3 strategies for caregivers facing medical uncertainty

No one likes living with uncertainty, especially concerning people for whom they are caring. How can family caregivers live with at least some medical uncertainty without greater anxiety and

anguish? Here are some ideas: ASK ABOUT DIFFERENT MEDICAL INFORMATION A care receiver’s diagnosis provides a great deal of helpful information, but not knowing it does not mean family

caregivers need be clueless about what to expect. As Northwestern University family psychiatrist John Rolland has pointed out in his book _Helping Couples and Families Navigate Illness and

Disability_, doctors often can distinguish among three possible phases — initial crisis phase, chronic and terminal — of many illnesses. The initial crisis phase is generally considered the

first six months of a condition, when the chances of curing it are higher. The chronic phase is when the condition, such as diabetes or arthritis, is not likely curable but will need to be

managed indefinitely. The terminal phase is when the disease, such as kidney failure, has reached its end stage and the care receiver will probably die soon. Without clear direction, many

care receivers and caregivers believe an illness is acute when it is likely chronic, or chronic when it likely has become terminal. For instance, without a medical diagnosis, Hal and Corinne

thought his condition was still in the acute or curable stage even a year after he started having symptoms. It was only when she stopped asking the doctors “What is Hal’s diagnosis?” and

asked instead “Is his condition acute or chronic?” that Corinne learned his condition was likely chronic. She was then able to shift her energies from fixing him to helping him live as well

as possible with the symptoms he had. FIND YOUR BEST GUIDE Consulting with a guide familiar with the terrain may help caregivers live with medical uncertainty. It can be a trusted primary

care provider with general knowledge of a medical area or a specialty provider, such as a neurologist or rheumatologist, with more specific, though imperfect, knowledge. It can also be

someone without a medical background at all. Some caregivers’ best guide is someone with the lived experience of having been through similarly uncertain caregiving who can commiserate and

share what worked for them. It can be a good friend or mental health professional who can provide emotional guidance. It can be a faith leader to help strengthen one’s resolve in the face of

not knowing. SEEK ACCEPTANCE, NOT UNDERSTANDING Most of us try to be logical. We approach solving any problem by learning its cause, seeking the right remedy and then taking the prescribed

actions to fix it. But caregiving often requires that we suspend this logic. To adapt, we sometimes must set aside the question of why a care receiver is ill or disabled to accepting that

its cause and remedy may forever remain unknown. Like early American explorers forging ahead into the wilderness, we feel our way forward hill by hill without a good map but with the faith

we will respond with thoughtfulness and concerted effort to any challenge we meet.