Concepts of chronic care, illness and restorative care Flashcards
Chronic disease
The actual medical or health problem with associated symptoms or disabilities that require long term mgmt
Chronic illness
A person’s perception of a chronic disease and their experience with it, as well as other’s perception and responses to the disease
Secondary Health condition
Any physical, mental or social disorders resulting directly or indirectly from an initial condition
Example, a person that experienced a car crash may develop anxiety or depression
Non-communicable diseases
Diseases not caused by an acute infection
General definition of chronic disease
Irreversible, having a prolonged course, unlikely to resolve spontaneously
Chronic disease effect on functioning
Physical, emotional, intellectual, social, and spiritual and can have some degree of disability
Disabilities
-Restriction to perform an activity in a “normal” matter
-Can be related to a effects of a chronic illness or a disease state or caused by modifiable and non-modifiable risk factors
Risks of having MCC (Multiple chronic conditions)
-Conflicting medical advice (doctor hopping)
-Adverse effects to medication (Htn and other meds)
-Unnecessary and duplicative test
-Preventable hospitalization
Modifiable risk factors for chronic disease
-Diet, weight, glucose control, Medications, substance abuse
Phases of chronic care: Pre-trajectory
You have genetic or lifestyle habits that place you at risk of a chronic disease which are identified
-No symptoms of disease yet
Phases of chronic care: Trajectory onset
-Onset of symptoms that occur with the disease
-Focus on the diagnostic workup
-Nurses role: Explain testing and procedures, offering emotional support
Phases of chronic care: Stable
-Symptoms are managed usually in the home
-Nurses role, reinforcement of positive behaviors, offer ongoing monitoring, offer education and encourage health promoting activities
Phases of chronic care: Unstable
-Exasperation of symptoms, complications occurring or reactivation of overall illness
-Difficult to keep symptoms under control
-May need more testing or regiment readjustment to get symptoms under control
-Care is still occurring at home
-Nurses role: Guidance and support, keep up and reinforce previous education
Phases of chronic care: Acute
-Severe and unrelieved symptoms or development of illness or complications
-REQUIRES hospitalization
-Nurses role provide direct care and emotional support
Phases of chronic care: Crisis
Critical or life-threatening, situation requiring emergency treatment
Nurses role, collab with other health care providers to stabilize the patients condition
Phases of chronic care: Comeback
-Gradual recovery after an acute period, learning to live with disabilities and return to an acceptable standard of living (Independence)
-Nurses role, assist in care coordination, rehab
Phases of chronic care: Downward
-Rapid or gradual worsening of condition, physical decline with increasing disability or difficulty in controlling symptoms.
-Differs from acute or crisis stage as this associated with increased disability
-Nurses role: Provide home care, and other community based care to help patient and family adjust to changes . Integration with new treatment strats
Phases of chronic care: Dying
Patient is dying, final days or weeks with the body shutting down
_nurses role, provide emotional support and direct care
Direct Care
-Assessment, wound care, mgmt , overseeing , and admin of meds as well as technical skills
-Alot can be done at home now as well
Supportive care
-Monitoring, education, consoling , patient advocate, referrals, case mgmt
Primary prevention chronic disease
-Prevent people from developing the disease
-Education about exercise, diet, immunizations
Secondary prevention, chronic diseases
-Early intervention to slow or halt the progression of the disease
-Low dose aspirin to prevent acute MI after development of htn
Tertiary prevention: Chronic disease
Treating and rehab
-Preventing further exasperations of the disease, or deteriorating worse
-Example: Chronic pain mgmt programs, cardiac rehab programs, follow up care after a surgery
Goals of restorative care
-Increase functional levels
-Maximize existing abilities
-Increase independence
-Utilize available resources
-Multidisciplinary approach for best results
-Preserve self esteem
-Improve quality of life
-Assist in adaptation to lifestyle changes
-Achieve tasks independently
-Provide psychosocial support to client and family
-Help the patient set realistic goals
