Healthy Transitions

Your health through the ages

Helping a Sick Loved One

The importance of utilizing active coping.

Recently, my work intersected with my personal life and I was stumped. For the past year now, my grandmother’s health has declined. (Though, my goodness, at my age I am so lucky to even have a grandparent.) She has congestive heart failure (CHF) and mild dementia. In the months leading up to the holidays, her condition worsened rapidly. One morning, as I sat with my mother, her daughter, I felt lost as to how I could help make this easier for my family.

In a tearful conversation, I told her this, but then I did what I often do when stumped: I checked the literature to learn if others had the answer. And sure enough, I found a recent article in the Journal of Health Psychology by Natalie Hundt and colleagues (2013) addressing ways to help patients with CHF.

In this study of patients with a chronic illness, including CHF, the authors found that “illness intrusiveness,” meaning the extent that illness interferes with activities of daily life and its quality, was associated with avoidant coping strategies. Avoidant coping strategies include withdrawing from activities and perhaps even shying away from contact with others, including loved ones. Interestingly, avoidant coping is common among caregivers of those experiencing dementia. On the flip side, active coping involves the opposite sorts of behaviors like turning to hobbies and social support for distraction, and positive reframing.

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When I conduct research, one of my most important considerations is how will the findings “translate” in everyday life. In other words, how might this actually help others? And so, armed with Hundt and colleagues’ article, I have been trying to translate these findings into our lives.

We used to think that maybe visits, especially from my rambunctious 2-year-old twin boys, might be too much for my grandmother and tire her out. Now we think differently. She relishes this form of social support. Yesterday, I saw a glimmer in her eye as my boys tore through boxes of toys that my sister, cousins, and I had played with years ago. Although her activities are limited, it is important to figure out what aspects of active coping are feasible. For example, I have noticed that her memory has actually seemed better (a positive reframe) and I told her so (which I might have avoided talking about earlier). She was pleased to hear this and even joked that maybe I could help her cheat on the memory tests during her next doctor’s appointment.

It startled me when my grandmother deteriorated so fast. But, no matter where she is in her illness course, my own utilization of an active coping style is the best way to encourage the same for her. In this way, things do feel easier.

Liteature cited:

Hundt, N. E., Bensadon, B. A., Stanley, M. A., Petersen, N. J., Kunik, M. E., Kauth, M. R., & Cully, J. A. (2013). Coping mediates the relationship between disease severity and illness intrusiveness among chronically ill patients. Journal of Health Psychology. Advance online publication. doi: 10.1177/1359105313509845

Rachel Annunziato, Ph.D., is a professor of psychology at Fordham University.

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