Challenges for People Entering Rehabilitation

     

      For people who are diagnosed with pulmonary disease or heart disease life suddenly changes forever.  The physical toll and limitations a new illness presents is only the beginning of many unfamiliar challenges recently diagnosed individuals face.  How does this new illness affect activities of daily living?  Are lifestyle changes necessary in order to slow down the progression of the disease or prevent another event from occurring?  How has this affected the psychological well-being of this individual?  These are all important aspects of life that need to be addressed when people enter a program at the Center for Cardiac Fitness.

     During my time as an intern, I was able to spend a great deal of time with many people talking about their conditions and the challenges they face on a daily basis.  There were a few recurring themes I observed that seemed to be the primary challenges people encountered regardless of their diagnosis: behavior modification, acceptance of diminished ability to engage in activities of daily living, and psychological health contributed to the various challenges many people face when diagnosed.

 

Behavior Modification 

     

     By entering cardiac or pulmonary rehab each person is going be engaging in behavior modification regarding their current level of exercise.  The term behavior modification refers to changing lifestyle habits, for example quitting smoking or decreasing the amount of saturated fats one consumes on daily basis.  For all people entering rehabilitation program the exercise prescription they will follow will either be a continuation of previously established exercise, or for most people the beginning of an exercise program.  But establishing exercise is not the only goal for many people who enter the program.  Cessation of smoking cigarettes is a goal that is commonly addressed with patients who have a history of smoking.  Although once diagnosed with pulmonary disease or heart disease it is vital to stop current smoking habits, for some this is a challenging behavior to change.  Many of these people have smoked for decades and it is no easy task to simply quit cold turkey.  Social support from the staff and other patients and reminders of how critical it is to quit smoking along with additional assistance offered by the staff, especially the Psychologist and Dietician, all play a role in helping people modify unhealthy behaviors in an effort to reaching the goals set before them.  These tools are available to the patients who struggle with modifying behavior due to the lifelong habits they have formed.

 

Acceptance

 

  It is no secret that as we age activities of daily living can sometimes become difficult to accomplish, no matter how routine they may have seemed in the past.  This sudden change in capacity can be especially dramatic for those who have suffered a myocardial infarction.  After experiencing an event as serious as this, the physical toll is apparent to many people as they return to their normal daily routine.  As many patients have stated, they feel like they need time to regain strength and get back to where they were physically before the event occurred.  Not only could they be aware of physical limitations, but the psychological effect a serious MI can be limiting in as well.  Many people are cautious to engage in more strenuous activities due to fear of a second cardiac event.  Limitations put in place by Physicians, even if they are not welcome ones, also result in people having to deal with a lessened ability to do what they once could.  Instructions not to drive or lift heavy objects after a bypass surgery are commonly complained about by the people who are limited by them.  All of these factors contribute to the difficult road that is faced after suffering a major cardiac event

     Any person diagnosed with pulmonary disease certainly has the potential to experience the same difficulties mentioned previously.  For those in these cases especially, tasks as simple as waking to the mailbox can become daunting and sometimes impossible.  The sudden diminished ability to adequately deliver oxygen to the body’s tissues can affect all aspects of life and this loss in ability is difficult to work around and deal with.  Similarly to the strategies that can facilitate behavior modification, teaching people how to accept these changes and help them deal with them is an important part of the rehabilitation process.

 

Psychological Health

 

     One aspect of health that seems to be one of the more frequent issues faced by the people rehabilitating is psychological health.  Whether it be stress, anxiety, or even depression, it is not uncommon to hear people speak of the psychological strain being forced to live with a new disease or recover from a major cardiac event has.  Stress management is important for everyone, stress can contribute to factors that cause health problems, and the problems people experience with their health can result in even more stress, perpetuating the feeling of stress.  Learning how to manage stress is important for overall wellness and at the Center for Cardiac Fitness stress management strategies are frequently discussed.  There are education classes that focus specifically on stress management and meditation and relaxation is practiced on a weekly basis.  The staff Psychologist is also available for people who need more guidance with their stress management.

     Another aspect of psychological health that can be difficult to manage is depression.  All of a sudden life is changed forever once one is diagnosed or experiences an event and as mentioned earlier the ability to do what you once could, may be gone.  This realization can be very difficult to accept and becoming clinically depressed is a real possibility.  Just like stress management it is important to recognize potential signs of being depressed, and take steps accordingly to get the help that is needed.  It is hard enough adjusting to life with a serious condition and depression will only make everything more challenging.  Educating the patients to recognize signs of depression is a strategy for combating this problem.  Constant communication with the patients is key for picking up on potential problems and queues that could reveal someone is struggling psychologically.