Whether your loved one refuses to confront a chronic disease or an addiction, know how you can help and where your limits lie.
Reviewed By Louise Chang
Whether it's the smoker with the incessant cough or the diabetic person who ends every dinner with a sugary dessert, we all know someone who blatantly ignores pressing health concerns.
It's particularly painful to witness a loved one refuse to make necessary, maybe even lifesaving, behavior changes. Offering support can be tricky, especially when the would-be recipient seems unwilling to accept it. But it's worth it, say the experts -- when you go about it the right way. Here's what they suggest.
Understand the Resistance
Before you can attempt to break down your loved one's resistance to behavior change, you need to learn what's causing it. Generally, that's not something that happens overnight. "It takes time to understand why the person is so resistant," says John Burton, MD, a Johns Hopkins geriatrician. While people's reasons for resisting healthy lifestyle changes vary, experts point to a few common causes.
"People who have just been diagnosed with a chronic disease that requires lifestyle changes may still be reeling from the shock of the diagnosis," says Cedric Bryant, PhD, chief exercise physiologist of the American Council on Exercise. "Some people simply feel it's unfair that they have an illness or chronic condition." In turn, they're likely to resist lifestyle changes required to manage the condition. This refusal to take action is a telltale sign that the person has not yet accepted the diagnosis.
Sometimes, fear prevents people from taking action. For instance, sedentary patients who are given a "prescription" to lose weight may have unstated concerns about their ability to safely execute the recommendations. These folks may need support beyond what a loved one can offer. To enhance their comfort level, they may want to consult a professional who has experience working with patients whose health needs are similar to their own, Bryant suggests. For example, someone who is newly diagnosed with cardiovascular disease and told to lose weight may benefit from the expertise of an exercise physiologist and/or nutritionist who specializes in working with other heart disease patients.
Even if your loved one isn't ready to tackle much-needed behavior changes, you can do more than wait helplessly.
The first thing you should do? "Get informed," urges Malinda Peeples, MS, RN, CDE. "If your spouse is diagnosed with a chronic disease, you're both going to be living with it," says Peeples, president of the American Association of American Diabetes Educators. Knowing what, when, and how changes need to happen will come in handy in the event that your loved one chooses to adopt them.
If your loved one suffers from an addiction, learning about the impact your relationship has had on its progression -- possibly with the assistance of a certified counselor -- can be just as enlightening as understanding the addiction itself. "It can be growth-promoting for a spouse or significant other to learn about aspects of the relationship that potentially promoted the addiction," says James Garbutt, MD, a psychology professor at The University of North Carolina at Chapel Hill. There's no doubt that such revelations can be painful for both parties. But by exposing the vulnerable aspects of a relationship, you also make them available for repair.
Support Health Changes
So should you attempt to reach out to your loved one who appears adamantly opposed to being touched? The answer hinges on an honest assessment of your relationship with the person in need. "I always encourage [support from a significant other] when there's a close and functional relationship," Burton tells WebMD.
Support often begins with subtle, indirect measures.
"Allow your loved one to move through the stages of acceptance," Peeples suggests. If you push before someone's ready, you'll meet with resistance rather than success.
Garbutt says there are signs when an addict is not ready to change. "The person who's hiding the behavior and denies or minimizes it is less ready for change," he says. So, too, is the person who makes attempts to control, rather than relinquish, the addictive behavior, notes Garbutt. He offers the example of the alcoholic who switches from hard liquor to beer, or reduces alcohol consumption from four nights to two. While such overtures are intended to show "control" over alcohol, in reality, they're sure-fire signs that the alcohol continues to exert control over the alcoholic.
While you can't force loved ones to change, you can change their environment. For instance, if you live with someone who is diabetic, this can be as simple as eliminating "off-limits" foods from the kitchen cabinets and frequenting restaurants that serve only healthy choices, suggests Peeples.
Take the Right Approach
When you decide to confront your loved one about making changes, your approach is important. "You've got to be careful not to create an adversarial relationship," Burton tells WebMD.
"Play the role of encourager as opposed to nagger," Bryant says. "Try to recognize any efforts towards change and provide a positive comment on them." If the urge to nag is strong, exert that energy instead into modeling the behavior you hope your loved one will mimic, Bryant offers.
Above all? Recognize that, in the end, the decision to change rests with the individual. "There are people who smoke, who understand the risks, and who just can't change," Burton tells WebMD.
"Ultimately, you cannot control your family member," Garbutt says.
Published Oct. 17, 2005.
SOURCES: John Burton, MD, Johns Hopkins geriatrician. Cedric Bryant, PhD, chief exercise physiologist, American Council on Exercise. Malinda Peeples, MS, RN, CDE, president, American Association of Diabetes Educators. James Garbutt, MD, psychology professor, University of North Carolina, Chapel Hill.
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