Chronic Illness and Palliative Care - Coursework Example

Chronic Illness and Palliative Care Name Course Tutor Date Chronic Illness and Palliative Care Chronic illness is identified as a disease that is persistent and long lasting. It is usually referred to as a recurrent disease. The term chronic refers to the onset and development of the disease in one’s body. The various types of chronic diseases are; hemophilia, persistent fatigue, cardiovascular illness, arthritis, rheumatoid arthritis, AIDS, asthma, cystic fibroids, epilepsy, cancer, allergies, lupus, diabetes, psoriasis and osteoarthritis. Palliative care refers to the treatment or a form of medical intervention that seeks to reduce the severity of disease symptoms. It aims at bringing relief and improving life quality. Asthma refers to a common chronic illness that inflames and narrows the airways, and is characterized by recurring and variable symptoms. It is caused by genetic and environmental factors. It is characterized by chest tightness, coughing, wheezing, and shortness of breath. These symptoms could be deterred by avoiding exposures to agents such as: allergens and irritants and by inhaling corticosteroids. The environmental factors that triggers asthma includes: psychological stress, exposure to endotoxin, high ozone levels, air pollutants, volatile organic compounds, and respiratory infections such as Chlamydia pneumonia and rhinovirus. Psoriasis is an illness that is chronic and appears on the skin. Usually occurs when the immune system sends incorrect signals that fasten the growth cycle of skin cells. The five types of psoriasis are plaque, guttate, inverse, erthrodemic and pustular. The plaque psoriasis is the most common and it appears as raised areas of skin that is inflamed. Depending on its severity, psoriasis can be treated by topical treatment in the form of solutions, mineral oil, and petroleum jelly, phototherapy treatment or systemic treatment, which involves taking the pill or injection. When one is first diagnosed with a chronic illness, feelings of despair and worry surfaces up. One is usually overwhelmed, as the condition requires several changes to the lifestyle they live. These changes include diet changes, regular medication and monitoring of the body and controlling the alcoholic intake (Donna R. Flavo, 2009). Despite the fact that there are medical treatments to control the condition, patients suffering from chronic illnesses are affected both mentally and emotionally and harbor great fears of uncertainty as to whether their condition will be permanent or will worsen day after day. Daily living with a chronic disease can be frustrating, depressing, and stressful. It is difficult for a patient to live with chronic illness and this can be reflected by his decreasing job performance and output, mood disorders, improper social functioning and even depression. Chronic disease control needs keen attention to social, clinical, environmental, and behavioral aspects. The aspects, which include lifestyle, difficulty in taking medicine or non-adherence to medication and help from others could result to inadequate control of the chronic illness. For an effective long-term treatment, a chronic disease requires proper chronic care management (Donna R. Flavo, 2009) Chronic care management brings together the oversight and the educational activities conducted by specialists in health care to help the patients living with the chronic disease to understand their condition and manage it well. Chronic management also involves encouraging and motivating patients to undergo therapies and other necessary medical interventions and helping the patients to achieve and maintain a reasonable quality of life (Anderson, 2007). Coping with chronic illness is possible in several ways such as; staying connected by maintaining good relationships with family and friends, taking good care of oneself by having complete rest, eating well, exercising and being happy, having a daily routine and being active as much as possible. Living with the illness gives one a better understanding of how the body functions and a renewed outlook towards life (Kelly, 2011). Maintaining a good quality of life and at the same time managing your chronic illness well is very important. In order to do this a patient needs to do some certain things such as: Learning, an individual should get all the facts about his condition and be well updated. This will bring about a feeling of being in control and comfort. One could get adequate information by being involved in an organization that deals in that illness. Medication self management; A person living with a chronic illness should ensure that he/she is aware and understands all the prescribed drugs and know how to take the correct dosage of the medicine. Talking to someone with the same condition; A patient diagnosed with a chronic illness may feel different from other people and it will really help identifying and interacting with patients experiencing the same condition. Good support; Another way of managing a chronic condition is by finding good support from different sources such as friends, family, psychologist, counselor, doctor or medical specialists. It is very helpful talking to someone who is approachable and one who is well updated and knowledgeable about your condition. Making sure that one gets the best support; it is not uncommon for a patient to be seeing a doctor that will oversee the management of their condition. It is thus very important for a patient to have a doctor of whom he/she can trust, who understands the patient, and who is very honest to both the patient and to himself. Scott should be able to maintain his quality life by understanding and managing his condition well by adhering to prescribed drugs. Some commonly used asthma medications have adverse effects to older adults. However, this should not deter him from taking his prescribed medication. He should ensure that he takes all drugs as instructed by the doctor since lack of doing so could aggravate his condition. In addition to that; Scott should also be well informed about his condition and ensure that he avails himself for all the scheduled appointments with his doctor (Kelly, 2011). The fact that he lives alone should make Scott have complete knowledge on the early signs and symptoms of his condition so as to seek appropriate care when the need arises. Empowerment refers to the process of increasing an individual’s capacity to make choices through self-actualization and transform those choices into actions and outcomes. Empowerment is also identified as the increase of social, political, economic, and spiritual strength of individuals or groups. Empowerment may be considered in three different levels; Personal, communal or organizational. However, it has to be noted that empowerment can only be achieved as a going concern, emanating from an individual in this case Mr. Scott going to the collective empowerment of the community. Personal empowerment is defined as a process by which an individual gains more power over her/ his life (Wallerstein, 2006). Studies show that the development of individual empowerment is directly linked to positive outcomes, including better management of the disease