Patients recently diagnosed with rheumatoid arthritis needs to be treated with respect, and we as health care professionals need to recognize and be able to identify and recognize that they (the patients) have emotions, ideas, values, feelings, hopes – by doing this we affirm him or her, their identities, their beings, creating a positive effect on their self image and self esteem.
For this to happen smoothly, we may have to setup the environment in such a way that it facilitates such an encounter, or we facilitate the patient using guided questions, or getting them to participate in “open” activities that will help them to express. Many times, a simple listening ear is more than enough. From here, we can identify and check if they have any wrong understandings, or had apostrophized their rheumatoid arthritis diagnosis, and correct them.
This does not mean that we belittle, ignore or minimize what they feel, think or believe, in fact even if the diagnosis and prognosis is not as good as we would like it to be, many patients with rheumatoid arthritis do not progress into severability disability and / or injury. With compliance to joint protection program, energy conservation program as well as consistent exercise, many end up with fairly good control and results post diagnosis.
We must not overlook the patient's spouse, family and relatives – they may need help to, to understand the disease, it's potential progress, their prognosis, living and adapting to the disease. Of course, they may have different attitudes and personalities to managing loss and pain, some may be protective, some may be resentful, some angry, some appear to have given up hope etc. Some may give up, as the fear of long term care for a person with rheumatoid arthritis may seem daunting, and future plans totally altered.
Some partners, spouses and families respond with utmost love, appreciation, dedication and being positive, some are unable to agree, some withdrawal, some even may choose to separate or divorce. There are many instances of role reversal, most often when the previous sole worker is diagnosed with rheumatoid arthritis – this sometimes becomes difficult for both partners or spouses to accept, causing loss of perceivable roles and self esteem, even resentment and anger for each other.
This plus financial costs of injuries as well as loss of potential incomes in the future, and this becomes a little more complex and painful. Social workers will be invaluable here, for family counseling, and to point in the direction of funding availability and help. Caregivers must be appropriately prepared and trained, and educated on the possibility of social isolation, burnout and stress. There needs to be a scheduled time for rest, relaxation and recreation.
Promotion of independence and mobility will be continued with by the occupational therapist.