Focusing on health promotion, disease prevention and early detection is the best strategy for successful chronic disease management. Identification and early treatment of intercurrent illness is particularly important in frail seniors. Equally important is open communication.
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How do you support an older person with chronic disease?
Supporting Older Patients with Chronic Conditions. Try to start by appreciating that people living with chronic disease are often living with loss—the loss of physical function, independence, or general well-being. Empathize with patients who feel angry, sad, lost, or bewildered.
What are the treatment guidelines for chronic pain in the elderly?
The most appropriate treatment guidelines for chronic pain in the elderly are by the American Geriatrics Society (AGS), which were first formulated in 1998 and recently updated with newer pharmacological approaches in 2009 [1].
What are the best ways to promote health for older adults?
Promoting Health for Older Adults 1 Helping Older Adults With Dementia. Alzheimer’s disease, a type of dementia, is an irreversible, progressive brain disease that affects an estimated 5.8 million Americans. 2 Providing Resources to Caregivers. ... 3 Increasing the Use of Clinical Preventive Services
How can I improve the patient's experience of chronic disease management?
Make sure the print is large enough for the patient to read. Encourage your patient and his or her caregivers to take an active role in discovering how to manage chronic problems. Think in terms of joint problem solving or collaborative care. Such an approach can increase the patient's satisfaction while decreasing demands on your time.
What are the treatment options for chronic disease?
Treatment of chronic illness comes in many forms including surgery, physical therapy, psychological therapy and radiotherapy. However, one of the most common treatment forms is the use of medication.
What are the four items of the disease management plan?
Components of disease management programs include:Population identification processes. ... Evidence-based practice guidelines.Collaborative practice involvement. ... Risk identification and matching of interventions to need.Patient self-management education. ... Process and outcomes measurement and evaluation.More items...
What are the 10 helpful strategies for coping with the patient having a chronic disease?
Here are 10 helpful strategies for coping with a chronic condition.Get a prescription for information. ... Make your doctor a partner in care. ... Build a team. ... Coordinate your care. ... Make a healthy investment in yourself. ... Make it a family affair. ... Manage your medications. ... Beware of depression.More items...
What are the 5 most prevalent chronic diseases of the elderly?
5 most common chronic diseases Afflicting the elderlyArthritis. Arthritis is the most common problem, as during their life expectancy. ... Heart disease. Heart disease is another leading killer disease of elderly people who are mostly over 65. ... Alzheimer Disease. ... Diabetes. ... Mental health and depression:
What are the components of the specific disease case management program?
The essential components of disease management are (1) the identification of the population with diabetes or a subset with specific characteristics (e.g., cardiovascular disease risk factors), (2) guidelines or performance standards for care, (3) management of identified people, and (4) informa- tion systems for ...
What is an example of condition management?
According to Employee Benefit News, “A good condition management program includes guidance on nutrition, exercise, sleep and stress management, but how those areas are prioritized should depend on the individual.” For example, if a participant's poor nutrition habits are a result of their stress levels, tackling their ...
What is the best approach in controlling a chronic disease?
Get Regular Physical Activity Regular physical activity can help you prevent, delay, or manage chronic diseases. Aim for moderate intensity physical activity (like brisk walking or gardening) for at least 150 minutes a week, with muscle-strengthening activities 2 days a week.
What are the support group for chronic lifestyle conditions?
For information, help and support, contact: BeyondBlue on 1300 224 636 for help with depression and anxiety. Kids Helpline on 1800 551 800 for phone and online counselling for young people aged 5 to 25. Mensline Australia on 1300 789 978 for telephone and online counselling for men.
What are your coping strategies?
Healthy Ways to Cope with StressTake breaks from watching, reading, or listening to news stories, including those on social media. ... Take care of yourself. ... Take care of your body. ... Make time to unwind. ... Talk to others. ... Connect with your community- or faith-based organizations.Avoid drugs and alcohol.More items...
What are the chronic diseases of elderly?
High blood pressure (hypertension) affects 58% of seniors. ... High cholesterol affects 47% of seniors. ... Arthritis affects 31% of seniors. ... Coronary heart disease affects 29% of seniors. ... Diabetes affects 27% of seniors. ... Chronic kidney disease (CKD) affects 18% of seniors. ... Heart failure affects 14% of seniors.More items...
What are common chronic health problems for the elderly?
Chronic DiseasesOlder adults are disproportionally affected by chronic conditions, such as diabetes, arthritis, and heart disease. ... The leading causes of death among older adults in the U.S. are chronic diseases—heart disease, cancer, chronic lower respiratory diseases, stroke, Alzheimer's disease, and diabetes.More items...
