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Sunday, 28 June 2015

Becoming an Active Self-Manager of a Chronic Illness

I recently did a short overview of self managing a chronic illness but now I am going to talk to you about actually becoming an active self-manager because it is impossible to have a long-term condition without being a self-manager of some kind.

Like I said previously, people deal with their chronic illnesses in different ways, some people manage by withdrawing themselves from life and their illness becomes centre of attention and some people, with the exact same condition and symptoms, somehow manage to get on with life. The difference between the two is not the illness or the symptoms, it is rather how the individual person DECIDES to manage it.

Self - Management is always a DECISION; a decision to suffer in silence or seek help, a decision to do something or do nothing.

Active self-management is a skill and like any other skill it must be learned and practiced. You are the manager therefore you set your own goals and aim to achieve them. Have a think about the following things:

1. Decide what it is that you want to achieve.
2. Look at all the different ways of accomplishing you goal.
3. Make a short term action plan, carry it out and check the results.
4. Make any changes needed.
5. Reward yourself for your success.

Firstly, we will look at Problem Solving.

Problems usually start with a general feeling of uneasiness and you may feel unhappy but just not sure why? On closer examination, you realise what the problem is... 

You are feeling alone and isolated because you haven't seen your family in a while due to not feeling well and them living too far away. 

Now we have the problem identified you decide to take steps to go and visit your family. But it's not that easy when you have a chronic illness. It would be irresponsible and may affect your health if you simply just jump straight in. 

Now you know what it is that you want to accomplish, you need to make a list of ways in which you can achieve it. 

The trip will seem overwhelming as there is much more to prepare for when you have an illness but nothing is impossible if you plan ahead. Before you became ill or before symptoms became problematic  you would have simply got in the car and made the journey but now you find driving tiring. 

You could consider leaving early in the morning and take regular breaks or maybe leave later on in the afternoon and stop in a b&b, making the journey over two days. There is also a train that you can take and stops 20 miles away from your destination or you could always fly. After a lot of thought you decide to take the train. 

To prepare yourself for the trip it is best to write down the steps necessary to make it a reality. These include: 

- Deciding on the best time to go. 
- Buying your train ticket.
- Working out how to handle your baggage. 
- Working out how you will get to the station.
- Wondering if you will be able to walk about on the train to use the toilet or get food. 

You can put these required steps into an action plan. You will phone the rail services to find out what they can help you with. You also decide that you will walk a short distance each day including a couple of steps and build this up so that you will be steadier on your feet when it comes to making the journey.

A week later you check your results. The phone call you made to the rail services answered a lot of your questions. They are able to provide extra help for people with mobility problems and have ways of dealing with many of your concerns. Although you have been walking short distances each day you are still unsteady on your feet and are worried about walking. You decide to speak to a physiotherapist and they suggest using a cane or walking stick. You are not keen on this idea as it is something you have avoided for as long as possible but taking time to think about it, you realise that using a walking stick will give you the extra security needed on a moving train and decide to go ahead. 
This is simply problem solving in order to achieve your goal. You are now able to take the trip. 

Here are a few step in problem solving and can be used for almost all of your problems:

1. IDENTIFY the problem: This is the most important step in problem solving, it can also be the most difficult step. For example, you may think that the problem is that you can't climb the stairs, when infact the real problem is the fear of loosing your balance and falling down the stairs.

2. LIST all the possible way of solving the problem: You may be able to come up with a good list yourself but don't be afraid to ask other people for help with ideas but be clear on what the problem is. For example, there is a big difference between saying you are unable to walk because your feet hurt and saying that your feet hurt because you are unable to find walking shoes that fit properly.

3. CHOOSE one of the ideas from the list to try: It can be difficult when trying something new but be sure to give your potential solution a fair chance before deciding it won't work.

4. Once you have given your idea a fair chance, check the results. If all goes well, your problem will be solved. 

5. If necessary, TRY again: If your first idea didn't work then choose another and try again.

6. Use other RESOURCES: You could involve other people from your circle of support for more ideas on ways to solve your problem.

7. If the problem is still unresolved: If you have exhausted all of your ideas and your problem is still there, you made need to accept that your problem is insoluble. This is sometimes hard to admit and in no way means you have failed. The fact that the problem can't be solved immediately doesn't mean that it won't be later on, nor does it mean that other problems cannot be solved. Don't give up. 

Next we will look at, Making Decisions: Weighing the Pros and Cons

Making decisions is part of problem solving and is an important part of self-management. Here is a useful process: 

1. Identify the options: You made need to make a decision about getting help in your home to carry out everyday tasks or continue to do all the work yourself. 

3. Identify what you want: Identifying your deepest, most important values, like spending time with your family, helps you to set priorities and increase your motivation to change. You may feel like you want to carrying on your life as normally as possible but by pushing yourself you will have to sacrifice other things. 

4. Write down the pros and cons for each option: Taking into account the emotional, social and physical effects, write down as many items for both pros and cons. 

5. Add up the ratings for the pros and cons columns and compare them: you should go with the column with the highest ratings or if the totals are close or you are still not sure, skip to the next step.

6. Apply the gut test: If something feels right to you then you have probably reached a decision. If you are unsure then you should probably leave it to the math of the pros and cons. 

Here is an example: 


The decision in this example would be to get help because the pro score is (11) which is significantly higher than the con score (7). If this feels right in your gut, then you have the answer. 

We will now look at Taking Action: 

Taking action is key to successful problem solving and decision making. 
You have made a difficult decision or have looked at a problem but knowing what to do is not enough. It is time to take action and here is what to do: 

1. Setting your goal: You need to decide what it is you want to do before you can take action. Make sure you are realistic when setting a goal. Some goals can seem like dreams because they are so far off, or so difficult that we are overwhelmed and don't even try to accomplish them. 

2. Work out how to reach your goal: There are many ways to reach any specific goal. The job here is to list the options and then choose one or two to try out. When choosing your options be cautious because many of your options are never seriously considered because you assume that solutions do not exist or are simply impractical. Never make this assumption until you have thoroughly investigated each option. Assumptions are major enemies of self-management. 

Now make an Action Plan: 

Take things a week at a time, what can you achieve within the next week? This is called an action plan: something that is do able, and sets you on the road toward your goal. When making an action plan, it should be something YOU WANT to do, not something you feel you should do to please others. 

Action plans are the most important self-management tool. There are many things we can do to make us healthier but we fail to do them. An action plan 

Here are the steps of an action plan:

1. Decide what you will do this week. Make sure you are action specific. For example, rather than saying you want to loose weight, this is not an action but a result of an action; you will replace crisps for an healthy snack like an apple. 

2. Make a specific plan: WHAT are you going to do? HOW MUCH will you do? ( this question is answered in terms of time, distance, portions, or repetitions.) WHEN will you do this? HOW OFTEN will you do the activity? 

Deciding on Some Guidelines

1. Start where you are and start slowly. 
2. Give yourself some time off. 
3. How sure are you that you can complete this entire plan? Score yourself on a scale of zero to ten, zero being totally unsure and ten being totally certain. If your score is 7 or more then your goal is realistic. 
4. Write your plan down and place it where you can see it every day. 

Carrying out your action plan and Check the Results:

At the end of each week, see if you have managed to complete your action plan. If you are having problems this is the time to use your problem solving skills. 

Rewarding yourself:

The best part of being a good self-manager is the reward that comes from accomplishing your goals! 

I hope this helps and if anyone has any questions please feel free to message me xx



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