eat 5-10 fruits and veggies daily Exercise - 3 times a week Maintain a reasonable weight Sleep 7-8 hours nightly Empowering ourselves

ADD UP YOUR SCORE Eat 5-10 fruits and veggies daily Exercise - 3 times a week Maintain a reasonable weight Sleep 7-8 hours nightly Practice a relaxation technique Empowering ourselves

ADD UP YOUR SCORE Eat 5-10 fruits and veggies daily Exercise - 3 times a week Maintain a reasonable weight Sleep 7-8 hours nightly Practice a relaxation technique Schedule fun activity weekly Empowering ourselves

ADD UP YOUR SCORE Eat 5-10 fruits and veggies daily Exercise - 3 times a week Maintain a reasonable weight Sleep 7-8 hours nightly Practice a relaxation technique Schedule fun activity weekly Have a friend/mentor at work Empowering ourselves

ADD UP YOUR SCORE Eat 5-10 fruits and veggies daily Exercise - 3 times a week Maintain a reasonable weight Sleep 7-8 hours nightly Practice a relaxation technique Schedule fun activity weekly Have a friend/mentor at work Healthy work-home balance Empowering ourselves

ADD UP YOUR SCORE Eat 5-10 fruits and veggies daily Exercise - 3 times a week Maintain a reasonable weight Sleep 7-8 hours nightly Practice a relaxation technique Schedule fun activity weekly Have a friend/mentor at work Healthy work-home balance Nurture a spiritual life Empowering ourselves

ADD UP YOUR SCORE Eat 5-10 fruits and veggies daily Exercise - 3 times a week Maintain a reasonable weight Sleep 7-8 hours nightly Practice a relaxation technique Schedule fun activity weekly Have a friend/mentor at work Healthy work-home balance Nurture a spiritual life Asked a colleague how they are doing Empowering ourselves

HOW DID YOU SCORE? Empowering ourselves

HOW DID YOU SCORE? 10 : You re lying Empowering ourselves

HOW DID YOU SCORE? 10 : You re lying 8 or 9 : You can t count Empowering ourselves

HOW DID YOU SCORE? 10 : You re lying 8 or 9 : You can t count 6 or 7: You re amazing Empowering ourselves

HOW DID YOU SCORE? 10 : You re lying 8 or 9 : You can t count 6 or 7: You re amazing 4 or 5: At least your honest Empowering ourselves

HOW DID YOU SCORE? 10 : You re lying 8 or 9 : You can t count 6 or 7: You re amazing 4 or 5: At least your honest 2 or 3: Welcome to palliative care Empowering ourselves

HOW DID YOU SCORE? 10 : You re lying 8 or 9 : You can t count 6 or 7: You re amazing 4 or 5: At least your honest 2 or 3: Welcome to palliative care 0 or 1: Go straight home Empowering ourselves

Discussion question

Discussion question What are the beliefs that put you at risk of not taking care of yourself?

Discussion question What are the beliefs that put you at risk of not taking care of yourself? What are the situations which put you at risk of losing balance?

Discussion question What are the beliefs that put you at risk of not taking care of yourself? What are the situations which put you at risk of losing balance?

Discussion question What are the beliefs that put you at risk of not taking care of yourself? What are the situations which put you at risk of losing balance? Share ways / tricks to staying in health.