Hereditary
Assessment of functioning
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Aging does not cause disease nor does disease cause aging Dizziness, confusion, forgetfulness and incontinence are not normal aging, but usually signs of a disease process Even if someone has a disease, symptoms may be corrected or relieved
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Chronic Illness
Persists for a long time and is either incurable and/or results in pathological changes that limit normal functioning. Virtually everyone will eventually develop some type of chronic condition.
Chronic Diseases
HTN DM CHF OA COPD Cancer Mental Health Illness- depression/ dementia/ psychosis etc Chronic Infectious Diseases: HIV/AIDS, Hepatitis
Obesity
Cognitive impairment
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friends
3. Affording medical care
* Arthritis (34%), obesity (28%), hypertension (23%),cardiovascular (20%), lung (17%) ** Physical (31%), pain (28%), emotional (16%), daily activities (16%) *** Eating/weight (39%), joint pain (32%), sleep (25%), dizzy/fatigue (23%), foot (21%), backache (20%)
If these reactions last too long, they can have an negative effect on the illness
..Glimmers of Hope
The Cancer, Kidney, Diabetes, & Heart & Stroke Associations working together Moves to develop true community clinics Concerted efforts to produce model of care that makes the best use of resources & improves access to relevant & effective care Government has identified priorities & improved collaboration
Health System
Health Care Organization Delivery System Design Clinical Information Systems
Decision Support
Productive Interactions
Improved Outcomes
Model Development 1993 - Initial experience at GHC Literature review RWJF Chronic Illness Meeting -- Seattle Review and revision by advisory committee of 40 members (32 active participants) Interviews with 72 nominated best practices, site visits to selected group Model applied with diabetes, depression, asthma, CHF, CVD, arthritis, and geriatrics
Productive Interactions
Productive Interactions
Assessment of self-management skills and confidence as well as clinical status Tailoring of clinical management by stepped protocol Collaborative goal-setting and problem-solving resulting in a shared care plan Active, sustained follow-up
Self-Management Support
Emphasize the patient's central role Use effective self-management support strategies that include assessment, goalsetting, action planning, problem-solving, and follow-up Organize resources to provide support
Decision Support
Embed evidence-based guidelines into daily clinical practice Integrate specialist expertise and primary care Use proven provider education methods Share guidelines and information with patients
Physical Illness
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Gender:
Four times more common in women than men One in three women and one in 12 men over the age of 50
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Osteoarthritis
Cartilage surrounding joint breaks down Knees and hips most common sites, but may affect the back and fingers Those who overuse joints are at greater risk
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Rheumatoid Arthritis
Disease of the immune system affecting tissue surrounding the joint Can appear at any age, but most commonly diagnosed among women between the ages of 20 and 50 More rigorous drug therapy or surgery may be necessary
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Caused by a buildup of uric acid crystals in the fluid that bathes the joint; usually affects the big toe Causes severe pain and swelling in that joint
Ankylosing Spondylitis
Degeneration of the joints that support, and are part of, the spinal column
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Treatment
Adequate rest Stretching and daily ROM exercises Maintaining ideal weight Taking aspirin and ibuprofen Hot and cold treatments for minor discomfort Over-the-counter preparations containing capsicum, camphor, or menthol For more severe cases, corticosteroid 55 injections to fight inflammation
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Assistive Devices
Canes Lid and jar rubber or synthetic openers Faucet turners Reachers/grabbers Flipper type door handles Extended handles on tools
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Lifestyle:
Encourage use of affected extremity to increase muscle strength Avoid doing things for him/her that he or she can do Be supportive and sympathetic but firm and direct Expect some emotional ups and downs May need to install hand rails by toilet, bed, etc
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Aphasia
American Stroke Association
Stroke survivors, although able to think as well as before the stroke, may experience an interference in the use or understanding of language The individual is unable to get the right words out or is unable to process words coming in
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Responses and Support Be patient Allow the person time to understand and respond Use visual cues and gestures Use short, clear words Use visual aids Nod when understanding Allow person to write instead of speak
Discomfort in the center of the chest that lasts more than a few minutes Discomfort in other areas of the upper body in one or both arms, the back, neck, jaw or stomach Shortness of breath accompanied by chest discomfort or can occur before the chest discomfort Breaking out in a cold sweat, nausea or lightheadedness
Response: Call 9-1-1; Start CPR if individual stops breathing (only if qualified) www.americanheart.org
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Women at Risk
American Heart Association
The risk of dying from a heart attack is higher for women than men As with men, women's most common heart attack symptom is chest pain or discomfort Women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain
Response: Call 9-1-1; Start CPR if individual stops breathing (only if qualified) www.americanheart.org
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The Red Dress was designed to build awareness that women are at risk; give a sense of hope that women can reduce their risk and empower them to do so; and provide a clear call to action coupled with a sense of urgency. The Heart Truth
Response Nitroglycerin tablet is placed under the tongue and allowed to dissolve Works in Angina one-half to three minutes Mild to severe chest pain which may radiate to the neck or shoulders, lasting less than three minutes Caused by some obstruction in a major blood vessel of the heart (arteriosclerosis) Brought on by exertion, cold, eating a heavy meal or excitement Management strategies: Losing weight, stopping smoking and managing stress
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Excessive thirst Extreme hunger Unusual weight loss Increased fatigue Irritability Diabetes is expected to Blurry vision increase as much as 165% Itching over the next 50 years, Poor wound healing especially among those age 75 and older Stress such as infection or surgery may worsen symptoms
Caused when the body is unable to make use of sugars and starches Glucose accumulates in the blood and may appear in the urine
www.diabetes.org
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