Health In Aging Blog


Regaining Physical Resilience After Serious Illness

Barb Resnick HeadshotBarbara Resnick, PhD, CRNP
Professor
Sonya Ziporkin Gershowitz Chair in Gerontology
University of Maryland School of Nursing

I’ve been blogging here about my difficult recovery following months of cancer treatment. One thing I’ve learned: To fully recover, you must fight to regain your physical endurance and strength, also known as your physical resilience (see this earlier blog post about another important factor in your recovery, emotional resilience).

The advice I’m offering applies to you if you’re the one who’s experiencing the illness, and it’s also relevant if you’re a caregiver for someone living with a serious condition.

Getting Yourself Started

To regain your energy and strength, begin to resume daily activities as soon your healthcare team gives you the green light. Then, slowly but surely, you can increase the time you spend each day doing some form of physical activity. That can be easier said than done, especially when you’re coping with symptoms such as pain or fatigue. Here’s my advice: Start small and begin with the basics. As soon as you’re able, start bathing and dressing yourself. If these tasks are too challenging, talk with your healthcare provider and caregiver about small steps you can take to stay active given your own situation.

Walking is also a great way to recondition. I found during my own recovery that keeping up my usual routine, which involved getting up and exercising every morning, was helpful. Even when I needed to go to the hospital for intravenous hydration, I would consider that my morning walk. Over time, I was able to walk more and more, and I found that walking at 6:00 or 6:30am worked well—even on days when it was hot and humid. Walking is a great way to start the day and can help ease symptoms such as pain and a low mood.

Depending on the weather, the time of year, and the availability of safe walkable space in your community, you may have to be a bit creative. In the summer, for example, early morning walking might be the best—especially if drinking sufficient fluids for hydration is difficult. If outdoor walking isn’t an option but walking is still something you’re able to do safely, consider climbing up and down the stairs, walking in the hallway if you live in an apartment building or institutional setting, or just marching in place while you’re sitting or standing. When it’s safe to do so, putting on headphones and listening to a book or music can help make the time pass more quickly and pleasantly. Continue reading

Building Up Emotional Resilience: The Key to Recovery

Barb Resnick HeadshotBarbara Resnick, PhD, CRNP
Professor
Sonya Ziporkin Gershowitz Chair in Gerontology
University of Maryland School of Nursing

As I noted in an earlier series of blog posts, I’ve been dealing with an intense course of cancer treatment. During my treatment, I’ve come face-to-face with some important but difficult facts—and since I think many of those facts hold true for others dealing with serious chronic illnesses like cancer, I wanted to share them here.

First, I’ve learned that cancer treatment can be a real rollercoaster. Your emotional resilience—or your ability to bounce back from a challenge—can dip. Along my journey through a long, slow recovery, for example, I’ve experienced dark moments when my resiliency has all but faded. I know that many people who cope with chronic illnesses experience these difficult, dark moments—which is why it’s so important to recognize them when they appear.

I’ve also learned that losing your resiliency is often as hard on your caregiver(s) as it is on you. It’s tough when you’re the person undergoing treatment, but it can be equally painful for a caregiver to watch someone struggle with a difficult recovery. These are the moments when you need to say to yourself—or reach out to your loved one and say—“Please fight just a little bit longer.” Let’s look at some ways to make that possible.

Strengthening Your Resiliency Muscles

Where resiliency is concerned, what can you do to help yourself or the person you are caring for draw on inner strength for the road ahead?

Begin by recognizing the difference between physical and emotional resiliency.

We’ve already seen that emotional resiliency is your ability to bounce back from a challenge. Physical resiliency, on the other hand, refers to your ability to recover physical strength after you’ve undergone intensive treatments for cancer, surgery, or other serious medical conditions. Each type of resiliency can be impacted by an illness, and each person may respond to resiliency differently. Physical activity is something that I truly enjoy, for example, so remaining physically resilient was less challenging for me than maintaining my emotional resilience. You need both types of resiliency when you’re dealing with tough medical challenges. Let’s focus here on strategies for conserving your emotional resiliency (my next blog post will be on regaining physical resiliency). Continue reading

How to Be the Best Caregiver/Care Coach You Can Be (Part Two)

Barb Resnick HeadshotBarbara Resnick, PhD, CRNP
Professor
Sonya Ziporkin Gershowitz Chair in Gerontology
University of Maryland School of Nursing

Remember my recent blog post about being a terrific caregiver and care coach?  Here are some more tips based on my professional and personal experience.

Remember, Actions Speak Louder Than Words

You may not be an individual’s primary caregiver or care coach. You may just want to show you care. We all have people in our lives we really care about who have received some type of life-threatening or life-impacting diagnosis.  It could be anything from experiencing a hip fracture or a stroke, or a cancer diagnosis requiring treatment or palliative care management (comfort care).

