Health Coaching for Patients With Chronic Illness

As a health coach, I occasionally get a question from a random person who wants to know what a health coach really does and what value they bring to the table. This article really does a nice job of summing up what a health coach can do, particularly in a healthcare setting.

Health coaching is one of those somewhat new and emerging careers that still needs some explanation. Think of it this way, at some point in anyone's life -- particularly during times of exasperation when goals have not been reached or coming to terms with an illness which has not quite registered with the individual -- that person could use a little helping hand.

Wouldn't you be better at reaching a goal if you had good support from a someone who was cheering you on and simply supporting you emotionally? Wouldn't you be more prone to accept that a chronic disease like diabetes isn't the end of life, but could simply be the start of truly taking care of oneself with proper social support and proper understanding? In talking through issues that are troublesome or even thought-provoking enough to the patient/client without their complete understanding of their current condition is hard enough!

As this article further points out, Health coaching encompasses five essential roles:

(1) Providing Self-Management Support: Here a coach can help with various aspects from teaching disease-specific skills, promoting healthy behaviors, providing emotional support and encouraging the patient to be part of their own solution.

(2) Bridging the gap between clinician and patient: It is hard enough for a patient to be given a new medication that they've never taken before for a newly-diagnosed illness, but if they don't truly understand the 'why's' of taking the meds in the first place, that could lead to confusion and neglect. It helps the patient in knowing they are being heard and also that there is someone there to help them  better navigate current obstacles or needs they may have, wouldn't you agree? What about questions they may have regarding cultural issues or other personal barriers?

(3) Helping Patients Navigate the Health Care System: Particularly for the elderly or more soft-spoken patient, many times they may need assistance with who they should follow up with or where they should go for certain tests or programs. It is helpful to have a voice for those that may not believe they are heard.

(4) Offering Emotional Support: While many clinicians give excellent information to the patient, it may be too rushed or not thoroughly explained to the patient. This is also where a health coach can step in and provide emotional support once trust and rapport have been established with the patient.

(5) Serving as a continuity figure: Despite a patient going to all designated appointments or taking medications when they should, who checks in on them from time to time to make sure they are following a healthy routine of taking care of themselves? Again, a coach is there to 'connect' with the patient and make sure that they are heard and benefiting from good self-care.

All in all, health coaches have been shown to provide excellent support and knowledge to bridge the gap between clinician and patient. Think of it this way, doesn't a student who is having a hard time in a class like statistics benefit from having a tutor so they can get a good grade? Of course! The same goes for a patient who is having a difficult time coming to terms with their own personal situation -- they need to know they are heard and understood. Even if a client's particular goal is not necessarily disease-related -- such as losing 10 pounds -- it helps to consult with a coach that can hold the client accountable enough to really instill good, positive behaviors that can ultimately keep disease off the radar!

Don't Nudge Me: The Limits of Behavioral Economics in Medicine

How do we get better at resisting the everyday temptations that exist in our environment? What are the everyday temptations you may ask? How about the overabundance of quick and easy fast-food "drive-through windows" or the easy access to a quick and easy snack that you can pick up at just about anywhere. To add to the lack of healthy options that our environment offers the everyday citizen, how "walkable" is your neighborhood and how safe is it to walk there at any given time of the day or night? 

To add more fuel to the fire, local food markets that meet daily needs (by offering healthy food choices), safe housing, access to adequate health care services and social support are frankly...lacking in supply -- especially in lower-income households. If we take just one aspect from those above-mentioned determinants of health like access to health care, then how do we ensure that those patients then comply with properly taking care of themselves? This is where the limits of behavioral economics in medicine comes into play. "Lessons to be learned from behavioral economics can be used to create environments that nudge people toward wiser decisions and healthier lives".

This also prompts the inquiry to behavior change being added to the mix of complications that affect overall population health. Particularly with those that suffer from chronic lifestyle illnesses such as diabetes, there happens to be an exceptionally high risk of those that don't comply with following treatment of their illness. In fact, The New England Journal of Medicine about 10 years ago estimated that up to two-thirds of medication-related hospital admissions in the United States were because of noncompliance, at a cost of $100 billion a year. So how can we improve medication adherence for chronic health problems effectively? 

The bottom-line is that it is very difficult for patients to change their behavior. Changing behaviors that are so firmly established can be a daunting task! But, what if there was a way to communicate more effectively with the patient or client to understand where "there head is at" rather than simply telling them what they need to do to get better? How can their compliance improve if clinicians, therapists or those that work closely with the public don't bother to first meet the patient where they are and build rapport and trust? How can we tackle so many of our healthcare concerns that are largely lifestyle related through wiser and more effective approaches? To a large degree, building our society's self-efficacy through various channels of communication by putting the responsibility of their wellbeing on their shoulders can be a positive approach if taken one step at a time. This clearly would be a work in progress.

In the words of Lou Holtz, "Life is ten percent what happens to you and ninety percent how you respond to it". Those words seem pretty wise to me, what do you think? 

Junk Food Is Made To Be Twice As Distracting As Healthy Food

Just yesterday I was at a work-related event where lunch would be provided. Some of the participants brought in their left-over Halloween Candy simply because they no longer wanted it in their house! While I can't blame them, there is no reason to 'unload' it on the innocent who are trying to stay away from the stuff!

Interestingly enough though, a little can go a long way. In other words, try limiting yourself to one or two 'fun size' candies and believe it or not, that should be enough to satisfy the sweetest of the sweet tooth individual! 

Another great reason to limit yourself to one or two 'fun size' candies, can be seen in the results of the two-phase study conducted by Corbin A. Cunningham of Johns Hopkins University Department of Psychological and Brain Sciences. (You can read more about the study at the link provided below). In many ways, the study shows that indeed a little can go a long way when it comes to what a 'complete deprivation of certain foods mindset' can do to trick us into going down the path of junk food overload!

What would you do if you were told you could never ever ever have a piece of dark chocolate caramel (or whatever your go-to junk food choice was) ever again? You'd probably want to go crazy and have as many as possible, right? Complete deprivation just doesn't work -- moderation works better. 

The long and the short of it is -- based on the information from the study and the way we are behaviorally wired, it is simply healthier to have a mindset that sets us up for successful and doable baby-step behavior changes rather than one of unrealistic goals, wouldn't you agree? 

It's Not Your Fault Junk Food Is Twice As Distracting As Healthy Food