A Way Forward by Keith Meldrum

Person-centred care.

While this is not a new healthcare concept, I would suggest that it is not a common model of care when treating and supporting people living with persistent pain. I fully acknowledge that there are individual practitioners and clinics that follow this philosophy but pain management in healthcare, by default, remains transactional.

What is person-centred care. One definition is that it “means treating patients as individuals and as equal partners in the business of healing; it is personalised, coordinated and enabling. It is not a medical model and should be regarded as multidisciplinary, recognising that a person may need more than one professional to support them. Working in this way means recognising people’s capabilities and potential to manage and improve their own health, not seeing them simply as victims of disease or passive recipients of care.” [1]

It defies comprehension to me that, in the 21st Century healrhcare education and systems concerning pain management continue to teach and establish a paternalistic model.

They are hierarchical.

Healthcare systems are engineered to treat the patient as subordinates, with an expectation of passivity. It replaces treatment of the individual with treatment of cohorts.

It treats the disease, not the person.

The concept of person-centred care is centuries old. Hippocrates (450 BCE to 380 BCE) is quoted to have said that “it is more important to know what sort of person has a disease than to know what sort of disease a person has”. [2]

Living with persistent pain is an immersive human experience; it affects every aspect of a person’s daily life. It is not logical to try to treat and support someone’s pain without treating and supporting the person.

Person-centred care is A Path Forward.

Pain BC

Pain Canada

References:

1, 2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465833/

A Way Forward by Keith Meldrum 7th October 2023

This post this not to be negative and definitely not support the concept of toxic positivity 

I was talking with someone recently about our respective health issues, and that of others who are dealing with worse situations. I disclosed that recently I had a difficult day following a conversation with my specialist about my symptoms progressing, which is expected as this is a progressive disease.

I was just surprised at the noticeable change that has occurred in the last five or six months.

Nonetheless, I was frustrated, angry, and disappointed that despite doing the

things that are within my control my symptoms are progressing (faster that I expected or hoped) and I had to admit that despite my best efforts I can not “win”.

With that, I don’t believe there is value in using terms like win, lose, battle, fight, etc. in reference to health conditions, but in that moment I told myself that I am I losing this battle.

I know that’s not helpful, but it was (is) how I felt in the moment. And afterwards.

I knew I needed to allow myself to feel all that and not pretend it was “fine”. I mean, it’s not. I talked to my wife, told her how I felt, and she didn’t try to make it better rather she supported me.

So many people are dealing with so many challenging things in their lives. By looking at one another we simply can not know what others are dealing with.

We need to give ourselves permission not to be okay, for a while. I don’t believe that we help ourselves if we overly focus on these moments, but I appreciate that saying that can be a simple view to a complex issue for some. But, in general, I suggest that it is necessary to allow ourselves to feel all the emotions of anger, frustration, disappointment, sadness, grief, etc. If there are things we can learn from these times, then we carry that new knowledge with us.

But sometimes it’s just about dealing with a challenging situation and experiencing the emotions that go with that.

Sometimes it’s about being a human being.

A Way Forward by Keith Meldrum 7th October 2023