By David G. Epstein, SHRM-SCP, CWP, CPLC
Director of Human Resources & Talent Strategy
Mobilization for Justice, Inc.
Many Americans have chronic illnesses, ranging from diabetes and cancer to hypertension and cardiovascular conditions, to name a few. According to the United States Center for Disease Control (CDC), more than half the U.S. population has at least one chronic disease, with over a quarter having two or more. While coaches cannot treat or diagnose, they can have a positive impact in helping their clients manage these health challenges by lending a gentle, nonjudgmental ear, helping to set healthy goals and keep clients accountable to those targets.
Coaches Can Be a Powerful Partner
As a health coach, you can have an impact on your client’s goals. If your client has a chronic illness such as diabetes, you can help your client in several ways.
Ensure coordination with health care team: As a coach, it is important to collect information on the health care team that your client is currently seeing (i.e., primary care, endocrinologist, therapist, etc.). With client permission, it can be helpful to share goals and coordinate with their health care team. If your client is missing a specialist from their care team, it is helpful to suggest and provide information/materials (i.e., if you have a client with diabetes, they may need a nutritionist but never thought about it).
Empower them to feel like they can manage their disease: Having a chronic illness is exhausting. Most diabetics, for instance, will face “diabetes distress”. The constant decision making and monitoring of glucose levels every day takes its toll. And despite best efforts, clients may not meet their A1C goal, or may develop anxiety and depression, resulting in skipping doctor visits or not taking medication. Discuss options that may help reduce the burden such as diabetes support groups, technology such as continuous glucose monitors, and support systems through family and friends as well as caregivers. Gradually suggesting ways to improve quality of life can help empower clients to make decisions that make their lives better and ensure they can be held accountable.
Offer guidance and encouragement: Lending a gentle ear to your client can make a world of difference. Those who battle one or more chronic illness are often tired and in need of emotional support. They are more likely to experience anxiety and depression.
If you as a coach or a family member have experienced chronic illness, consider whether self-disclosure may help. While not always appropriate, sharing your personal experience may help your client open up more or help them build trust and empathy.
Holding clients accountable: At each session, ask how they are feeling. What is their A1C if they’re diabetic? If it’s not at target, ask them what we can do to create a plan to improve results. Have they followed through on plans and seen their endocrinologist? Checking in and holding clients accountable without judging will help them. Be extra forgiving and explain why it is important to keep commitments to exercise, doctor visits, taking medication, etc.
Help navigate complex health care system: The health care system is extremely complex and very expensive for those with chronic illnesses. The average diabetic has a cost of $12,000 to $20,000 per year. Understanding their health plan and being able to help navigate the best ways to utilize primary and specialty care will help reduce stress and costs. For example, help plan for a hospital stay by ensuring that both the hospital and doctor are in network, as out-of-network care can quickly become extremely expensive. In terms of prescription medicines and insulin, which can be in the thousands per month, is your client using the medical plan’s specialty pharmacy? Is there a mail order program and/or a coupon available from the pharmaceutical company? This can make a huge difference in copays. If on Tresiba, is the medication available through an approved specialty pharmacy that provides a 90-day supply? If so, a copay could be only $75-$100 instead of $1,000 or more, depending on the plan guidelines. You may need to have them get prior authorization from the doctor, who communicates with the medical insurance company that this is a required medication if not covered by the plan’s drug list.
While coaching for people with chronic illness such as diabetes is not a substitute for clinical care, it can be a powerful additional resource for those living with chronic illness. From lending a gentle ear to helping establish health goals and navigating the increasingly complex health care system, coaches can keep their client accountable and healthier. But always refer them to clinical specialists when needed.
David G. Epstein, SHRM-SCP, CWP, CDP, is the Director of Human Resources & Talent Strategy for Mobilization for Justice, Inc., in New York City. He is a Certified Wellness Practitioner, a Certified Diversity Professional, and a Senior Certified HR Professional. He is a Life and Career Coach and professional member of the American Counseling Association.
