Chapter 36 Living in Harmony With Chronic Conditions

1. Chapter 36Living in Harmony With Chronic Conditions

2. Older Adults and Chronic Illnesses • Nearly half of older adults suffer from arthritis. • More than one-third have hypertension. • Nearly one-third have a hearing impairment. • More than one-fourth have a heart condition. • More than 1 of 8 has a visual impairment. • Almost 1 in 8 has a deformity or orthopedic impairment.

3. Older Adults and Chronic Illnesses (cont.) • Almost 10% have diabetes. • Approximately 1 in 12 are affected by hemorrhoids and varicose veins.

4. Stimulating Patient Self-Healing • Create a therapeutic human and physical environment. • Educate. • Empower. • Reinforce, affirm, and validate. • Remove barriers to self-care and self-awareness.

5. Goals of Chronic Care • Maintain or improve self-care capacity. • Manage the disease effectively. • Boost the body’s healing abilities. • Prevent complications. • Delay deterioration and decline. • Achieve the highest possible quality of life. • Die with comfort and dignity.

6. Assessing Chronic Care Needs • Care may differ from patient to patient and within the same patient from time to time. • Nurses must identify changing needs and adjust care accordingly. • Consider the caregiving capacities and limitations of the family. • Review and validate care plan priorities and goals. • Supply them with a written copy of the care plan.

7. Factors Promoting a Positive Physician-Patient Relationship • Accessibility of the physician • Sufficient time allocation for office visits and telephone consultations • Comfortable and patient-appropriate communication style • Respect for patient’s involvement and decision-making • Consideration of needs of entire family unit • Openness to alternative and complementary therapies • Attitude of hope and optimism

8. Patient Preparation for Office Visits • Write down questions, symptoms, and concerns. • Maintain records of laboratory tests, vital signs, and other relevant medical data.

9. Benefits of Using a Chronic Care Coach • Support • Encouragement • Reinforcement • Assistance • Feedback

10. The Informed Patient: • Is well equipped to manage the chronic condition successfully and prevent complications. • Uses knowledge for empowerment. • Seeks information from various organizations. • Uses the Internet to learn about new information and share knowledge.

11. Benefits of Using a Support Group • Patient gains valuable information. • Patient gains perspectives from those living with similar situations. • Patient may be more willing to ask questions and express concerns with peers.

12. Making Smart Lifestyle Choices • Compliance with the prescribed treatment plan • Sound dietary practices • Regular exercise • Stress management • Assertiveness in protecting one’s own needs • Development of a healing attitude and mind-set to live positively with the illness

13. Factors Affecting Patient Ability to Manage Illness • The status of the illness may change • The status of the patient may change • The status of the caregiver may change

14. Defense Mechanisms • Denial • Anger • Depression • Regression

15. Source • Eliopoulos, C. (2005).  Gerontological Nursing, (6th ed.).  Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).