Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Copyright 2010 Wolters Kluwer Health | Lippincott

ott Williams & Wilkins

CARE OF THE CHRONICALLY
ILL
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chronic Illness


Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Occur in people of every age, socioeconomic
level, culture
Medical conditions or health problems with
associated symptoms that require long-term
(3 months or longer) management
Conditions that do not resolve or for which
complete cures are rare
Management: people must learn to live with
symptoms or disabilities, carry out lifestyle
changes or treatment regimens
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Decrease in mortality from infectious
diseases
Lifestyle factors
Longer lifespans
Improved screening, diagnostic
procedures
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Managing chronic illness involves more than
treating medical problems
Usually involve different phases over
person's lifetime to which person must adapt
Persistent adherence to therapeutic regimens
One chronic disease can lead to
development of other chronic conditions
Chronic illness affects entire family
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Day-to-day management of illness largely
responsibility of people with chronic disorders,
their families
Management of chronic conditions: process of
discovery
Management
Collaborative
Expensive
Ethical issues may be raised
Living with chronic illness means living with
uncertainty
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Importance of prevention
Lifestyle changes/interventions to prevent
chronic disease
Once disease occurs, focus shifts to:
Managing symptoms
Avoiding complications
Avoiding acute illness
Promoting health
Maintaining functional status

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
When is a medical condition considered
chronic?
A.1 month
B.3 months
C.1 day
D.3 days

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
B. 3 months
Rationale: Medical or health problems with
associated symptoms or disabilities that
require long-term management 3 months
or longer are considered chronic.

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Alleviate, manage symptoms
Psychologically adjust to, physically
accommodate disabilities
Prevent, manage crises, complications
Carry out regimens as prescribed
Validate individual self-worth, family
functioning
Manage threats to identity
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Normalize personal, family life as much as
possible
Live with altered time, social isolation,
loneliness
Establish networks of support, resources that
can enhance quality of life
Return to satisfactory way of life after acute
debilitating episode or reactivation of chronic
condition
Die with dignity, comfort

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Identify specific problems, trajectory phase
Establish, prioritize goals
Define plan of action to achieve desired
outcomes
Implement plan, interventions
Adhering to regimens to control symptoms, keep
illness stable
Dealing with psychosocial issues that can hinder
illness management, affect quality of life
Follow-up, evaluate outcomes

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Heart Disease
(Angina Pectoris VS Myocardial Infarction)
Chronic Obstructive Pulmonary Disease
(Emphysema & Chronic Bronchitis)
Diabetes
(Diabetic Ketoacidosis VS Hyperglycemic
Hyperosmolar Nonketotic Syndrome)
Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins