Chronic Illness Versus Normal Illness
Dyer (1990) compares the process of “normal” and “chronic” illness:
We usually expect to follow a pattern that is characteristic of most illness. “The person has an illness and falls from the path of normal health. Then, comes a period of diagnosis and treatment followed by a period of convalescence (the general recovery of health and strength after illness). Finally, the person returns to good health again” (p. 251).
The person is supported, typically, by family, friends, neighbors, and their church community during the illness, treatment, and recovery, assuming that at some point the person will return to normal health and their assistance will no longer be needed (p. 251).
However, in the case of the chronically ill, a different cycle occurs. In the chronically ill, the person loses his normal health. He goes through a period of treatment and sometimes recovers. “But for a number of reasons, depending on the illness, the person does not return to a condition of normal health but continues in a fluctuating pattern of chronic ill health. The person may have periods when he feels better or worse, but at no time does he ever return to complete good health.” (p. 252).
According to Dyer (1990), “Unfortunately, family members, friends, and neighbors do not know how to respond to this unfamiliar pattern, and they usually shift their attention away from the chronically ill person as others with the more normal cycle of sickness occupy their attention” (p 252). At this point, the person with the chronic illness feels a lack of support, understanding, and help. This can lead to increased pain, depression, and anxiety.
There are different ways the chronically ill patient deals with the persistent poor health:
- The person may experience depression and apathy and feels like giving up
- The patient may fluctuate between two opposing ways of handling the illness
- “I’m not going to let this get me down; I’m going to try to live my normal life” This person will try to assume normal duties in the home, community, or church but is really not well. Everyone around the patient is relieved but patient is really not well and may be resentful or distressed by the expectation to live a normal life.
- The person may avoid seeming well to avoid being reburdened with old duties, with the expectation that others will help. (p. 253).
It is as though people think that one is either sick or well, not acknowledging the fact that there are intermediate degrees of sickness and health. Because the person continues to live with illness, that person becomes preoccupied with getting better and the treatment and symptoms become the center of his thoughts and actions. Others may begin to avoid the patient. The ill person may find it difficult to respond to simple greetings such as “how are you doing?” The sick person may respond with, “I’m OK”, as to not complain (p. 254). A more honest response might be, “I’m about the same but I appreciate your concern”. It is difficult for people who don’t live with chronic illness to understand.
It is very difficult for family members, such as spouses, to deal with the person with chronic illness. “Chronic illness can disrupt and divide a family, or it can provide the family with an opportunity to grow in understanding, patience, sacrifice, and love for one another” (Dyer, 1990, p. 256).
For the chronically ill person and his family, the friends, neighbors, and church can either be a source of support and help or elicit feelings of neglect, rejection, and misunderstanding. Most people help at the beginning of the illness, but then become confused when the person doesn’t get better, so they withdraw their attention (p. 256).
Here are some ideas for helping the chronically ill person and family:
- Discuss in some detail with the person how his illness is affecting him and his family and find out what his needs are
- Make short visits to not overtire or over stimulate the patient
- Send a card or make a short phone call to the sick person
- Look for ways to help with young children
- Send a small gift
- Avoid saying things to make the person feel pressured such as “I hope you can come back to church every Sunday now”
- Don’t ask, “What can I do to help?” People don’t like to have to ask for support. Express sensitivity and go ahead and do something (p. 258).
Dyer, W.G. (1990). Chronic Illness. In R. L. Britsch & T.D. Olson (Ed.), Counseling:
A guide to helping others, volume 2, 250-259.