How are elderly patients treated?
Use proper form of address. Establish respect right away by using formal language. ... Make older patients comfortable. ... Take a few moments to establish rapport. ... Try not to rush. ... Avoid interrupting. ... Use active listening skills. ... Demonstrate empathy. ... Avoid medical jargon.More items...•
What Is Advance Care Planning?
CDC’s public health activities to prevent and control disease include a substantial focus on chronic disease management. Advance care planning can...
How Can A Plan Help Me and My Family?
A plan relieves family members from wondering if they “did the right thing” on your behalf. A plan also provides your health care team with informa...
Communicating and Documenting Your Wishes
An important part of advance care planning involves having conversations with family members and other loved ones about what you would want in the...
What are the challenges of coping with chronic conditions?
For many older people, coping with multiple chronic conditions is a real challenge. Learning to manage a variety of treatments while maintaining quality of life can be problematic. People with chronic conditions may have different needs, but they also share common challenges with other older adults, such as paying for care or navigating ...
How to make a medication plan for a patient?
For example, minimize the number of doses per day. Tailor the plan to the patient's situation and lifestyle, and try to reduce disruption to the patient's routine. Indicate the purpose of each medication. Make it clear which medications must be taken and on what schedule. It is helpful to say which drugs the patient should take only when having particular symptoms.
Why do older patients want to know?
Most older patients want to understand their medical conditions and are interested in learning how to manage them. Likewise, family members and other caregivers want this information. Physicians typically underestimate how much patients want to know and overestimate how long they spend giving information to patients.
Why is it important to have a clinic?
Clinicians can play an important role in educating patients and families about chronic health conditions and can connect them with appropriate community resources and services.
How to explain a diagnosis?
In explaining diagnoses, it is helpful to begin by finding out what the patient believes is wrong, what the patient thinks will happen, and how much more he or she wants to know. Based on the patient's responses, you can correct any misconceptions and provide appropriate types of information.
How to encourage a patient to take notes?
Encourage the patient or caregiver to take notes. It's helpful to offer a pad and pencil. Active involvement in recording information may promote your patient's retention and adherence.
What to do after proposing a treatment plan?
After proposing a treatment plan, check with the patient about its feasibility and acceptability. Work through what the patient feels may be obstacles to maintaining the plan. They may not be medical. For instance, transportation might be an issue.
Why do we need a health plan?
A plan relieves family members from wondering if they “did the right thing” on your behalf. A plan also provides your health care team with information on your health care preferences and if you would want life-sustaining measures if there appeared to be little likelihood of your recovery.
What Is Advance Care Planning?
It is about doing what you can to ensure that your wishes and preferences are consistent with the health care treatment you might receive if you were unable to speak for yourself or make your own decisions.
Why is advance care planning important?
For the many older Americans living today with one or more chronic conditions, advance care planning is an important part of chronic disease self-management. While some people living with a chronic disease enjoy a reasonably good quality of life, in many cases, chronic diseases are ultimately accompanied by slow, ...
What is chronic illness?
A chronic disease is a long-lasting condition that can be controlled but not cured; it affects the population worldwide, and in the U.S., it is considered the leading cause of death and disability.
What are the three risk factors that play a part in every disease?
As you probably have noticed; lack of physical activity, poor nutrition, and tobacco use are three controllable risk factors that play a part in every disease.
How can we reduce the statistics on the single greatest preventable cause of death in the world today?
By not using tobacco and staying clear of second hand smoke we can reduce the statistics on the single greatest preventable cause of death in the world today.
How to help arthritis pain?
Assisting devices- for severe arthritis using a cane, one-touch lamps or other assisting devices can help protect your joint and improve quality of life. Minimum trauma – by reducing stress on joints.
What is the CDC's Alzheimer's program?
CDC’s Alzheimer’s Disease and Healthy Aging Program works with partners and states to gather information on self-reported cognitive decline and caregiving among adults through the Behavioral Risk Factor Surveillance System (BRFSS). To encourage using these data for action, CDC developed an interactive data portal and a series of statistical briefs and infographics.
How to help arthritis?
CDC recommends several proven ways to help people manage arthritis symptoms: Join a self-management education program, such as the Chronic Disease Self-Management Program, that teaches the skills and confidence to live well with arthritis every day. Be active.
What is the CDC's goal?
CDC’s National Center for Chronic Disease Prevention and Health Promotion funds partners to improve the health of older adults by: Helping those with dementia remain active, independent, and involved in their community as long as possible . Providing resources to help caregivers stay healthy and deliver quality care to their care recipients.
