27 Mar Carol’s Story: A Rebel at Heart
“Carol” has lived with schizoaffective disorder for most of her adult life, and although she has maintained independent living with in-home supports for much of that time, she has few connections with family or friends, and she typically presents in public with rambling, tangential speech and odd behaviors, such that many times people react unkindly towards her when she goes out in public. Consequently, she spends most of her time at home alone. She only goes to see her doctor “when they make me so I can keep getting my meds.”
January: At time of Vail Care intake, Carol’s health was steadily declining, largely due to rapidly progressing symptoms related to COPD. She had been a smoker for more than 40 years and was still smoking. She had tried to quit once years ago, when her doctor told her she needed to quit and instructed her to start using nicotine patches instead. This was not a successful intervention.
February: During the Vail Care Health & Wellness Assessment, the nurse learned two very important things about her:
- When asked “What is the most important health issue facing you today?” she answered with one word: “Breathing.”
- Carol said she doesn’t like when people “lecture her.” She described herself as “a rebel my whole life,” and also stated, “I do what I want to do, and you aren’t going to tell me different.
- The nurse asked, “Could we just get together to talk more about your breathing troubles?” to which Carol replied, “Yes”.
March: The nurse met with Carol twice in the month of March and used Motivational Interviewing techniques to help Carol find her reasons to stop smoking. Carol talked almost non-stop during the meetings, but the nurse was able to ask questions and provide education along the way. Carol listened and respond at times, sometimes asking serious questions. The nurse shared how Big Tobacco had manipulated the public by covering up the truth of how addictive their drug was, and how they were getting rich while their victims were just getting sick. The nurse shared information about how resilient the human body is and that it is able to repair itself in so many ways once we stop letting it be abused and the progressive nature of COPD but that how fast it takes over is largely dependent on the choices that the individual makes.
Eventually, the nurse suggested to Carol that if she really doesn’t want to be controlled by anyone, then she might want to fight back against her old friend the Marlboro Man since he had been calling the shots for her for a long time. Carol pondered this though.
April: The nurse called Carol to check in several times. Carol reported to the nurse that she had been smoking less and less, because she didn’t want someone to be stealing her money. Later in the month, when they talked, Carol said she continued to think about their previous conversations and she told the nurse, “It is all in my head whether or not I smoke.”
May: At a home visit, the nurse observed that the overflowing ashtrays had disappeared. Carol said, “I made the decision. It’s all psychological, so I told myself I am not going to do it, so I haven’t.” Carol had been smoke-free for one month.
June: Carol still isn’t smoking. She started going for short walks instead of smoking when people in her building irritate her and she has learned to stop and rest for a bit when she feels tired.
Success! In a period of six months Carol, with the support from her Vail Care team, was able to quit smoking, very likely improving her health and reducing future healthcare costs. Carol told the nurse at their last meeting, “I am not going to let others control me.”