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When You’ve Hit Your “Can’t”: Part Two


“I find myself pushing past pain and/or fatigue and borrowing spoons more often than I should.” -K.

Tired, sad dog

You may have heard of the “spoon theory”, Christine Miserandino’s 2003 article on how a person with chronic pain and or fatigue has a finite amount of energy each day, made tangible by a handful of spoons. Each “spoon” represents the amount that a person can physically do each day, with some tasks taking more energy, or “spoons” than others. This means that some tasks, like home organizing or cleaning, can simply become too physically demanding for a person suffering from chronic pain or fatigue. Following is the second part of an article that synthesizes the insights eight people shared with me for how they manage their household tasks while dealing with chronic pain and/or fatigue.

Ask for Help

Most of the people that I interviewed stated that it is important to remember that it is okay to ask for help when possible. Some ask for assistance from significant others and loved ones, such as in F.’s case in which she asks her husband to empty the dishwasher, “so all [she] has to do is load it”. Some people living with chronic pain, like R., hire a housekeeper once or twice a month. The housekeeper completes the tasks that cause R. “the most pain”. Consequently, R. “feel[s] less guilt and stress over not being able to fully complete a task”. For people who might feel uncomfortable asking for help, Unstuck, LLC (2018) suggests that asking for help can be a way to build relationships, bring the asker better health, and increase productivity.

Break a Task Down

Sometimes, a large task can be broken down into small parts. Suppose you wish to get the bathroom counter clean but only have enough stamina to clean for a few minutes. Why not clean half the counter now, and the rest when you have a little more energy? Another example, writing thank-you cards, can be spread out over several days. Miserandino (2008) recommends adding the stamps to all of the envelopes one night, using a self-inking stamper or address labels for the return address the second night, and a third night to put in a short message on non-blank cards. Dividing a task into small sub-tasks can make the overall task seem less overwhelming.

Another way to break a task down is to set a timer. D. sets a timer for 10 or 20 minutes and then gets whatever cleaning done they can within that time. When the timer goes off, D. then decides whether they need to take a break or are able to continue with another 10 minutes or so. If a break needs to happen, D. notes that “at least [they] can say [they] have done some cleaning, rather than none at all”. This tactic can also be useful if a person has difficulty beginning a task.

Work-Then-Sit

Sometimes, it may be necessary to work a little, then sit for a while. For the chronic pain sufferer, there will always be days in which you can do more than others. R. keeps a list of “sitting tasks that [they] can do even when they don’t have the energy to be up and about—things like paying bills, sorting the mail, etc”.

Modify Tasks

It takes me all day just to do a load of laundry, wash my dishes, and sweep the floor or vacuum. Our new place has a dishwasher and that will help with that task. We have laminate floors now and a Swiffer® takes care of the entire place.” –S.

If you don’t own your home or are otherwise not able to make changes to flooring and appliances, there are steps that can be taken to make some of your tasks easier.

People who do not live with chronic fatigue or pain may not be aware that many cleaning and organizing tasks, such as sweeping the floor, actually have several mini-steps, any one of which could become too difficult for someone who no longer has energy. In the floor-sweeping example, some of the mini-steps are 1) picking up things that are on the floor, 2) moving some furniture aside, 3) retrieving the broom and dust pan, 4) the physical sweeping, 5) sweeping dust piles into the dust pan, 6) throwing out the accumulated dust, 7) returning the broom and dust pan, 8) returning any furniture that was moved, and 9) returning any items that are supposed to go on the floor. One modification to this task is to sit in a rolling office chair and ride over to the next dust pile. A second modification might be to invest in a long-handled dust pan.

Bethel Marcus, an Occupational Therapist and Certified Hand Therapist, suggested the use of a rolling push cart on each floor of the house (2009). This can be used to set and clear the table, clean around the house, or pick up lost items around the house. In my career as a special education teacher, I learned that almost every work task can be modified in some way to suit the needs of the clients. Perhaps one of the special education teachers in your local schools can offer some suggestions in how to modify troublesome tasks. It certainly would not hurt to ask.

Food Prep

Several people do their food prep while sitting down. This can be done at the dining table, or with a tall, rotating kitchen stool that is a good height for chopping or constantly stirring a finicky pot. The rotating chair is essential so that you apply minimum torque to your back. In addition to the stool, I also make use of a quality anti-fatigue pad in my kitchen and usually wear shoes with good support when I need to be on my feet.

Some people I interviewed made frequent use of slow and/or multicookers (Crock-Pot® and Instant Pot®, respectively, are example brands of these convenience appliances). One person keeps “a stash of frozen meals” that they can “plunk in [a pot] for days when [they] forget to start supper or just don’t have the energy”. By preparing and setting aside what could be easily cooked, it ensures that families are getting the right nutrition and not spending extra money on restaurants and take out.

While I personally do not deal with chronic pain or fatigue, many of my friends and loved ones do. It is therefore of the utmost importance to me to provide accurate information and to connect people to the experiences others have faced. I am honored that so many people chose to share their personal stories with me. I hope to continue to grow and learn from others who wish to share what they have learned.

References

Marcus, B. (2009). Self-care task modification when living with myositis (Part II: Household activities). Retrieved from https://www.hss.edu/conditions_self-care-task-modification-myositis-II.asp

Miserandino, C. (2003). The spoon theory. Retrieved from https://butyoudontlooksick.com/articles/written-by- christine/the-spoon-theory/

Miserandino, C. (2008). Tips for the chronically ill: Writing thank you notes. Retrieved from https://butyoudontlooksick.com/articles/daily-living-tips/tips-for-the-chronically-ill-writing-thank-you- notes/

Unstuck, LLC. (2018). 5 big benefits of asking for help. Retrieved from https://www.unstuck.com/advice/5-big- benefits-of-asking-for-help/

Crystal Thurber has a Master of Science degree in Special Education and a Bachelor of Arts in Elementary Education. She has taught, assisted, and substitute-taught in public and private schools, in grades ranging from preschool through post-secondary. She had earned her Provisional Special Education teaching certificate for the Adapted Curriculum before changing careers in 2018. Crystal is now the owner and founder of Compassionate Decluttering, LLC, based out of Fairfax, VA. She still maintains her Virginia K-6 teaching license.

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