Transitions in status from wellness to
illness, illness to wellness
Coping with recurrence and remission
A view of illness that incorporates the whole illness experience – from beginning to end – may be difficult for a health practitioner to grasp. The reasons for this may be many and varied: from the inability of the ill person to retell their whole story, to the busyness of the health professional, preventing them from grasping nothing more than the presenting issue.
Contemporary dying emphasizes the individual and their personal experience (Mellor 1993), and what emerges is an individual response to the particular challenges of the illness journey. But illness should not be regarded as a unique transition for the individual, since similar developmental experiences occur throughout the life span, in response to life's movements and challenges.
In this chapter, an emphasis is placed on understanding the illness journey as part of life's transitions, with similar characteristics to other journeys made in life. This requires a longitudinal view of illness along the illness trajectory, rather than as a series of events. Health professionals, therefore, should endeavour to gain insight into the whole narrative of a person's illness – to seek an understanding of the ups and downs that are inherent in the illness experience and its impact on the person. This requires a different perspective than the myopic immediacy of a particular health care encounter and also means that illness, and its associated life problems, should be viewed as an inherent part of the person's whole life narrative. In palliative care practice, with its philosophy of care of the total person, this perspective is especially pertinent. In that sense, it is the transition response that is important rather than a focus on the outcome – further illness or survival.