Our CEO recently told me about a wound care patient he still thinks about, even though he hasn’t seen her in over 20 years. Her chronic wound was so infected she was at risk for a lower limb amputation, but she kept missing appointments. When he asked point-blank why she wasn’t coming in, she admitted she was embarrassed to ride the bus because of the overwhelming odor of her wound. She was willing to risk amputation to avoid the shame of being around other people.
This is not an unusual story. Though it’s not often discussed in the exam room, many patients with chronic wounds suffer from anxiety, depression, loneliness, and isolation. Some skip appointments or delay treatment because they feel embarrassed or ashamed.
In addition to addressing physical symptoms, wound care clinicians should also help their patients deal with the emotional aspects of suffering from a non-healing wound. Common issues include loss of mobility, dealing with pain and altered sleep habits, and contending with a chronic illness, such as diabetes.
According to Christina Le, CNO of Wound Care Advantage, it’s important to create a positive environment from day one and make treatment a team effort, with the patient being a key player. Here are five tips to help encourage patient resilience:
- Be a continuous source of emotional support. Tell the patient you’re happy they’re being proactive and coming in for treatment. Be enthusiastic about their commitment to tackling the situation and healing the wound.
- Encourage the patient to talk about how the wound has impacted their quality of life. Let them express their feelings and listen to what they have to say.
- Emphasize teamwork. At every visit, encourage the patient to inform you of changes in tissue, drainage, pain level, etc. Share images and measurements as the wound heals.
- Educate. Offer information, resources, and a dietitian, if needed. Write things down if they’re anxious or forgetful, and encourage them to call if they need help between appointments.
- If the patient is ashamed of the way their wound looks or smells, offer reassurance. Tell them you've treated all shapes and sizes, and there’s nothing to be ashamed of. In some instances, you may be able to offer items that can help mask the smell of the wound if they are going to be in public.
When Pastor Michael Layne of Greensburg, Indiana discovered he was not only a diabetic, but had a diabetic foot ulcer, he felt a great sense of shame on his first visit to Decatur Hospital's Wound Care Clinic.
"My first time going to the wound center...the staff was really wonderful. The one thing I really appreciated about them was that they didn't talk down to me. They didn’t shame me because I let things go so long.”
“You either deal with something or you lay down and die, and I wasn't ready to do that," he said. See Pastor Layne's video here.
It's important to acknowledge your patients' struggles and help them build a sense of resilience. By having more control over their feelings and tapping into their strengths, they'll be more active participants on their healing journey.