„"No one is sick alone. Mental well-being is a team effort involving the patient, therapist, and caregiver together."“
Author
Monika Tempel, oxygen and meaning
Patient, therapist, caregiver
Typically, a chronically ill patient has a relationship with their healthcare provider on the one hand, and with their family members or other caregivers on the other. The term "caregiver" is derived from the English words "carer" or "caregiver" and refers to a person who does not provide professional care for the patient. The patient thus has two dyads (two-person relationships) with two different individuals. Healthcare provider and caregiver are not in direct contact with each other. A triad (three-person relationship) would be more helpful and desirable, in which each participant communicates with everyone else, including the healthcare provider with the caregiver and vice versa – provided the patient has given their consent. Caregivers are sometimes referred to as co-patients or second-order patients. They, too, can develop symptoms that may even resemble those of the patient. At the same time, family members are often co-therapists. They support the patient with practical matters or specific treatments, or they pass on information to others. In this context, family members are often caught between hope and worry.
Communication within the family during chronic illness
Being able to talk to each other about each other and share burdens is a true art. Successful communication within the family can significantly contribute to mental well-being. In reality, "speechless" couples who only talk about trivial matters are quite common. In cases of serious illness, this situation becomes a problem with far-reaching consequences. Patients often feel dependent on their partner and fear becoming a burden. The caregiver, in turn, wonders how they can bear all the burdens. This can lead to mutual feelings of guilt. Sometimes, one partner protects their partner from stressful experiences and consciously avoids difficult topics. This can lead to "loneliness as a couple." Communication takes place even in silence, because the body signals one's state of being. Eye movements and facial expressions around the mouth are particularly noticeable. Even if the other person says they are fine, one relies on their own gut feeling if they perceive a discrepancy. Mutual eye contact is an indicator of successful communication.
Coping with illness COPD
When dealing with chronic illness, it is particularly important to find ways to talk to each other about anxiety-provoking topics. Experts distinguish between different forms of positive two-person communication and coping strategies (dyadic coping): both people can share the burden equally, one person can bear a significantly larger share of the burden, or one person can ask the other for help and receive it. Harmful coping strategies include one person being malicious or hurtful to the other, communicating superficially due to a lack of interest ("it'll be alright"), or feeling overwhelmed and exploited. Previously, COPD was viewed as a disease that gradually worsens over time. Episodes of severe shortness of breath trigger feelings of helplessness, anxiety, and insecurity in both the patient and their caregiver. As the disease progresses, the patient becomes more confined to their home, and both the patient and their caregiver have to forgo many things that were previously important to them. In most cases, however, the course of COPD nowadays is more like a roller coaster ride, as stable periods of good health are followed by episodes of acute deterioration, from which one recovers over time.
