After earning my first degree as a double major (Biology and Applied Mathematics) I worked for a variety of companies. Pharmaceutical, Pharma-development and Medical Devices with, and without, pharma piggy backs for the past 21 years. However, after going through my third downsizing in that time I am back earning my Bachelors in Applied Psychology with plans to certify as an End of Life Doula working with Hospice patients and their families/support system(s). I live about 30 miles North and a bit West of Boston, MA with my 3 cats and hope to resume being a Host Parent for international teenage girls attending high school once I am working in my new field.
My primary academic interest is the process and effect our hormones and body chemistry have on our psychology. How does a change in brain or endocrine chemicals change or effect our behavior, moods and coping skills. What specific adjustments to care and interactions with a Hospice patient need to be undertaken to provide the best standard of life for them as they transition from this existence to the next – however they perceive that next level/place to be.
When considering the discussion topics I see a very clear delineation between HEALTH and WELLNESS. Specifically as they relate to Hospice Care – HEALTH is the measurable functioning of individual body systems in order to assess the overall functional level of that body (aka our “meat suit”). These measurements provide data that can be used to adjust levels of medication, hydration, nutrients and pain management options. This for me is the technical part of caring for the physical body, similar to the maintenance and care that is required to keep a vehicle in optimal operating condition.
WELLNESS is a less definable measurement, and is completely subjective to the person involved. What one person sees as optimal conditions for wellness (an isolated cottage surrounded by gardens and livestock with limited technology and two close friends in a nearby village), another may view as borderline torture. What we define for ourselves as the optimal levels of physical endurance, social interaction, proximity to modern amenities, or income sources depend largely on our personal history and psychology. Both of which are fluid and do change over our lifetimes. As we grow and evolve as people, our requirements for feeling WELL will adjust as well.
Working with, and caring for, my mother as she went through the dying process clearly highlights for me the difference between HEALTH and WELLNESS. She died in June of 2015 from kidney failure, brought about due to diabetes and the effects of a serious injury that required several surgeries, over-dosage or certain medications, and two bouts of c-diff followed by a heart attack over a period of three years. So from the data alone her HEALTH was not only seriously compromised, by most accepted definitions it stunk. She was clinically very Unhealthy. And yet – she still had her WELLNESS. She had dozens of loving, caring friends spend time with her at home. Her children and grandchildren adored and respected her. She had a husband of 52 years who would do anything she asked. Her spirit was at peace, her heart unburdened with regret or “I should’ve dones … “ Her faith was solid and abiding and she knew she was in control of her decisions up to the end. These factors are what made her WELL even as her physical body was shutting down.
By using the four lenses with each person, or situation, I have faced, and will face in the future, a more complete understanding of the optimal way to address each situation will benefit the family and patient.
- History – is there family history of a disease state or illness. Have there been traumatic events that led up to their condition being what it is currently.
- Sciences - How does the patient react to specific chemicals / foods / medications etc. Is it necessary that their air be filtered in order to facilitate easier breathing? Do they require specific foods for proper system function?
- Humanities – What has brought the person joy or comfort throughout their journey here? Do certain pieces of music cause pleasant or painful memories – are either emotion wanted? What has been their unique way of being in the world? Are they known as the Hostess, Nurturer, Hermit or Aloof. What expressions of creativity do they wish to have around them during this time?
- Social Sciences – How has the person interacted with their family, culture, social groups, neighbors? Are there relationships they want to mend, things that they have left unsaid or apologies that they want to make. This can help not only the patient but those left behind. Clearing the air of long held hurts or grudges unburden both people and let the transitional processes happen more effectively.
SOURCES
Chambers, R. A., & Wallingford, S. C. (2017). On Mourning and Recovery: Integrating Stages of Grief and Change Toward a Neuroscience-Based Model of Attachment Adaptation in Addiction Treatment. Psychodynamic psychiatry, 45(4), 451–473. doi:10.1521/pdps.2017.45.4.451
Prilleltensky, I. (2013). Wellness without fairness: The missing link in Psychology. South African Journal of Psychology, 43(2), 147-155
Shaughnessy, J. J., Zechmeister, E. B., & Zechmeister, J. S. (2015). Research Methods
in Psychology. 10. New York, NY: McGraw-Hill Education.
VandenBos, G. R. (Ed). (2010). Publication manual of the American Psychological
Association (6th ed.). Washington, DC: American Psychological Association.
No comments:
Post a Comment