Fear

Doctor Collecting a Blood SampleNo one likes to be afraid. One of the most basic primal instincts is self-preservation, and fear is a response to a perceived threat to our own well-being. When we are afraid, our sympathetic nervous system gets activated, which raises our pulse rate and blood pressure, along with a whole host of body responses designed to get us ready to “fight or flee.”

What does that have to do with supportive care, you might ask? A lot. I was reading an article recently about the high cost of health care, the need for reform, etc. (are there any other kinds of articles out there these days?), and I was taken by the statement it made that visits to the emergency department are driven largely by fear.

Think about it…if you have a serious illness, and maybe you’ve been in the hospital not so long ago, it doesn’t probably take much to get you thinking about what might go wrong. A little pain here, a bit of feeling short of breath, and soon, the nervous system activates. I’d bet it becomes a pretty vicious cycle: you get scared, which makes you feel worse, which makes you even more fearful, and so forth. Little wonder that you’d make a trip to the ED, especially if it is the middle of the night.

If you are in a facility like a nursing home, your own fear may be only part of the equation. The nurse taking care of you, who is already overworked and drastically underpaid, and likely tired, does not want you “crashing” on her watch. The facility administrators do not want a problem with “bad” statistics – a complication, or worse, a death (even though a large number of us die in these types of facilities, but that’s a whole different topic).

When you read the definition of palliative care that was developed by the Center to Advance Palliative Care (CAPC), you see that palliative care is “an extra layer of support,” among other things.

For all the work going on around preventing hospital re-admissions, it seems that a focus on that extra layer of support could alleviate a lot of fear, reducing that neural activation. Maybe it is just as easy as that.

Something to think about…