INTRODUCTION:
I didn’t set out
to learn the four “P’s.” One evening during the period when Mike was receiving
hospice services (2019 or 2020), my older son and I were having a conversation
in the car. I can’t recall how the topic of life lessons came up, but my son
asked, “What have you learned from Dad’s illness?” The first word that popped
out of my mouth was, “patience,” followed quickly by “prayer.” Later, as I
thought further, “perseverance” and “poco a poco” (little by little) were
identified.
People have
commented, “You are so patient,” or “You are a prayer warrior.” I did not
intentionally identify these character traits as goals for my life. I learned
these lessons simply because there was no other way around or through what I
was facing. Mike’s diminishing energy meant things had to be done slowly,
little by little. We experienced situations where there were no human answers
and prayer was the only option. Chronic illness is chronic, so perseverance is a skill that will be developed (whether
we plan it or not!).
Because the
lessons are learned slowly, we may be surprised when someone says, “You are so
patient.” As we learn these skills over time, we will be able to recognize the
power of prayer and that answers to prayer and God’s timing may not be immediate
(perseverance, patience, poco a poco). An example from our experience is the
story of “The Miracle Machine,” which I will describe in a separate essay.
THE FOUR “P’s”
by Gail K. Kachnycz; 01 March 2021
The care giver for
someone with chronic illness will learn “The Four P’s:”
1. Prayer
2. Patience
3. Perseverance
4. Poco a Poco (little by little)
PRAYER
“I have been driven many times upon my knees by the overwhelming conviction that I had nowhere else to go. My own wisdom and that of all about me seemed insufficient for that day.”
-Abraham Lincoln
The circumstances
of chronic illness may be so overwhelming that we find ourselves driven to our
knees, figuratively and perhaps literally. Since we find ourselves in this
posture, prayer is the natural next step. The type of prayer is not a rote
repetition of a memorized verse of petition. It is a heartfelt outpouring of a
person’s thoughts and feelings; true communication with God.
Prayer may take
many forms. “Pray-reading” the scriptures involves reading verses that state
the truth about God’s character and His purpose and promises for us, then
agreeing with them. This may be done quietly in our spirits, spoken with our
voices, or written in a journal. The person with chronic illness and/or the
care giver may surround themselves with prayer supporters. The groups may be
small (2 or 3 gathered) and increase in numbers of participants (see Blog Post on Prayer Circles). Praying with others provides immediate support and seeing the
answers to specific requests is encouraging to the person in the center of the
circle and all who surround them.
Prayer is powerful. Other aspects of prayer for those with chronic illness and for their care givers will be addressed more fully in other articles.
PATIENCE
The care giver of
a person with chronic illness will learn patience. Expect this and plan for
this.
Chronic illness,
by its very nature, will cause impaired physical function and possibly affect
mental abilities. Activities of daily living, such as hygiene, bathing,
dressing, eating, walking will take more time. Allow the loved one to do as
much as they can for themselves. This will help preserve not only their level
of function, but their independence and sense of dignity.
The ability to
think quickly or speak quickly may be impaired. Fight the urge to supply words
or complete the end of sentences. Wait, wait, wait. Allow the loved one to find
the word or thought and express it. Conversations will be slower. Get used to
the slower pace.
The chronically ill person may be well aware of their decline and be frustrated by this. It can be very hurtful if they vent their frustration in your direction. Learn to recognize what is happening. Be patient, examine your own heart, and when you can talk to the person without defensiveness or retaliation, talk it over and clear the air. Don’t ignore it; this will lead to resentment.
PERSEVERANCE
There is no
escaping chronic illness, so you will learn to persevere. A care giver may want
to leave the situation if he or she is feeling burned out, and there is no end
in sight to the demands of care giving. Respite breaks, self-care “me” time,
prayer partners and counseling support should be in place to address the stress
of care giving.
The journey
through chronic illness and care giving will provide plenty of opportunities to
develop perseverance. Insurance red tape, billing errors, miscommunication with
or between health care providers will all require perseverance to unravel and
correct them. In these situations, it is helpful to have connections with
others dealing with these same types of issues. They will immediately
understand what you are going through, can pray “with understanding,” and may
be able to offer practical suggestions on how they have managed a similar
situation.
Sometimes
perseverance will not require any overt action on your part. You will just need
to remain steadfast, trusting in God, until the circumstances change. Perhaps
the loved one requires multiple surgeries or a series of medical treatments.
Just hang in there, just keep going. The Lord knows your limits and will
sustain you through this.
Perseverance is easier when there is a purpose or goal to be achieved. Hardship can be endured, knowing that the desired result requires sacrifice. Examples include athletes or those who pursue a difficult course of study, or those who work hard to make a business successful. In chronic illness, discouragement and an attitude of “What’s the use?” can creep in. A positive outcome may be off the table. There can still be goals to achieve, but the focus may have to shift. The question may need to change from, “What can I achieve?” to “What can I share for those who follow after me?” Leaving a legacy is important. Showing perseverance in the face of adversity is an example worthy to follow.
POCO A POCO
Little by little
is the method needed to achieve any goals in chronic illness. Fatigue or lack
of endurance limits the time that can be devoted to a task. The demands of
everyday routines, especially if needing to work while managing chronic
illness, or navigating numerous medical appointments, shorten the time that can
be devoted to other pursuits, whether practical or personal. Don’t give up
(persevere!), but learn to approach the project in small segments.
Breaking down a project into its component parts requires planning. Some people, who have the gift of helps or administration, are good at planning. Others may feel overwhelmed and not know where to start. The person with chronic illness and/or the care giver may want to ask for help to divide a project or task into manageable parts.
Examples for a
family event might be:
1. Deciding what tasks can be done well in advance (purchase
non-perishables, cook/freeze food).
2. Determining what tasks can be delegated? (transporting
guests, organizing games/activities, making or buying party favors?)
3. Making a schedule for the week leading up to the event,
assigning tasks for each day, so that energy can be reserved for the day of the
event.
4. The event itself may need to be “poco,” that is, smaller
in scale. Did the host previously buy/prepare all the food? Perhaps consider
asking guests to bring a dish to share or purchase prepared foods if budget
allows.
Almost any task
or goal can be achieved this way, little by little. It may be disappointing to
realize that activities that were once performed with ease must now be planned
and divided into manageable parts. There may be periods of denial and grieving
the loss of function or abilities before the transition to the new normal. This
can be frustrating, but it is another opportunity to exercise patience as the process
of using the new approach unfolds.
Just being aware that the Four P’s will be needed, and expecting them, can smooth the path of chronic illness. Recognizing what is happening, and planning to adjust, can reduce stress. Knowing that this process of supports has been experienced by others can reduce feelings of isolation and reserve strength for what is valued to be important.
“And not only this, but we also exult in our tribulations, knowing that tribulation brings about perseverance; and perseverance, proven character; and proven character, hope; and hope does not disappoint, because the love of God has been poured out within our hearts through the Holy Spirit who was given to us.” Romans 5: 3-5
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