For Western North Carolina residents with chronic health problems, help is nearby. Mars Hill resident Peggy McConnell has several chronic conditions, including atrial fibrillation, which wakes her up in the night. Although she is receiving regular medical care, last May, McConnell decided to get extra help: She enrolled in Living Healthy, a six-week workshop sponsored by the Land of Sky Regional Council, a multicounty agency that partners with local governments and organizations.
Developed by Stanford University Patient Education, the workshop series is also known as the Chronic Disease Self-Management Program. It’s a standardized curriculum taught throughout the United States and in 26 countries.
After completing the workshop series, McConnell is having fewer atrial fibrillation episodes and, overall, feels better, she reports. “My condition is improving; it’s not keeping me awake at night like it used to,” she says.” I’ll feel the afib start or getting ready to start, but I’ll just take a deep breath and focus on something else, and it goes away faster.”
Peggy’s husband, Stephen McConnell, came along, too, for help with diet and exercise. He found the program’s goal-setting approach — breaking larger objectives into smaller steps — very helpful, he says. One of his goals was to substitute a piece of fruit for a cookie once a week, which he says he’s still doing. And another goal, walking 10 minutes a day, three times a week, has grown to a 20- to 30-minute walk almost every day, he adds.
“The most valuable thing [I got from the class] and what I am most surprised with is the ability to keep it up,” says Stephen. “I do now enjoy my walks. I know I don’t have to walk a great deal, but I walk around the blocks where I live. I can slow down if I get heavy breathing,” he says. “I can get out and walk, and I always feel better when I do that.”
“I found it made me feel healthier living each day,” says Peggy, who was also seeking relief from chronic hip pain.
“If you go to a doctor’s office, or get medication from a doctor or nurse, and you want to take the next step [to improve your health], the class is a really good way to begin,” says Stephanie Stewart, program coordinator of Living Healthy. “A chronic health condition is any condition that is persistent and requires daily management,” she says. People with chronic health conditions, along with their caregivers, are eligible to attend the workshop free, Stewart notes.
“One of the recent revisions of the program is that it is inclusive for people with chronic physical as well as mental health concerns,” says Rebecca Chaplin, master trainer and former program coordinator of the Land of Sky workshops. The connection of the body and the mind, says Chaplin, is a key feature. An adjustment in thinking can change the experience of symptoms, she says.
“All the classes have a short lecture that gives background information on the topic for that day,” says Stewart, who was a class facilitator before becoming program coordinator. Topics include ways to deal with frustration, fatigue, pain and isolation; appropriate exercise for maintaining and improving strength, flexibility and endurance; nutrition; and decision-making. After each lecture, participants can share their ideas and experiences, learn a skill and create an action plan, says Stewart.
The workshop does not focus on diagnoses, she says. Participants are invited to share their illnesses in the first class, but they’re not required to do so, nor must they discuss them again. “Even though everyone might have different diagnoses, a lot of the challenges are similar, like difficult emotions, not getting enough sleep, pain, fatigue and stress,” she says.
Developing an action plan is a key component. “At the end of every class, there’s a lot of focus on choosing goals that we want to do. We break it down into the details,” says Stewart. For example, if participants want to exercise more, they might decide they will walk; then they will decide when, for how long, how often and where they will walk, she explains.
Another unique component of Living Healthy is that the classes are led by peer volunteers who also have chronic health conditions. A few years ago, retiree Jane Kennedy saw a Mountain Xpress ad calling for people interested in being trained to help. In December she will co-facilitate her third class.
One of Kennedy’s favorite things about the program is how it’s organized across six consecutive weeks. That approach “really gives the participants an opportunity to incorporate into their lives the subjects that we’re covering,” she says. “They set little goals each week and then come to class and report what happened with their goal, whether they were successful or not.”
She also likes the way the class is designed to encourage participants to help each other. “It’s really participants talking to each other about what they’ve learned, what they’ve tried, what’s worked for them, doing brainstorming together,” Kennedy says. “People are just a wealth of knowledge for each other.”
Integrative Family Medicine provides space for Living Healthy each week. “Collaborating is truly a no-brainer,” says Dr. Chad Krisel of IFM.“We’re constantly trying to find ways to communicate to our patients [how they can become] self-dependent and how to take control of their own lives in terms of the choices that they’re making on a day-to-day basis.”
The program “is the right prescription for health care right now,” says Chaplin.
“I think this is a great opportunity for health care providers to partner with community-based programs like the chronic disease self-management program. The more we can work together, the better outcomes and the better savings will come from it,” she says.
Living Healthy workshop
Tuesdays, 4-6:30 p.m., Dec. 1 – Jan. 12
Integrative Family Medicine, Asheville
Living Healthy Chronic Disease Self-Management Program
Land of Sky Regional Council Living Healthy Program
Chad Krisel, MD
Integrative Family Medicine