Last week, I recognized that I have been skimping on my self-care practices. For me, it’s things like reading poetry, making time to get my hair cut, deep cleaning of the house that make me feel more grounded and alive. And while I hadn’t completely neglected those things, I was procrastinating and finding many excuses NOT to do those things, and that made me feel unsettled and anxious.
While your means of care will differ from mine, the key point to remember is that this is not a reward system, nor is it a form of self-soothing.
The World Health Organization (WHO) has produced several definitions. One of which is:
“Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a health-care provider“ (https://www.ncbi.nlm.nih.gov/books/NBK544166/#ch1.s5)
What is needed for self care is positioned from one individual’s point of view.
The International Self-Care Foundation ( https://isfglobal.org ) proposes a model to both measure and organize self-care.
If it’s not measured, it doesn’t happen.
Consider these three ways to measure:
- Measure against health norms. These are the normal population ranges of key health norms relevant to self-care (e.g. body mass index or calorie intake), split by gender, age etc. These norms represent the comparators and potentially goals, for individuals to compare themselves with.
- Measure your own self-care status. This is the individual’s self-care starting point or ‘balance sheet’ – assets and deficits across 7 pillars of self-care. The individual’s self-care balance sheet represents a self-care health record or passport. A simple example is the World Health Professions Alliance (WHPA) ‘Health Improvement Card.’
- Measure change in yourself. The object of self-care is for individuals to make adjustments to their practices. In this it will be helpful to record self-care activities, and outcomes in order to discern change.
Each of these measurement areas can be mapped across seven pillars to give a consistent overall framework. These pillars include cognitive, behavioral and physical activities.
- Health Literacy – the capacity of individuals to obtain, process and understand basic health information and services needed to make appropriate health decisions
- Mental Wellbeing – knowing your body mass index (BMI), sleep score, genetics, cholesterol level, blood pressure; engaging in health screening.
- Physical Activity – engaging in moderate-intensity physical activity such as walking, cycling, or sports at a desirable frequency.
- Healthy Eating – includes things like having a nutritious, balanced diet with appropriate levels of calorie intake.
- Risk Avoidance or Mitigation – this includes factors such as: quitting tobacco, limiting alcohol use, getting vaccinated, practicing safe sex, using sunscreens.
- Good Hygiene – includes behaviors like, washing hands, brushing teeth, washing food.
- Rational and Responsible Use of Products, Services and Medicines – includes awareness of dangers, and using responsibly when necessary.
There are many elements in disease prevention and lifestyle resiliency, but at the core is a need for individuals to change lifestyle habits.
However, there are significant systems-based challenges with implementing change:
- Today’s healthcare systems are ‘sickness services’ oriented towards treating the sick instead of preventing disease. Worse still, health systems encourage complacency towards one’s own health.
- Self-care is the foundation of healthcare, but it occurs largely outside formal health and social systems, making it harder for governments to engage and support.
- Self-care can be supported at many different levels – in the family, in the community, in companies or cities, but currently there is little connection or integration.
- The individual elements of self-care are simple in concept and some are even commonsense, but they should be approached in an integrated and holistic manner. “Modern” approaches tend to target one problem at a time.
- There is much interest and support in the individual elements of self-care, but no natural champions covering the entire self-care space.
In addition to system-based obstacles, it is also difficult for individuals to adopt and sustain good practices for the following reasons.
- Holding the belief that “It won’t happen to me” or “‘they’ exaggerate the risk.’
- Delaying Self-talk, such as “I’ll start tomorrow, I have bigger problems today” or “we’ve all got to die from something.”
- Lack of motivation as “Lifestyle modification is hard to keep up” and “I don’t have time/money/energy for it.”
- Clinging to the Sick-Care Model – “If I get sick I go to the doctor – that’s why I pay my taxes/insurance.”
Taking all of this together, it is apparent that while the threats of lifestyle diseases are massive, the challenges of adopting consistent, relevant and useful self-care routines are also daunting.
- You might start by taking account of your current state and then set some goals in the areas listed above as “pillars.”
- A good question to ponder to move you forward might be “What can I do right now to move forward?”
- Educate yourself and start small. I’d love to hear about your goals!