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Michael Arloski, Ph.D., PCC, CWP

Coaching People With Health Challenges: What The Wellness Coach Needs To Know ���

Wellness/Health Coaching And Health Challenges

Wellness/Health Coaching And Health Challenges

1.  Are you actively doing wellness/health coaching now?

2.  Do you work with people with medical/health challenges?

3.  Do you wear two hats? 4.  Divide into small groups 5.  Discuss

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Right From The Start…•  Clients with any kind of

medical conditions MUST be under current treatment or have an active relationship with a healthcare provider

•  Clients MUST be cleared for weight loss efforts by medical personnel

Regardless Of The Health Challenge Proceed As A Coach

•  Always distinguish between coaching and treatment

•  Use solid coaching methodology •  Use Readiness for Change

Theory •  Fit the coaching to the client •  Be the behavioral change expert

You do NOT need “treatment-level” knowledge of any disease

•  You are not responsible for diagnosis

•  Refer treatment questions to the treatment team

•  But you DO need to “speak the same language”

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•  What are my client’s known medical challenges?•  What treatments, medications and possibly self-testing/

monitoring are they engaged in? (Clients with medical conditions MUST be under active medical care.)

•  When was the onset of their challenge(s)?•  What is their level of knowledge about their challenge(s)

and treatments?•  What is their level of medical compliance?•  What more do I (the coach) need to know?

Understanding Your Client And Their Health Challenges.

Explore And Clarify The Client’s Level Of Self-management Knowledge And Practice.

There is often an astonishing lack of patient education about their disease!•  Check it out.•  Refer to best resources

for education, or if qualified, blend with education you provide.

•  What lifestyle improvements have healthcare providers recommended? Specific behavioral changes.

•  How much success has your client had with this?•  What is your client’s history at attempting changes like

this? Explore the successes and failures.•  What sources of support does your client have, or not

have for making improvements to their lifestyle?•  What are the barriers and challenges?

Your Client’s “Lifestyle Prescription”

Coaching Methods ���That May Affect Medical Status

•  Relaxation training may affect blood pressure and dosage levels needed

•  Walking/exercising programs may affect cardiovascular conditions

•  Nutrition programs must be in alignment with medication (i.e. Vit. K and blood thinners, Statins and grapefruit, etc.)

•  Coordination with treatment team is ESSENTIAL. Your Logo

Integrating Coaching ���With The Client’s Treatment Team

•  All communication must be HIPPA compliant

•  Best process is to communicate jointly with your client

•  No secrets•  Get commitments from

client about their communication with their treatment team

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Medical Compliance/Adherence���And Coaching

•  Knowledge: Explore with client what they know and need to learn – create commitments and action steps (and accountability) to obtaining more knowledge

•  Organization•  Tracking – keeping record

of medications, self-testing, etc., in ways that work for the client

•  Accountability12

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Medical Compliance/Adherence���And Coaching

•  Working though barriers both internal and external

•  Strategizing affordability•  Empowering the client to

greater self-advocacy•  Increasing awareness of

support services•  Consciously Coaching For

Connectedness!

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Coaching The Client With Heart Issues

Lifestyle Prescription Heart Issues

The Client’s Lifestyle Rx comes from the medical treatment team

•  Lifestyle behaviors to shift –  Increase activity –  Improve diet (low cholesterol,

low salt, in line with meds.) –  Manage stress better –  More rest –  Smoking cessation –  Less isolation, more connection –  Moderate alcohol use

•  Congestive Heart Failure •  Atherosclerosis •  Hyperlipidemia •  Hypertension •  Atrial Fibrillation •  Myocardial Infarction•  Mitral Valve Issues•  Metabolic Syndrome •  Stroke

Heart Coaching – Know The Basics

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•  Learn about blood thinners and what the client has to do to check and maintain proper viscosity

•  Learn about the most common medications (statins, beta blockers, blood pressure meds) and most common side effects your clients will talk about

•  Learn basic blood pressure ranges (age appropriate)•  40% of open-heart surgery patients experience depression•  Co-Morbidities - Big link between diabetes, heart disease, and

stroke. In fact, two out of three people with diabetes die from heart disease or stroke.

•  Huge potential role with Cardiac Rehab and Follow Up!

Heart Coaching – What The Coach Needs To Know

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Dean Ornish - Heart Disease Reversal

•  Absolute clinical evidence that heart disease can be reversed

•  Solid studies published in JAMA, Lancet, etc.

•  Holistic Program •  Tough, but doable for the

dedicated patient •  Do we have an “ethical”

consideration to inform our clients about this option and offer our support???

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Surgical Recovery

•  Behavioral Changes are already here!

•  Medical Compliance•  Breathing Exercises•  Dietary Changes•  Rest•  Activity•  Full recovery may take

a year or more!

Coaching The Client With Diabetes

What Diabetes Is: ���Type One & Type Two

Diabetes is a disease in which a person’s body cannot properly store and use fuel (glucose) for energy. To use glucose, your body needs insulin, made by the pancreas.

A person has diabetes because either:•  Their body makes too little or no

insulin. This is called Type 1 diabetes.

•  Their body can't use the insulin it makes. This is called Type 2 diabetes.

Know Your Numbers!

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Pre-Diabetes Pre-diabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes.

Estimate:More than 41 Million Americans have pre-diabetes.

Successful lifestyle change prevents the development of diabetes from ���pre-diabetes ���70% of the time!���People with pre-diabetes can often prevent or delay diabetes by walking 30 minutes a day 5 days a week. Losing just 5 to 7% of body weight prevents or delays diabetes by nearly 60%.

