Living with Chronic Illness: Finding Resilience · A time for listening and caring: Spirituality...

Living with Chronic Illness:Finding Resilience

2012 Michigan BCCCP / WISEWOMAN / MCRCEDP Annual Meeting May 2-3, 2012

Debra Mattison, LMSW, OSW-CUniversity of Michigan Health System

debmatt@umich.edu

All slides in this presentation are the property of the presenter. Please do not duplicate slides without the written permission of the presenter.

Objectives

• Explore common psychosocial stressors across the illness continuum from diagnosis to end of life

• Identify effective interventions to support and assist patients living with chronic illness

• Acknowledge our own psychosocial stressors as professional caregivers

Diagnosis of Chronic IllnessA Dark Night of the Soul

• Sadness, Trial, Loss, Frustration, Failure

• Touches the Core

• Pushes to the Edge

• Forces Questions

Powerlessness

• No Longer Able to Impact Destiny

• Feel Controlled and are Controlled

• Fears

Regaining Power and Control• Help Patient Confront Fears and Increase Sense

of Control

What are you most worried about or afraid of?What would you like to see yourself be able to do,

to feel, to experience?Let’s explore choices you have…How can you get around, through, above…?What helps you feel more in control or like you

have more power?

Self- Concept

• Look and Feel Different

• Loose Sight of Self

• Relationships

• I Don’t Matter

Improving Self-Concept• Focus on the Patient’s Unique Life and

Experience

How do you matter?Who do you make a difference to?What have you done that only you could do?What is life still expecting of you?What do you hope to leave as your legacy?

Isolation and Loneliness

• Different

• Disconnected

Increasing Connectedness

• Help the Patient Search for Sources of Significance and Connection

When do you feel most nurtured?Where/with whom do you feel connected?What comforts and encourages you now?

Hopelessness

• Ambiguity and Uncertainty

• Wear and Tear

• Search for meaning

Encouraging Hope

• Help Patient Identify Hope as Something that is Always Appropriate and Meaning as Something that is Always Possible

What might you want to hope for today?What do you hope for most?What meaning have you given to your

cancer?How has your illness mattered to others?

I’m Beyond Tired!

I’m sick of being sick!

Cultivating Resilience

• Ability to Bend and not Break

Changing Responses (Do)

Shifting Perceptions (Feel)

Experience and Attitude (Meaning)

Physically Cared For

• Fuel Our Bodies

• Re-Charge

• Non-Abuse

Mentally Focused

• Realistic View of the World

• Choose between What Is and What Isn’t

Emotionally Connected

• Healthy Relationships

• Distinguish What We Feel from Who We Are

Spiritually Aligned

• Purpose and Meaning

• Hope and Comfort

• Being versus Doing

Allow the Story

• Listen

• A Patient’s World View

• What It Means to Be Well or Sick

• Their Values and How They See Wellness Occurring

Notice the Words

• Power

• Perspective

How Would You Feel…..

• “I’m sorry to tell you that you have failed the treatment.”

• “Do you want to try again with another treatment?”

• “We will need you to strictly comply with the protocol. Can you do this for me?”

• “There is nothing more we can do for you.”• “If your heart should stop, would you want

us to do anything to help you?”

Communicate

• About• To• With

How are things going for you and your family?What has been most difficult for you since we last

Collaborate and Problem Solve• Address Practical Issues

• Do Advanced Planning

• Involve Family

What practical problems is your illness creating for you?Sometimes people…..is that something you have thought

of/are experiencing?Here’s what we can anticipate and plan for.

See the Person

• Disease vs. Dis-Ease

• Medical Emergency vs. Human Emergency

• Parts vs. Whole

• Who are you?

• What is going well?

Every Patient is

• Like ALL other Patients

• Like SOME other Patients

• Like NO other Patient

Healing Meaning Options

• Control and Acceptance • Ask Different Questions• Hope, Purpose and Meaning• Personal Strength and Autonomy

Our Psychosocial Stressors

• Powerlessness

• Self-Concept

• Isolation and Loneliness

• Hopelessness

Self-Assessment Questions

Reflection and Affirmation

• Frankl, V. (1968). Man’s search for meaning. New York: Washington Square Press.

• Lawlis, G. F. (1996). Transpersonal medicine: A new approach to healing body-mind-spirit. Boston: Shambhala Publications.

• Moore, T. (2004). Dark nights of the soul: A guide to finding your way through life’s ordeals. New York: Gotham Books.

• Puchalski, C. M. (2006). A time for listening and caring: Spirituality and the care of the chronically ill and dying. New York: Oxford University Press.

Selected References

Living with Chronic Illness: Finding Resilience · A time for listening and caring: Spirituality...

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