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Chronic care refers to medical care which addresses pre-existing or long term illness, as opposed to acute care which is concerned with short term or severe illness of brief duration. Chronic medical conditions include asthma, diabetes, emphysema, chronic bronchitis, congestive heart disease, cirrhosis of the liver, hypertension and depression.
The incidence of chronic disease has increased as mortality rates have decreased. Condition, injuries and diseases which were previously fatal can now be treated with chronic care. Chronic care aims to maintain wellness by keeping symptoms in remission while balancing treatment regimes and quality of life. One of the greatest challenges in this field of health care is dealing with the co-existence of multiple disorders. Chronic care is complex in nature because it may extend over a pro-longed period of time, requires input from a diverse set of health professionals, various medications and possibly monitoring equipment.
According to 2008 figures from the Centers for Disease Control and Prevention chronic medical care accounts for more than 75% of health care spending in the US.  In response to the increased government expenditure in dealing with chronic car policy makers are searching for effective interventions and strategies. These strategies can broadly be described within four categories. These are disease prevention and early detection, new providers, settings and qualifications, disease management programs and integrated care models.
Nursing care for the chronically ill
A nurse has to be qualified to handle all the needs of a chronic client and has to be an advocate to put the case of the chronically ill across to the health administration, hospital board or their families.
A variety of specialists such as surgeons, dietitians, nutritionists, and occupational therapists have to be in attendance for the maximum benefit of the client. Someone suffering from chronic pain for a long time may need the help of a psychiatrist. Everyday activities that the physically fit see as normal may be a Herculean feat for the chronically ill and they need all the support that they can get. The nurse may be privy to some of these help that the chronically ill can benefit from. They need to be proactive and put these patients in contact with these help but also sensitive enough to give their client the freedom to decline any help if they think that they do not need it.
Chronic pain might also get the person to start questioning their faith and/or wanting to have a deeper spiritual experience because of their pain and suffering.
The patient also needs to take time to participate in some fun activities. They may need to check out of the facility/hospital or get out of the house occasionally preventing an association of hospitals with pain. This further helps the patients keep their sanity and keeps them psychologically sound.
They may need a nurse who is qualified in palliative care. Some may be dying and they need respect and dignity as they die in pain. They also need a nurse who is non-judgmental and one who is also compassionate and caring. The family has to be involved to help the client better manage the pain. One very important quality is co-ordinating the best care for the client and some amount of diplomacy and empathy.
In some cases, such as with diabetes or sleep apnea, the treatment is long term and difficult for patients to understand and comply with. In theses cases chronic care management is highly recommended to help the patient learn about the consequences of refusing treatment and how to best follow treatment.
- Larsen, Pamala D. (2011). "Chronicity". In Lubkin, Ilene Morof; Larsen, Pamala D. Chronic Illness: Impact and Intervention. Jones & Bartlett Publishers. pp. 3–4. ISBN 0763799661. Retrieved 10 March 2014.
- Ellen, Nolte; Cécile Knai, Martin McKee (2008). Managing Chronic Conditions: Experience in Eight Countries. WHO Regional Office Europe. p. 2. ISBN 928904294X. Retrieved 11 March 2014.
- Busse, Reinhard; Miriam Blümel, David Scheller-Kreinsen, Annette Zentner (2010). Tackling Chronic Disease in Europe: Strategies, Interventions and Challenges. WHO Regional Office Europe. p. 3. ISBN 9289041927. Retrieved 11 March 2014.
- As good as it gets? Chronic care management in nine leading US physician organisations - American Hospital Association Chronic Care Management