complications, more effective decision making and adoption of healthier lifestyles (Oudshoom, 2006). Personal empowerment includes the enablement process and the appropriation process. Enablement process is termed as the professional intervention that is aimed to recognize, support, and emphasize on the patients’ ability to have control over their life. Appropriation process is identified as the results of this intervention on the patient. In empowering Mr. Scott, the focus is to enable, him becomes a better manager of his own care. The elements of the empowerment concept in a health care setting includes: expanding the possibilities, implications and support to effective decision making, facilitation of the learning process, personal contribution to the therapeutic relationship and valorization of Mr. Scott’s strengths as a whole. For Mr. Scott to be empowered he needs to participate in the therapeutic relationship by being encouraged to open up and talk about his bottled up fears and worries about his condition and about his future. Mr. Scott’s possibilities should be broadened through drawing up a positive picture of the future and by outlining various examples of patients who had the same condition and succeeded in managing their disease. A patient needs to be considered as an individual and the impact of the changes to take place in the patient’s life, work, and family should be seriously considered (Wallerstein, 2006) In this context, Mr. Scott needs to enlist the assistance of someone to help him with the house and farm chores. The fact that his wife left him three months prior does not seem to make the matter any lighter. He should consider getting someone to be doing thorough cleaning of his home as well as preparing healthy meals, which exclude dairy products and shell fish for him. As the health care professional, I should also provide detailed information about the condition so as to enable him to fully learn and have a better understanding of his condition. In the empowerment process, there has to be shared decision making and Mr. Scott has to participate by voicing his opinions and views about the interventions to be followed. A care plan needs to be developed for Mr. Scott as a chronic patient. The care plan is very important as it helps in effective management of the illness while promoting a better quality life to him. The two types of care plans are the General Practitioner Management Plans (GPMP) and the Team Care Arrangements (TCA). Before providing these plans, a medical doctor has to assess whether a plan is necessary for the patient and also has to obtain consent from him. An effective plan should have a well-written and structured approach to aid the patient and the health care giver to identify the patient’s needs and planning what needs to be done (Toofany, 2007). A proper plan should consist of the following four parts: Part one should include the patient review calendar and all that is needed to be done. Part two should consist of the annual review. Part three is all about the personal health background of the patient. Part four should comprise of the chronic disease care plan review. General Practitioner Management Plans This type of care plan is commonly suggested to individuals with a chronic medical condition. It is defined as the plan of action that a patient agrees with his general practitioner. This type of plan identifies the patient’s health and care needs, outlines the services to be provided by the doctor and also provides the list of actions that one could undertake so as to help manage his/her chronic condition. Once a patient agrees to this care plan, the doctor will begin documenting the investigations and assessment of the patient’s care and health needs. All this is documented in a management plan and a copy of the plan is given to the patient. A review of the plan should be done on a regular basis (Kelly, 2011). Team Care Arrangements This plan applies to patients with chronic medical condition but with needs of complex care. This will help to effectively coordinate the care a patient needs from his/her doctor and other health care providers. This program requires the doctor to work together with at least two other healthcare providers who will provide treatment to the patient (Kelly, 2011). The patient in this case should identify and let his/her doctor know the private information related to the care that should not be disclosed to the other caregivers. Once a care plan for a patient becomes effective, it should be regularly reviewed so as to check that the patient’s goals are met and to agree and adjust to any changes. Scott needs to be provided with both of the care plans since he has special needs. These care plans may be provided by his doctor or his practice health care team. He should agree to such care programs prior to his doctor commencing the care plan. Scott needs to be provided with continuous care since of the other present conditions that could worsen his chronic illness. The present conditions that pose a risk to Scott’s life are: lack of proper diet, poor standards at his house, working environment at the farm, which exposes him to potential triggers to his illness, and a lack of companion to monitor and aid him in his daily normal activities. A team care arrangement plan will be suitable to help Scott to better his life and manage his illness well. The fact that he has been alone since his wife left necessitates a health care provider to support and monitor him. The health care provider should also ensure that arrangements are put in place so that Scott eats foods that are nutritionally adequate and his living conditions are clean and safe enough for him. Scott’s doctor should review his care plan after six months. References: Anderson G (2007). Chronic Conditions: Making the Case for Ongoing Care Chart book: Partnership for Solutions. Baltimore, MD. http://www.rwjf.org/pr/product.jsp?id=14197 (accessed 20 June 2009). Centers for Disease Control (2009). Chronic disease overview. Available at: http://www.cdc.gov/NCCdphp/overview.htm Healthy People 2010 - www.healthypeople.gov Weinberg D, Lusenhop R, Gittell J, Hoffer J & Kautz C (2007).Coordination between formal providers and informal caregivers. Health Care Management Review 32, 110. doi: 10.1097/01.HMR.0000267792.09686.e3 Kelly, M. D. (2011). Self-management of chronic disease and hospital readmission: a care transition strategy. Journal of Nursing and Healthcare of Chronic Illness, 3: 4–11. doi: 10.1111/j.1752-9824.2010.01075. Donna R. Flavo. (2009). Medical and Psychosocial aspects of chronic illness and disability. Sudbury, Mass. Jones and Bartlett Publishers. Streiner, D. L. & Norman, G. R. 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Copenhagen, WHO Regional Office for Europe (Health Evidence Network report). http://www.euro.who.int/document/e88086.pdf WebMD.com 5 Nov.2007.Coping with Chronic illness: what goes wrong: when it comes to Self- managing Chronic conditions. Wallerstein, N. (2006) What Is the Evidence on Effectiveness of Empowerment to Improve Health? Copenhagen, WHO Regional Office for Europe (Health Evidence Network report). http://www.euro.who.int/document/e88086.pdf (last accessed 29 April 2009). Read More