In Hong Kong, over 70% of elders suffer from one or more chronic illness(es). Chronic illnesses can create stress in elders and the carers, both physically and psychologically. Apart from impairing physical and mental health, chronic illnesses may also have negative impact on occupational and social functioning and thus affecting the quality of life of the elders and the carers.

Recognizing the psychological changes and adjustment difficulties brought about by
chronic illnesses can facilitate adaptive coping. The following tips aim at helping elders
and carers to maintain both physical and mental wellness and live in a positive manner.

What are the Stressors of the Patient and the Carer?

1. The patient
   • Has to undergo long term treatment and medications and bear with the subsequent financial burden
   • Worry about deterioration and relapse, and grief for the loss of health and independence.
   • Frustrated about the lack of progress, feeling defeated and worthless.
   • Difficulties in role change, such as changing from the role of a carer to that of a care recipient, affecting family and marital relationship.
   • Feel that he or she is not understood, gradually isolating himself or herself.
     
2. The carer
   
   • Has to take care of the patient’s needs in daily living, such as preparing meals, bathing, and ensuring compliance to drug regime while worrying about the health of the patient, leading to burnout.
     
   • Has to sacrifice personal entertainment and social life, hence weakening social support.
   • Stress in handling emotional and behavioral problems of the patient.

What are the Adverse Effects of Inappropriate Stress Management?

• Deteriorating Health: Inappropriate coping may lead to deteriorating health and may even endanger life.
  
• Oversensitivity to and anxiety over bodily signs: sometimes the patient takes on the ‘sick role’ in daily life and develop increased dependence on others.
• Dysthymia and Suicide: Dysthymia or chronic low mood is quite common among the chronically ill, with prevalence rate four to five times higher than that of the average population. Some of them even contemplate suicide.

Strategies for Coping with Chronic Illness

1. Acquire Necessary Knowledge and Skills

• Understand the illness actively by consulting health care professionals and reading relevant reference books.
• The carer may acquire nursing skills to meet the specific needs of the patient in order to provide appropriate support.

2. Be Optimistic and Think Positive

Positive thinking and an optimistic attitude can increase the patient’s compliance to treatment regime and can motivate them to adjust their lifestyle (e.g. quit smoking and alcohol use, giving up fatty foods), thus help to promote healthy living. Moreover, the patient should continue to participate in activities of daily living to improve self care abilities.

3. Practise Healthy Lifestyle

It is of vital importance to maintain healthy lifestyle for good health. Here are a few practical tips:

• Observe good sleep hygiene.
• Regular exercise can help to relax the body and boost up the immune system. To increase the fun, invite friends to join you!
• A balanced diet is important. If the appetite is not good, have ‘frequent small meals’ and choose food that boosts the appetite. It is helpful to share food with family and friends.
  

4. Build up a Support Network

Regular social life helps to increase confidence, improve mood and promote a positive attitude. Keep an open mind and accept the care and support from relatives and friends. Seek advice from health care professionals and share with other patients. Remember social isolation is not a natural consequence of chronic illnesses.

5. Pick Your Own Relaxation Strategies

Try relaxation exercises, such as deep breathing relaxation, progressive muscular relaxation, Tai Chi or listening to music. These help to break the vicious cycle of excessive anxiety迳deteriorating health迳escalation of anxiety迳 fluctuating course of illness, which can be brought about by anxiety.

6. Act Smart & Seek Help

There are many different organizations that provide services and support to the chronically ill and their carers. Check out the elderly centres nearby.

If you still feel very stressful after trying the above methods, you should seek professional help. Call the hotlines below for assistance:

Hotline of Social Welfare Department: 2343 2255
Mental Health Hotline of Hospital Authority: 2466 7350
Hong Kong Society for Rehabilitation: 2794 1122