Caring for People With Medically Unexplained Symptoms: Kron's "Well"

Do you need to permission to be ill even when you have a brain tumour? A Year to Live, A Year to Die tells the difficult story of Stewart Selman and his wife, Rebecca Peterson, who cared for him. We pick up the story after Stewart's catastrophic diagnosis of a brain tumour. Rebecca admits that there were low-points during which she threatened to send Stewart away because of his behaviour.

The juxtaposition of compassion, grief, anger and love in A Year to Live, A Year to Die will be familiar to many carers. This may be particularly true for people who are caring for someone who does not have permission to be ill. Both the caregiver and the person with the medically unexplained symptoms (MUS) live with ambiguity and uncertainty. They may be caught in a dispute with employers, medical advisers, or benefit assessors because they lack the 'legitimacy' of a diagnosis. It is possible that the burden of this ambivalence adds to the impact of the severity of the symptoms. It is a common finding in research literature that people with MUS have more negative views about their symptoms and the impact that these have had on their lives than do patients with a clearly defined and potentially disabling medical condition.

Dancing, video games, laughter and health

I’ve just learned about an upcoming project that will use movement and/or dance to promote the mind-body connection. The group is for people with medically-unexplained conditions who are referred to as revolving-door or heart-sink patients. The sort of patients who have an extensive history of investigations but no diagnosis to explain their symptoms. The same group of patients is targeted by Dr. David Beales for breathing re-training. His patients learn how to balance the body’s systems by improving the way in which they breathe.

A while ago I mentioned that bibliotherapy is available on the NHS in pilot areas and suggested that video games might not be that far behind. Mid Devon’s Primary Care Trust spread the message that laughter is good for you and that humour helps to make connections between people by its involvement in Off The Wall last World Mental Health day. Big Ideas in the North West offers stress management, complementary therapies, failure-free dance workshops and a rich variety of techniques to introduce health living support and boost the confidence of people with severe weight problems.

It seems as if there are some exciting projects out there, all of which are aimed at boosting the health of groups who are typically marginalised in some way by the traditional health care system. These projects all support the movement towards encouraging patients to be more involved in their own health-care and self-management of long-term health conditions. Importantly, these projects offer choice. Dance, movement, breathing re-training, self-help books, support groups, laughter and video-games might all appeal to different client groups. It will be interesting to see if the projects can attract further funding from PCTs and become both self-sustaining and more widely available.