8-27 Chronic Illness

Question 1

__% of the general population today has at least ___ chronic condition (___% of that general population are ____)

Answer 1

45% of the general population today has at least ONE chronic condition (Most of that general population [88%-> are 65 and older] )

Question 2

What are 4 Behavioral choices pt may make that can lead to Chronic Dzs?

Answer 2

1. Sleep Deprivation
2. EtOH abuse
3. Bad Eating
4. Smoking!

Question 3

What are some psychological rxns to chronic Illness? [3]

Answer 3

• Outsourcing Guilt (projection or blaming it on something else)
• Shame [pt may think society views them as “lazy” if they’ve failed in caring for their health]
• Change in Identity[no longer same person u used to be]

Question 4

What are the Multi-morbity risk strongest correlated with? [3]

Answer 4

Morbid risk correlated with:

• Age
• Lower education
• public Health insurance/medicaid

Question 5

Why is there a INC in Chronic Dz prevalence? [3]

Answer 5

1. You have an AGING POPULATION
2. INC population prevalence of many dz
3. Improved Life expectancies now-a-days dude

Question 6

A. What are the 5 STAGES OF HAVING CHRONIC ILLNESS?

B. This is similar to what?

Answer 6

A. IARDR (chronically, I Am Running from Depression and Ruin)
I=Isolation / A=Anger / R=Reconstruction / D=Depression intermittently / R= Renewal(hopefully)

B. Similar to Stages of Grief!!

Question 7

What did the N Engl J Med in 1984 determine regarding Chronic dz?

Answer 7

**That it took 4-6 months for a pt to finally accept a Chronic Dz and return back to a healthy normal mental state

Mental Health screens showed no real difference between healthy pts and chronic ill pt as long as dx was stable and 4-6 months had passed

Question 8

What’s the best way to invoke a response of change in a non-compliant pt??

Answer 8

determine WHAT THE PT FINDS IMPORTANT or WHY THEYD WANT THIS CHNGE in order to provoke that change in them? [“don’t you want to see your grandson grow up and grad med school?”]

Question 9

What is the CHRONIC CARE MODEL (CCM) for Chronic dz?

Answer 9

Uses effective team care to change daily care of chronically ill pt from acute-reactive to—> PROACTIVE-PLAN OUT AND POPULATION-CENTERED SYSTEM!
[involves more use of community resources/pt registries/integrated decisions/pt education of dz

Question 10

What is the concept of the “Medical Home”

Answer 10

Allows for Care coordination and integration for chronically ill pt by contacting them regularly to ensure compliance/transitional ease w/therapy
[Think of the 7 part House]