Adherence Management (AdM) Home Coaching: Family Guide To ImprovedHealth

Over my MANY years in nursing and as an audiologist, I cared for countless people and their endless array of illnesses and injuries. For the young and middle-aged, normal health is pretty much on automatic pilot. There are many colds, an occasional touch of flu, scrapes, bruises, a broken bone or two, and a few sutures to ensure wounds heal properly. Others have challenges with early-onset chronic illnesses such as diabetes or epilepsy. Still others lay the foundation for future chronic diseases by engaging in behaviors of smoking, drug use, over-eating, excessive drinking, and a lack of physicalexercise.

Many years ago, Dr. Ivar Lovaas was fond of saying, “All behavior returns to baseline.” Baselines are the habits we form and the lifestyles we live. Taking pills, following restrictive diets, and exercising daily typically are not behaviors of our youth. They are not the baseline of habits necessary to achieve or maintain optimum health. As we approach middle age, the rituals required to follow a medical care plan are not in our book oflife.

As you will read later in this book, most new behaviors needed to stave off bad habits or overcome genetic predispositions are not reinforcing. My colleague and friend Dr. Aubrey Daniels is fond of saying, “Behavior goes where reinforcement flows.” On the surface, nothing is reinforcing about taking a handful of pills. Medications can be inconvenient, expensive, and confusing. On top of that, some side-effects may make us feel sick while our disease may not have any symptoms. It is understandable why people give up takingpills.

You Are Not Alone.

In my early 30s, I was visited by a kidney stone and was introduced to bloody urine and enough pain to get my attention. The stone passed, and I was fixed. Over the next several decades, there were several more stone episodes to remind me that I was not super-human. I was human. On a 2003 return trip from Washington, DC to Dallas, I noticed a small amount of particular pain in my left shoulder. There was not the crushing sensation that I had seen in so many patients during my ER years. There was no profuse sweating, but I called my family practice doctor as I waited for