Psychosocial Aspects

Severe symptoms of HCV or the side effects of treatment may affect your ability to work. You may find you could use some form of income assistance. Depending on your circumstances, you may be able to collect benefits from the following places:

• Human Resources Development Canada Employment Insurance (EI): Benefits are calculated based on the number of hours worked. Applicants for EI Sickness Benefits must have a minimum of 600 hours of insurable work in the past 52 weeks. If you provide medical proof of illness, Sickness Benefits will last for 15 weeks. EI also offers retraining programs if illness prevents you from keeping your current position.
• Canada Pension Plan (CPP) and Quebec Pension Plan(QPP): If you have paid CPP/QPP premiums, you may qualify for a disability pension. Eligibility is based on the number of years you have contributed and a detailed medical assessment you must submit to indicate your condition is both “severe and prolonged.”
• Social Assistance: Your local welfare office may provide you with financial assistance for shelter, living expenses and essential medical needs. Eligibility for a disability pension varies among provinces/territories.
• Employee Benefits Package: A disability pension paid out by a private insurance company may be available through your employer. Check with your personnel department or union representative for specific plan details.

• Carefully choose a time to tell your children.
• Tailor explanations to suit the ages of your children. Be prepared to reassure them if they ask about death.
• If children avoid the subject, provide information in a non-threatening way such as leaving a booklet on the table.
• Just like you, children of all ages need reassurance and information. It takes time to adjust, so be patient with them and yourself.

• Promote healthy options for personal exploration, e.g., sports, arts, hobbies.
• Encourage your teenager to talk to you or someone supportive about his/her feelings.
• Avoid overprotecting your teenager.

• Learn about HCV.
• Avoid judging the person.
• Listen to the person before trying to take over. It allows the person to express what he/she needs, wants and expects from you. You’ll see where you fit in.
• Expect the person’s mood and outlook to vary.
• Reinforce hope and optimism.
• Try not to neglect other relationships.
• Take care of yourself and talk to your own supportive people.

• Do your best to follow the treatment plans for each diagnosis (e.g. hemophilia, HCV, and possibly HIV and arthritis).
• Avoid risky behaviour such as drinking at parties.
• Practice safer sex. Although HCV is rarely transmitted sexually, you may wish to consider telling anyone with whom you had unsafe sex. Your present partner(s) may also want to get tested.
• Learn how to correctly interpret symptoms. The musclepain associated with interferon may feel like a bleed, or a bleed may be mistaken as a side effect of treatment.
• Get vaccinated for both hepatitis A and hepatitis B. There is evidence that hepatitis A can cause worsening of liver disease if you already have HCV. If you were born after1983 you probably have been immunized against hepatitis B.

If you are living with HCV you may feel as if you have lost something in life due to changes in health, routine and perhaps your vision of the future. The emotions you and your family experience may mirror those felt by people going through a grieving process. Grieving is usually associated with death but people diagnosed with HCV (and other illnesses) can feel grief too, due to the sense of loss.

The following steps may not occur in this order, but they will likely touch your life at some point.

• Shock and denial. You may feel so numb that you act as if nothing has happened. This may help you cope initially as a sort of anaesthesia, but can become a problem if you don’t take care of yourself (e.g., drinking instead of avoiding alcohol, and not seeing a health care provider).
• Emotions erupt. Your emotions may break out in heavy sighs or crying spells as you become more aware of your painful loss.
• Loneliness. You may withdraw from others that you feel “don’t understand.”
• Illness. Your body may temporarily break down due to this new stress in your life.
• Panic. You may not feel like your old self, or you might wonder “How will I manage?” This panic should pass.
• Guilt. With no ready answer on who or what was responsible for the HCV infection, you blame yourself. This will naturally lead to feelings of guilt or even anger at yourself.
• Depression. Commonly precipitated by feelings of isolation, hurt and sadness.
• Anger. Precipitated by the unfairness of your loss, your anger may be directed at your health care team, those close to you, God.
• Difficulty adjusting to a new situation. You may resist letting go of your attachment to the past. You may consequently withdraw further into yourself in an attempt to analyze your own thoughts and emotions.
• Hope. Eventually breaks through and begins to grow again.
• Affirming reality. Involves reconstructing your life using the resiliency and strengths you have learned you possess when experiencing the grieving process. You adjust to any limitations, set new goals, and learn to appreciate your new life.

• Go ahead, feel what you feel. Don’t tell yourself that a particular feeling is bad or try to pretend it’s not there. Your feelings are natural and you have a right to them. They can even help you move on to a more comfortable state of mind.
• Recognize your feelings. What are you actually feeling? Sometimes one emotion is covering up a different emotion. For example, sadness might cover up feelings of anger; anxiety might indicate excitement. Admitting to yourself “I’m angry” or “I’m scared” is a big step toward coming to terms with your feelings.
• Get to know what triggers your feelings. What led up to the feeling? Do some people, situations or anniversary dates create a certain feeling in you?
• Express your feeling and then let it go. You might fear alienating friends and family, but repressed feelings can fester and grow. “Bottling” up anger, for example, can result in excessive bitterness. Expressing your feelings can be done in constructive ways that cause no damage to yourself or others. Examples include crying, talking with others, or writing in a journal.
• Try to be as active as you can. Activities that hold your interest will help keep your mind off fears, depression and worry. Look for people and situations in which you can invest your love and energy.
• Reward yourself. Give yourself something pleasant to anticipate. Set aside at least 15 minutes daily to do something you really enjoy.