BY KAREN GALLAGHER
I don’t know if it is naive thinking, denial, or ignorance, but most folks do not focus on an anticipated crisis or an event that could be life changing. We are concentrating on our daily to-do list, such as making sure the lawn is mowed, or thinking about where the children need to be after school, or perhaps work issues.
Sometimes we have more serious concerns, such as financial setbacks or the illness of an elderly parent. These are expected bumps in the road and for most of us, this is a part of our daily life experiences. Nonetheless, they are stressful at times, and indeed upsetting. Second-level difficulties on our path often do pass with time. We understand that life is a journey with twists and turns; it does not flow in a straight line.
However, in the human experience, we might encounter a serious crisis or tragic event. These accidents or illnesses can completely derail the journey. They are critical life-changing eruptions which might be so enormous that an individual cannot return to their original path. In this example, an acquired disability may not be fully reversible or recoverable.
The combination of experiencing a sudden tragedy resulting in an acquired disability and the loss of control over life as once known creates an understandable emotional reaction for the individual and the family. Family caregivers must also join their loved ones and leave the comforts of their home path. The transition to the new journey for all involved includes pervasive new challenges.
So how does one travel down the new road with a sense of emotional fortitude?
Key tools for the success for this trip include a support team of professionals of varying disciplines working together to facilitate a sense of empowerment for the patient and family. Loss of control over one’s life impacts self-esteem and causes grief/depression that are major challenges for the individual with a new injury. Instilling a sense of control with knowledge, through psycho-education facilitates patients’ understanding of their new circumstances. Information is a form of stress reduction in most instances.
Additionally, assuring independence where possible assists patients to feel more involved with their lives and have increased control (as an example, a patient who has a payee can feel not in charge of his or her money). The payee might support the patient’s empowerment by assuring the individual to have a weekly or periodic review of finances. The review might need to be repeated, due to the cognitive issues. However, the intention is that the patient gains a sense of empowerment by implementing this type of a plan.
Facilitation of empowerment occurs by assisting patients to see themselves in a new light. A new patient can learn to reframe his or her self-image as a survivor and not a victim. Patients learn to change their vision of the future within the parameters of the disability. Metaphorically, if you break a leg and can’t run 10 miles anymore, can you ride a bike instead, or walk three miles? This approach does not in itself preclude the grief associated with the change, but is helpful in moving the patient from the “old self” to the “new self”.
Acquired disabilities are manifested emotionally by creating a changed sense of identity for the individual. Individuals who were productive in their home and work lives are now perhaps not able to work or have “valuable” roles in the home. Recreating that sense of self-esteem is critical to the emotional recovery process and replenishing a sense of control where it once was.
Grief and depression mirror many of the same symptoms and therefore will be referred to as grief. Both are common and normal responses to the multiple changes in patients’ lives. The loss of the previous life as one knew it is a constant and nagging feeling. Sudden tragedy and serious injury can cause complicated grief reactions that translate to extended time frames of grief, and a more difficult recovery process.
Addressing or supporting grief for patients and their families mean not defining it. Grief is an individual experience which is manifested differently in every case. Distinguishing a normal grief process from an impaired grief process is best determined by professionals.
Adjustment to the multitude of losses associated with acquired disability is a slow process. The goal is to assist the patient to reduce the intensity of the losses over time. Building a future and adapting to the alternative life helps to reduce the intensity of the losses. The grief and the losses will not disappear fully, but over time they become integrated, and not reconciled in life’s changes.
Validation of the patient and family in their challenges by one another, with the help of professionals, are key components in the adjustment processes. Loss of control, self-esteem issues, and grief are common emotional struggles. Gradual recovery gives everyone involved the time to reflect on the changes, and to transition toward the new direction of the journey.
As a result of this unplanned trip, the patient uses a compass to find north, remembering that the path in the past took you north before. Now in a “different part of the world,” so to speak, this new path does go forward to an area previously unexplored by the individual with an acquired disability. A good place.
Source: Innovative Health Magazine, August 2017