Imagine If take on Cardiac Rehab work

For the last few months Anna Hendrey one of our team has been supporting patients from across Cornwall who are recovering from heart attacks. She has gained huge insight into this area of work, which she talks about in our latest blog:

“Imagine If advocates for early intervention to protect health and wellbeing, but as we know too well, support is not always available. Community Navigation is one of Imagine If’s methods of providing holistic support, both as an early intervention and as a response. Community Navigation is a flexible combination of social prescribing (connecting people to support groups and services) and coaching (supporting people to develop the confidence and motivation to fully utilise such services). It’s been put to the test in several contexts, helping many overcome challenges and move toward their goals. But can Community Navigation help people who are recovering from heart attacks?

This pilot cardiac support project came with some questions for me. Surely the most pressing concerns on patient’s minds will be medical ones? Such as, why has this happened to me? Will I fully recover? How long will it take? Can I exercise? If so, how much? How will this impact my diabetes? Is breathlessness a symptom of the heart attack? Or is it a side effect of my new medication? And in most cases, they were. A small amount of time has been spent contacting cardiac nurses and researching diabetic support groups. But most has been exploring far more philosophical questions. For some, a heart attack is a huge moment of realisation – “a fork in the road”, one patient said to me, “a wakeup call”, said another. With this came surprisingly high levels of motivation.

This could be connected to something called “trauma drive”. People who have experienced trauma, in this case a heart attack, may perceive an increase in motivation, as the body works to avoid experiencing the trauma again. Sounds quite positive, right? But the body is essentially in panic mode, going into overdrive to avoid the situations and behaviours it associates with the trauma. It can present itself in some testing ways – obsessive thought and behaviour patterns, panic, mood swings, catastrophic thinking, rash decision making and aggressive behaviour, for instance.

As people begin to heal, the drive subsides and motivation can appear to decrease. Whilst signs of healing is positive, people can feel lost, confused or concerned about the apparent decrease.

With the right support, the energy of trauma drive can be harnessed to fuel positive change. Coaching techniques can be used to support patients to process trauma. I guide patients to untangle thought patterns, find their own logical solutions, set meaningful goals and utilise local support services to help them achieve these goals and make change sustainable.

Many patients discuss longstanding mental health problems with me, if not for themselves then for a loved one for whom they feel responsible. Because patients have not received the support they need to overcome or manage these (and not for lack of trying), they have developed poor coping behaviours, such as smoking, poor diet, avoidance of social situations or financial problems, alcohol abuse, obsessive behaviours or a sedate lifestyle. Some of these are risk factors that may increase the chance of having a heart attack.

Coaching allows you to explore the wider determinants of health and wellbeing, helping people recognise their strengths so that they can build healthier, happier habits and ditch the old ones. This takes time, patience and perseverance. But I’m already seeing incredible changes in the people I’m working with. Perhaps Community Navigation has a future in cardiac rehab too? Watch this space. “