Chronic Illness
“Chronic illness is the irreversible presence, accumulation, or latency of disease states or impairments that involve the total human environment for supportive care and self-care, maintenance of function and prevention of further disability: (Lubkin, 1995, p.8)
Principles Related to Chronic Illness / Trajectory o Duration- lasts for extended period, six months or longer. o Incidence- common in older adults but impacts all ages. o Predictability- one chronic condition impacts 85% of persons 65 years of age and older. The most common are visual impairment, diabetes, heart disease, deafness and hearing impairment, arthritis,
Alzheimer’s, osteoporosis, hip fractures, urinary incontinence, stroke, Parkinson’s disease and depression o Shape- multiple health problems with protracted, unpredictable course. Management during the acute phase is usually in the hospital, other phases are usually managed at home.
Implications of Chronicity:
1. Managing chronic illness involves more than managing medical problems. Adaptation to illness/disability is a continuous process.
2. Chronic conditions can pass through many different phases over the course of the disease – There can be stable & unstable periods, flare-ups & remission.
3. Keeping chronic conditions under control requires persistent adherence to therapeutic regimens.
4. One chronic disease can lead to other chronic conditions – Diabetes can lead to Neurologic & circulatory changes.
5. Chronic illness affects the whole family
6. People with chronic conditions & their families must assume major responsibility for the day-to-day management of the condition.
7. Management of chronic conditions is a process of discovery.
8. Managing chronic conditions is a collaborative process
9. Management of chronic conditions is expensive
10. Chronic conditions pose ethical dilemmas for the pt, HCPs & society.
11. Living with chronic illness means living with uncertainty