Chronic illness is defined as having a persistent or long-standing health condition, often lasting over a year or more. Living with chronic illness often requires one to make lifestyle changes to manage the symptoms that it comes with. Chronic illness may also impact one’s motor functioning. Some patients may find themselves requiring external help to fulfill simple everyday things (i.e. using the toilet, shower, and going to medical checkups). This could reduce their sense of autonomy as they become more reliant on others. Changes in bodily functions and energy level can cause one to spend less time in social gatherings and more time in isolation. Additionally, practical matters like the depletion of financial resources would also affect one’s quality of life. Inevitably, chronic illness would impact the mental and physical health of their caregivers and themselves.
Oftentimes, when involuntary lifestyle changes have to be made, the process of accepting and adapting to the new lifestyle would inevitably cause an increase in psychological stress. We may subconsciously be reluctant or resistant to making these changes to accommodate the illness. Our openness to adapt to these changes would also affect our caregivers’ levels of stress and anxiety. Increased stress levels can lead to many issues like disturbed sleep, tension and fatigue, increased irritability, and losing interest in things that used to be pleasurable. Extended periods of stress can lead to depression or anxiety in both the patient and their caregivers.
Management
To manage stress levels, there are a variety of methods that have shown to be effective for different individuals. These coping styles have been broadly defined as problem-focused coping and emotion-focused coping. Problem-focused coping is when one actively seeks to understand their chronic illness and make the necessary changes to adapt to their new reality. By taking steps to clarify the uncertainty and dealing with the stressor, it helps the individual regain their sense of control and reduces their stress levels. On the other hand, emotion-focused coping helps to manage stress by regulating one’s emotional response to the stressor, i.e., accepting the difficult circumstances and emotions with sympathy and kindness.
Comparatively, studies showed that emotion-focused coping is less effective in the long run as it ignores the root cause of the problem. Moreover, it is associated with increased anxiety, as well as poorer psychological adjustment, self esteem, and life satisfaction. In particular, lowered self esteem is associated with the severity of impairment from chronic illnesses. Therefore, managing chronic illnesses includes not only receiving the necessary medical treatment and making lifestyle changes, it also requires the individual to cope with the emotions surrounding the chronic illness.
Regardless of coping methods, the individual’s quality of life can be improved by understanding the practical and emotional management of the chronic illness. Some practical management includes understanding your condition (know what helps and what does not), going for regular health checkups and eating prescribed medication on time, and eating healthy.
Emotional management includes:
Spending time with friends and family
Explore stress-relieving activities (e.g., meditation, journaling, exercising)
Meditation has been found to lower anxiety, stress, depression and enhances quality of life.It also reduces perceived pain, increases attention, improves sleep and overall well-being
Journaling was found to facilitate both physical and emotional healing of clients with chronic illnesses
Seeking support when needed (e.g., support groups, financial aid, therapy)
Food for thought
Different types of chronic illness can impact one’s outlook of their life. For some, the chronic illness requires a small amount of effort to adapt to it but for others, the chronic illness can affect their daily functioning and their quality of life. Oftentimes, when one is struggling to manage the effects of their illness, they may look for ways to end their suffering. As such, the legality of voluntary euthanasia has been debated for many years. For the purpose of this discussion, we are referring to the population that is facing deterioration in their mobility as a result of their chronic illness.
Based on various reports, the idea of voluntary euthanasia is appealing to some as they see their deterioration as a loss of dignity which impacts their self-image and self-esteem. Moreover, effects from the chronic illness may lead to other issues like intolerable amount of pain, loss of appetite, independence, and control would reduce their quality of life. They may feel like a burden to their caregivers as they become more reliant due to the deterioration. Thus, to preserve their dignity as people and reduce their suffering, some patients would look to voluntary euthanasia.
Conversely, there are many arguments against voluntary euthanasia. For the population in the discussion, they may hold a negative outlook in life due to their predicament. As a result, their depression may hinder their ability to feel the positive feelings that they experience in their daily lives. Hence, depriving them of their reasons to live. Moreover, as long as the patient is alive, there is hope that they may find a cure or have methods to reduce their suffering so that they would want to be alive.
Regardless of perspective, for patients with chronic illness that would lead to severe deterioration and eventually death, end-of-life planning allows them to have control over their financial and healthcare decisions when they still can. This would help relieve them and their caregivers of the pain and discomfort that comes with making these decisions.
Interesting reads
https://www.sciencedirect.com/science/article/abs/pii/S1526590008005440
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563356/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1764532/
Co-author: Belinda Sng Qi Rong