People usually do not consider their health as one of their most important assets. This asset of health is expressed as your health status and determines your effectiveness, productivity, your resilience and physical as well as mental reserves. But your health assets need to be actively managed to achieve the best possible return on your effort. This is what is meant by the concept of self-care in health. The World Health Organisation (WHO) broadly defines self-care as follows: “individuals, families and communities’ promoting and maintaining their own health, preventing disease, and coping with illness and disability, with or without the support of a health worker”. To try and make sense of this definition is to understand what it means in the practical world. For this discussion, the focus will be on the individual – you.
Self-care means that every individual will aim to stay as fit as possible and to maintain a good physical and mental health status. As is clear from the WHO definition, self-care also does not only start when you are still young and fit and healthy, but very specifically includes “coping with illness and disability”. In modern healthcare the role of self-care includes maintaining a healthy lifestyle, to prevent illness or accidents, to self-manage the care for minor ailments like common colds, but especially to play an important role in self-care in long-term chronic conditions where lifestyle changes have become very important in the management of physical and mental chronic diseases. Your personal role in contributing to the restoration of the best health status possible after an acute illness or discharge from hospital, constitutes an important aspect of self-care. The long-term improvement benefit also includes the benefit of active and healthy ageing and to maintain your independence for as long as possible when ageing.
It may be easier said than done because self-care needs a mindset change. It reflects an individual’s choice on changes to lifestyle and to incorporate those changes into your daily living. It does not mean that you will now be on your own and that your family doctor is not involved in your care; on the contrary, the aim of self-care is to collaborate with your doctor as an active participant rather than just being a passive receiver of treatment. The self-care guidelines are proven scientifically to improve your health status. It includes taking prescribed medicines, counselling where needed, diagnostic kits that can measure your blood pressure or blood sugar levels. It now even extends to the use of digital technologies to support your self-care. That also means active participation and implementation of the treatment plan suggested by your doctor after a diagnosis of a chronic disease such as high blood pressure or diabetes has been made. The doctor can prescribe medication and suggest the frequency of use, but if you do not take those medications as prescribed, the set targets for control will not be achieved.
Self-care covers a comprehensive set of lifestyle and behavioural issues that becomes the responsibility of the individual. So, on a practical level, if your weight or smoking habits are a problem, your active participation in the management of these identified risk factors, that may negatively impact on your health in future, is essential. It includes hygiene like washing your hands regularly and brushing your teeth; it deals with nutrition in general i.e., what you eat, what type and quality and quantity of food eaten; engaging in regular physical exercising including participation in sport or actively engaging in your own fitness programme. It includes what you do to your body through the use of alcohol, smoking tobacco or indulging in too many over-the-counter medications for pain and other symptoms. It touches on the abuse of drugs like scheduled medications or other illegal substances.
Take self-care seriously. Self-care can be practiced 24 hours a day or seven day a week. Go check your health balance-sheet of assets against liabilities, decide on a self-care plan to improve or maintain your health and to get your chronic condition under better control. It is empowering to assume an active role in your own health and ultimately the health within the family and also the greater community. It is about self-empowerment. It is the right thing to do.
Article by Dr Martin de Villiers, MBChB (Stell) DOM(Stell) FCFP(SA) MBL