The Social Experience of Chronic Illness

Question 1

Why is the experience of living with a chronic illness a characteristic feature of older age in the 21st century?

Answer 1

• Reflects long-standing trend in decline in mortality from infections that began at end of 19th century, with improved public health measures, including sanitation, reduction in overcrowding in housing. Combined with rising standard of living post WW2, led to increase in life expectancy
• People are living longer, but these additional years are sent with long term health problems and consequently, the incidence of degenerative disorders has progressively increased, a major source of disability

Question 2

How does the disease label impact the socioeconomic life of a person living with chronic illness?

Answer 2

• People from more disadvantages social classes are more likely to experience financial, domestic and work-related difficulties as a result of living with their chronic condition
• This outcome reflect the extra costs incurred by individuals i.e. home alterations, special dietary requirements, additional heating costs, restricted mobility, employing at home help etc.
• Social care in England is means-tested

Question 3

Describe the ‘Crisis’ approach (labelling theory)

Answer 3

• Focuses on societal reaction of living with chronic illness
• Conceives the diagnosis of chronic as irreversibly changing the status of the individual; hence the use of the term ‘crises’
• Labelling theory recognises illness as a deviation (or primary deviance) fro the social ‘norm’ of healthiness. It’s seen to breach the norms of civil life
• In modern societies, doctors as trained state-sanctioned professionals are given the role and responsibility of applying disease labels to categorised an individuals signs and symptoms
• Shared cultural stereotypes become attached to particular conditions, and these can serve to shape the reaction of others to those carrying such a label
• As a consequence of this, we often see a characteristic behaviour change following diagnosis, often conforming to the cultural stereotypes of that conditions - sociologists call this secondary deviance
• This process of secondary deviance serves to alter a person’s self-regard and hence degree of social participation
• Disease labels thus constitute a self-fulfilling prophecy, having the power to ‘spoil the sufferer’s identity’ both personal and social
• This leads to stigmatisation

Question 4

What is stigma?

Answer 4

• Concept concerned less with social process of labelling of a particular state of ill-health as a disease, than with the consequences of the process for an individual
• This is the set of social experiences that reference the problems associated with the ‘management of everyday life’ post-diagnosis

Question 5

What is enacted stigma?

Answer 5

The social stigma that results from the attaching of a disease label, derives not only from societal reaction which may produce actual discriminatory experiences

Question 6

What is felt stigma?

Answer 6

‘Imagined’ social reaction or internalised sense of blame regarding the health condition, which can drastically change a person’s self-identity

Question 7

How can physical and social experiences following diagnosis of a chronic illness change?

Answer 7

• Person may become isolated
• Gradual withdrawal from everyday life
• Loss of confidence in communicating and interaction with other
• Restriction of social roles

Question 8

Describe the negative feedback look of having a chronic impairment or disability

Answer 8

• Restriction of activities and social roles
• Negative labelling - Negative social views and stereotypes transmitted in mass media and everyday life
• Diminished self-esteem and ‘felt’ stigma
• Isolation and withdrawal from social life
• Lack of confidence and skills