What is the role of a clinical preventive service?
Increasing early assessment and diagnosis, risk reduction, and prevention and management of chronic diseases for people with or at risk for Alzheimer’s disease and other dementias. Increasing the use of other clinical preventive services like blood pressure checks , cancer screenings, and blood sugar testing.
How much does Alzheimer's cost?
In 2019, health care and long-term care costs associated with Alzheimer’s and other dementias were $290 billion, making them some of the costliest conditions to society.
When was the Bold Infrastructure for Alzheimer's Act passed?
The BOLD Infrastructure for Alzheimer’s Act was passed into law on December 31, 2018 , Public Law 115-406. BOLD activities are designed to promote use of CDC’s Healthy Brain Initiative Road Maps.
Is dementia a reward for caregivers?
Although caregiving may be rewarding, caregivers are at risk of increased stress, depression, unhealthy behaviors, and poor attention to their own health. Caregivers of people with dementia are at even higher risk, and they may delay dealing with their own health needs.
What are the best ways to treat chronic pain in the elderly?
Various treatment options are available for chronic pain management in the elderly including either pharmacological or non-pharmacological measures or both combined. A comprehensive approach to dealing with common sequelae such as depression, isolation, and physical disability is considered effective. Non-pharmacological measures are considered particularly important in elderly patients as they have a lower frequency of adverse reactions compared with pharmacologic approaches and their benefit is usually enhanced when combined with drug strategies. Effective non-pharmacological approaches include physical therapy, cognitive behavioral therapy, and most importantly, patient and caregiver education interventions [12, 13], while pharmacological treatment modalities include non-opioid and opioid medications, pain modulating drugs, topical agents, and other newer therapies.
What is the most commonly used medication for elderly people?
Multiple comorbidities and the risk of polypharmacy in the elderly make it a challenge to determine the appropriate drug, dosage, and maintenance of therapy. Opioids are the most commonly used agents for this purpose in the elderly. The aim of this article is to discuss both the current well-established therapies used for managing chronic pain in the elderly and also the emerging newer therapies.
What is the best treatment for neuropathic pain?
Anticonvulsants: Antiepileptic drugs such as carbamazepine, gabapentin, and pregabalin are mainly used for neuropathic pain. In elderly patients with renal impairment, dose adjustment of gabapentin and pregabalin is required. Carbamazepine currently is the first line therapy for neuralgia. Gabapentin and pregabalin are recommended to be taken in short courses (two to four months) for certain types of neuropathic pain including diabetic neuropathy, central neuropathic pain after spinal cord injury, postherpetic neuralgia, and fibromyalgia. A meta-analysis study assessing 300 mg of pregabalin daily for neuropathic pain showed 50% reduction in pain [34]. Gabapentin dosage must be carefully titrated starting with 100-300 mg daily, up to a maximum dose of 3600 mg [35].
Why do elderly people have chronic pain?
Musculoskeletal disorders such as degenerative spine and arthritic conditions are the most common cause of chronic pain in the elderly. Other common causes of significance include neuropathic pain, ischemic pain, and pain due to cancer as well as its treatment [6]. Among elderly women, there is a high prevalence of vertebral compression fractures causing pain and discomfort.
What are the effects of chronic pain in the elderly?
Chronic pain in the elderly is associated with an increased incidence of adverse outcomes, including functional impairment, falls, depression, and sleep disturbances. Pain management in older persons differs significantly from that in younger persons. Concomitant chronic illnesses make pain evaluation and treatment more difficult in the elderly. Also, older people respond differently to various therapies, usually with lesser efficacy and more severe adverse reactions, including additional risks of polypharmacy and addictions. In addition to this, the majority of elderly living in nursing homes have some degree of cognitive impairment, which has an impact on their ability to report pain resulting in inadequate pain assessment and management [7]. There is a lack of evidence-based guidelines for the treatment of chronic pain in the elderly as studies tend to focus more on younger adults. However, in the recent past, there has been an increase in the number of studies focused primarily on pain control in the elderly.
What are the risks of taking opioids in the elderly?