(NDIC -http://diabetes.niddk.nih.gov/DM/pubs/insulinresistance/)

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Lifestyle Prescription Diabetes

The Client’s Lifestyle Rx comes from the medical treatment team

•  Lifestyle behaviors to shift–  Increase activity–  Self-testing, meds., etc.–  Improve diet (diabetes mgmt.

guidelines)–  Manage stress better–  More rest–  Smoking cessation

Diabetes  Wellness  

Knowledge  &  

Informa6on  Exercise  

Weight  

Medica6on  

Stress  

Lifestyle  

Nutri6on  

Suppor6ve  Rela6onships  

© 2007, Sutter Connect

•  Check out level of client knowledge and self-care practice•  Learn about self-testing and what the client has to do to check

and maintain proper blood sugar levels•  Learn about A1c and Fasting Blood Glucose levels•  Learn about the most common medications (metformin,

insulin, etc.) and most common side effects your clients will talk about

•  Co-Morbidities - Big link between diabetes, heart disease, and stroke. In fact, two out of three people with diabetes die from heart disease or stroke.

Diabetes Coaching – What The Coach Needs To Know

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Cancer & Lifestyle •  Being overweight or obese increases

the risk of several cancers, including cancers of the breast (among women past menopause), colon, endometrium, esophagus, kidney, and other organs.

•  Being active helps reduce your cancer risk by helping with weight control, and can also reduce your risk by influencing hormone levels and your immune system.

•  Diet = more fiber, fuits & veggies, whole grains & less processed meats reduce cancer risks.

•  One third of all cancer deaths are related to diet and activity factors!

(Am.Cancer Society)

Lifestyle Prescription Cancer

The Client’s Lifestyle Rx comes from the medical treatment team

•  Lifestyle behaviors to shift –  Increase activity –  Improve diet (low fat, low

sugar, high fiber, high anti-oxidants, in line with meds.)

–  Manage stress better (a huge factor!)

–  More rest –  Smoking cessation

Coaching Cancer Patients•  Coach around self-efficacy, to

what degree do they believe that they CAN affect their health

•  Support client in self-education to avoid “false hopelessness”!

•  Complying with medical care.•  Accountability and meds/

exercise, etc.•  Self-advocacy – making best use

of appointments, feeling in charge of their own treatment

•  Coach for connectedness•  Exploring the spiritual•  Group Coaching!

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Coaching Cancer Patients

•  Don’t assume they are not THRIVING!

•  Festival dancers in this picture are breast and prostate cancer survivor/thrivers!

•  More and more clients are living for years with cancer.

•  They may still need support and a real ally to help them with achieving and maintaining the best life possible!

Coaching The COPD Client Chronic Obstructive Pulmonary Disease

•  COPD is the 3rd leading cause of death

•  Emphysema and Chronic Bronchitis

•  Asthma and other various diseases

•  There is no cure for COPD and so treatment goals aim to slow the progression of the disease and to reduce symptoms.

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•  Once properly diagnosed the most immediate behavioral interventions are –  environmental: (reduction in exposure to workplace or

living environment pollutants, e.g. a person working in an industrial pottery who is daily exposed to clay dust);

–  strategic: an effort to immediately cease smoking; –  medically behavioral: compliance/adherence to medical

treatment (e.g. bronchodilator treatments, regular medical appointments)

Coaching The COPD Client

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•  Check out level of client knowledge and self-care practice•  Learn about the most common medications (bronchodilators,

etc.) and most common side effects your clients will talk about•  Co-Morbidities – COPD patients tend to have many more co-

morbidities than other disease patients – often as many as four other conditions

•  Coach for raising Self-Efficacy•  Coach to improve strength and exercise tolerance•  Coach for regular practicing of breathing exercises•  Mindfulness may be a helpful tool

COPD Coaching – What The Coach Needs To Know

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Check Out Dr. Arloski’s Blog Post Wellness Coaching And Chronic Lung Disease

www.realblancewellness.wordpress.com

Your Logo Copyright RBGWS 2012

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Coaching Practice Triads

Client  

Observer  Coach  

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•  Client = You are: your own age, body type and gender; your last medical exam and blood work revealed both borderline hyperlipidemia and borderline high blood glucose levels. Your physician has said that they want to put you on medication, but will give you a chance first to adjust your lifestyle. You are simultaneously concerned and wanting to minimize this information. You’ve always felt healthy, so what’s the big deal?

•  Coach = Your job is to: Assist your client in EXPLORING this news and their feelings and response to it.

•  Observer = Your job is to: OBSERVE the coaching to provide feedback to the coach and discuss.

Coaching PracticeHealth Challenge Role Play

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Living With Illness A Video Training Series Produce By

Is available for viewing by workshop participants at no cost. Just email:

Deborah@realbalance.com

Michael Arloski, Ph.D., PCC, CWP michael@realbalance.com

1-866-568-4702

National Wellness Conference 2015 Breakout Michael Arloski, Ph.D., PCC. CWP

Coaching People With Health Challenges: What The Wellness Coach Needs To Know

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RELATED ARTICLES POSTED ON DR. ARLOSKI’S BLOG: https://realbalancewellness.wordpress.com Wellness Coaching And Chronic Lung Disease: http://wp.me/pUi2y-fN Forging A New Wellness Path: Leaving Health Risk Reduction Behind: http://wp.me/pUi2y-d3 Cancer and Lifestyle Improvement: http://wp.me/pUi2y-7A

Pre-diabetes – A Wellness Opportunity To Help: http://wp.me/pUi2y-7o Maybe The Last Heart Attack: http://wp.me/pUi2y-71 Compassionate Detachment: The Being and Doing of Coaching Part One: http://wp.me/pUi2y-5K