It is hard in these situations to know how to respond and what to do.  Personally, I am a big believer in “actions speak louder than words.”  It never hurts to reach out to someone you care about who is undergoing treatment or who needs help and support coping with a long-term illness or disability.

Never be afraid to just DO or SAY something. Don’t be afraid to let the person know you heard about their illness and wish them well.  Show you care in any and every way.  Don’t hesitate because you are afraid you are intruding on the person’s privacy. If you heard about their illness, it is no secret!

Avoid Useless Gestures

Personally, I recommend against saying things like “let me know if I can do anything” or “call me if there is anything I can do.”  Essentially, when someone is ill they are not likely to pick up the phone and call for help.

Instead of empty gestures, provide words of encouragement that may have helped you in the past. For example, when I first started my course of radiation and chemotherapy, a colleague sent me a quote that Christopher Robin said to Winnie the Pooh:  “Promise me you’ll always remember that you are braver than you believe, stronger than you seem, and smarter than you think.”  I put this on my desktop and read it daily to help me through my own challenging treatment.  Continue reading

How to Be the Best Caregiver/Care Coach You Can Be (Part One)

Barb Resnick HeadshotBarbara Resnick, PhD, CRNP
Professor
Sonya Ziporkin Gershowitz Chair in Gerontology
University of Maryland School of Nursing

As someone who is generally the caregiver—professionally and as a woman, mom, wife and daughter—I have had the opportunity to learn recently what is most helpful when being on the receiving end of caregiving. My thoughts combine my professional work as well as the personal experiences I have had with the health care system and with some challenging health care issues.

There is a difference between short-term caregiving events (such as helping someone after a joint replacement, fracture, or cancer treatment), compared to long-term caregiving events (such as caring for someone who has had a major stroke or who has dementia or Parkinson’s disease).  The approaches recommended here can be used for both short- and long-term caregiving.

My most recent thoughts come from going through an extremely aggressive course of radiation and chemotherapy.  In this treatment, the health care team is focused on destroying cancer cells and not necessarily on helping the individual undergoing treatment cope.  Therefore, a caregiver, or what I like to think of as a “care coach” or “care champion,” is essential.  That role generally falls on family, friends, or co-workers.

Based on my experience, here are some ways to be a terrific care coach. Continue reading

Decisions, Decisions (Part 2)

Barb Resnick HeadshotBarbara Resnick, PhD, CRNP
Professor
Sonya Ziporkin Gershowitz Chair in Gerontology
University of Maryland School of Nursing

Let’s recap where we are in my story: When I last wrote, I talked about learning my diagnosis with esophageal cancer and working through the process of making care and treatment decisions.  I opted for additional scans to test for metastatic disease (cancer that’s spread beyond the original tumor), and I was able to do so for several important reasons: I decided, took charge, and planned for the possibility that a spot on my liver could be confirmation of metastatic disease.

Much to my amazement, I was informed that, in fact, the liver spot was simply a hemangioma (noncancerous growth due to an abnormal collection of blood vessels), and the oncology team was recommending a full blast treatment approach with a way more optimistic outcome than I believed possible. Thus, I weighed the possibility of better quality of life against the risk of treatment just making things worse.

I decided to go forward with treatment—a combination of 5 weeks of daily radiation, chemotherapy, and then surgery if the response to treatment was good. Surgery being the reward, as it is only done when cure of current disease is noted.

This entire process at my age (a few months from 60) made me realize that, no matter what age one is when diagnosed with a potentially life threatening disease, decisions around treatment are tough. Did I have things to look forward to? Of course: a recently awarded research project grant from the National Institutes of Health, a fourth grandchild on the way, and many other professional and personal goals I still wanted to achieve.

Many older adults have an equally expansive list of things they’re looking forward to. They will tell me they still enjoy playing bridge, want to finish a professional paper or book they are working on, and want to continue going to dinner with friends and seeing family. I will never again assume that an older adult does not want to pursue a treatment option when faced with a new and what might be life-ending diagnosis.

I have always believed my responsibility to patients was to inform them of the pros and cons of treatment options to help them decide on an approach most consistent with their goals. For older adults, cancer treatment or surgical interventions for cardiovascular disease may make their quality of life worse and even hasten death, but the decision to forego the treatment may still be difficult.

Whether you are a healthcare provider or a friend or relative of someone having to make these decisions: be open and supportive. and try to empathize. I still don’t know the outcome of my decision…but I am living with the consequences, doing the best I can to cope with the daily challenges, pulling on my own resilience and the resilience I have learned over the years in doing geriatrics, and hoping that I will come out on the other side and say it was a good decision!