A prerequisite before initiation of opioid therapy is the evaluation of risk versus benefit in view of its adverse effects, and efforts to reduce risks are mandatory. Administration of opioids in the elderly is done on a trial basis to titrate the effective dose reaching the therapeutic goal with minimal adverse effects, starting with the lowest possible dose and gradual titration. Respiratory depression is one of the major concerns of opioid therapy, though tolerance to this effect develops rapidly. Respiratory depression is particularly common in patients who increase their doses rapidly, patients using drugs like methadone with variable pharmacokinetics, patients with concomitant use of drugs like benzodiazepines or barbiturates. Elderly patients in particular with hepatic and renal dysfunction are at increased risk due to resultant drug accumulation, which warrants regular monitoring of parameters like glomerular filtration and dose adjustments [30, 31]. With due course of time, tolerance develops to the majority of the side effects of opioids (except constipation due to gastric hypomotility) like respiratory depression, sedation, nausea, and vomiting. Until the development of tolerance, patients are managed with combined administration of antiemetics and usage of assistive devices. Complications of long-term usage of opioids include suppressed production of pituitary, gonadal, hypothalamic, and adrenal hormones manifesting as depression, fatigue, and decreased libido [1]. With prolonged therapy, opioid abuse is another major concern. Every patient should be assessed for risk factors related to the potential abuse with available tools like opioid Risk Tool (ORT) and the SOAPP-R (revised Screener and Opioid Assessment for Patients with Pain) [32]. Although clinicians must remain vigilant about the possibility of misuse or abuse of opioid agents in all patients, older age is generally associated with a relatively lower risk for opioid misuse and abuse [33].
How long does it take for an elderly patient to return to the hospital?
Hospital Readmissions released in February 2013 by the Robert Wood Johnson Foundation, one in five elderly patients is back in the hospital within 30 days of leaving and many of these readmissions can be prevented [42].
What to do if HC agrees to take client?
Contact HC in same geographic area as patient, if HC agrees to take client, PD asks HC to contact HHS RN to schedule home visit with RN and patient near the discharge date
What are the HCs trained to do?
HCs were trained to teach and encourage their clients to monitor and record weight, blood pressure, pulse rate, and blood glucose, as indicated by the clients’ diagnoses; and to calibrate their relevant devices, all provided by the program, such as easy-to-read digital scale, BP monitor, and glucose monitor.
How do HCs help their clients?
They developed skills in helping their clients build self-efficacy, develop behavior change goals, reward themselves for meeting goals, and prevent relapse to unhealthy behaviors. These skills helped HC clients improve their success in mastering self-management behaviors such as following dietary recommendations, creating a physical activity plan appropriate for their health status and fitness level, and selecting tobacco use cessation strategies. Additionally, HCs learned how to assist someone in conducting a home fall risk and safety assessment and how to secure community resources to make home repairs.
What is home health services?
Home health services (HHS) after hospitalization can better prepare older adults and their caretakers to manage chronic diseases at home . However, HHS is primarily focused on delivery of skilled nursing care and during an episode of care it is challenging to find adequate time to mentor patients and caregivers in mastering disease self-management skills. Research has shown that inadequate control of chronic disease is often not due to a lack of technology or access to specialists, but rather due to a lack of support for daily lifestyle changes such as keeping records of glucose levels or increasing physical activity [23,24].
Why are healthcare systems more accountable for patient outcomes?
Healthcare systems are now more accountable for patient outcomes because of shifts to value-based programs [29], which makes reduction of preventable ED use and hospital readmissions even more critical. Consequently, different roles have emerged to complement delivery of healthcare services and improve outcomes of the highest-risk patients. For example, patient navigators assist patients by eliminating barriers to timely diagnosis and treatment [30] and care transition managers and nurse health coaches facilitate post-discharge planning and care coordination to reduce hospital readmissions [31]. In the corporate sector, employee wellness programs are offered to help reduce healthcare costs [32]. In the community, Community Health Workers (CHWs), have historically built on their cultural competence to advocate for improved health outcomes of underserved community members [33]. Health coaching is a health education method focused on lifestyle changes delivered in a coaching context which has proven to improve chronic condition self-management [34]. Health coaches have been used in various settings such as healthcare systems, community, and corporate [34].
What does a health coach do at home?
When the client demonstrated he/she could properly use their equipment, they recorded their baseline health status indicators such as BP, glucose levels or weight in their Personal Health Diary. On subsequent home visits, the Health Coach reviewed with the client their daily entries in the Personal Health Diary. Twenty-one out of the 33 Health Coach clients regularly tracked their conditions in their Health Dairies for a range of days from 21 to 224. With those clients not regularly tracking their condition, Health Coaches discussed ways to add this task to their daily activities. For those clients who were successfully tracking, the Health Coach complemented them on their commitment to monitoring their health, celebrated successes and discussed any trends which may be problematic. If, for example, the client was not staying within their recommended glucose parameters, the HC discussed any difficulties the client may be having with diet and physical activity or with taking diabetes medications. In this same example, if glucose levels were above those recorded on the “stoplight” of red flag symptoms, the HC helped the client follow through with the recommended action.