It’s one thing to deal with having a broken arm or pulled muscle — everyone has to face temporary setbacks in the normal course of life.
But it’s another thing entirely learning to live with a chronic condition such as diabetes or asthma, which take daily management and, most often, a change in lifestyle.
Leslie Gilbert coordinates the Lane Council of Governments’ Living Well program and teaches three classes: Living Well with Chronic Conditions, Living Well with Chronic Pain, and Living Well with Diabetes.
The free six-week classes help group members find support, manage stress, deal with fatigue and frustration, improve activity levels, improve communication between healthcare providers and family members and, in general, solve the problems associated with dealing with chronic conditions.
“The Living Well programs were created at Stanford School of Medicine and they are designed for adults with chronic health issues to work on their health habits and support their health, so no matter what their health issues are they can have a better outcome,” Gilbert says.
Classes include strategies such as how to work in exercise (every little bit helps), positive thinking, pain control and developing better relationships.
“The groups are peer-led,” she says. “All of the leaders of these groups have something we’re dealing with ourselves, so it’s not like we’re an expert shaking our finger at you. We help you plan, set goals and figure out what you can do differently.”
The diabetes class, for example, has an emphasis on monitoring levels — it’s not a medical class on how to use insulin, but it does provide support and information about sticking to a healthy diet. Caregivers also are encouraged to learn support techniques.
Gilbert, who grew up with her own chronic health issues, began teaching these programs in 2015, shortly after Lane COG took over coordination of the program locally from PeaceHealth.
“If we can make choices under our doctor’s care or within the medical system then we have things we can do,” she says. “That’s where my passion is. The real strength of it is to help people be more in control, because for so long medicine was about acute care. The doctor became known as the one who could fix everything, who knew the answer. There wasn’t a lot of investment to allow the patient to educate themselves and be in this for the long haul.”
Changes in the medical industry means patients are advocating more for themselves, which means figuring out more on their own what will and won’t work.
Yet many of us with chronic conditions need help and encouragement on how advocating works. “We’re starting to see that the daily choices we make can and do make things easier,” Gilbert says.
When life is challenging, it’s easy to lose track of the things that are actually going well. Gilbert suggests examining habits around sleeping, or starting a daily gratitude journal. Recognizing simple changes can make a huge difference mentally.
Katherine Witt, 78, is a graduate of the Living Well with Diabetes program. She’s been living with diabetes for 25 years and enjoyed the “refresher” that the class offered.
“There is a great deal of information available now online about diabetes,” Witt says, “and so you just feel kind of inundated with information about diabetes. The class is in a structured form so that makes it easier to be able to focus on various aspects of diabetes. It’s not covering everything willy-nilly.”
She enjoyed being with others dealing with similar circumstances and being able to openly share her thoughts and goals.
At each class, participants are encouraged to choose a specific goal for the upcoming week.
“Getting support in the class I felt was very helpful,” Witt says. “If your goal was to walk an hour a day, three days a week or something specific, then when you came back, you’d be able to tell the class if you succeeded or if there were some problems keeping you from reaching your goal. You felt that the class was supportive, and you felt accountable to them, so you really wanted to try to make sure that you fulfilled your goal.”
A safe space
Gilbert feels it’s important her group members feel safe asking questions. “People are emotional sometimes and there can be a lot of fear and grief and other emotions that come up,” she says. “Although we are an educational program, a lot of the time the most valuable thing is that they are in a room with people who share many of the same things they share. They can see that they are not alone.”
It’s a chance to talk about the things group members are struggling with. “One thing we talk about is how we get health information that is reliable,” Gilbert says. “A lot of information is basically scams.”
When you’re dealing with a chronic condition you get fatigued. You may have an inability to sit or stand for very long which makes events like a doctor visit or daily chores a struggle. Gilbert can suggest modifications, such as sitting on a stool when doing food prep or using adaptive tools for gardening.
“We talk about the idea of being able to pace yourself and plan your day, so you keep your energy,” Gilbert says. “Being able to break down activities into smaller chunks allows people to do more and keep their enjoyment of the activity. So much of it is mindset — this isn’t about curing your chronic pain because that isn’t easy to do but, to use the analogy of a pain scale, we can bring you from an 8 to a 6, or give you periods of time in your day where you’re able to cope better.”