Chronic care

Chronic care refers to medical care which addresses preexisting 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, but are not limited to, asthma, emphysema, chronic bronchitis, congestive heart disease, cirrhosis of the liver, hypertension and depression. Chronic medical care accounts for more than 75% of health care dollars spent in the US.

Nursing care for the chronically ill

A nurse has to be qualified to handle all the needs of a chronic client. He/She 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 specialist to name a few such as surgeons, dietitians, nutritionists, occupational therapists, and spiritual heads 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 an 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 that 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 coordinating 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.

Health care professionals by in large have been trained in the acute model of care. Both the World Health Organization and the Institute of Medicine have called for the retooling and retraining of health care professionals to address the needs of individuals with chronic conditions. Experts agree that this will require greater attention to the delivery of 1.) Evidence-based medical care, 3.) Evidence-based self-management support strategies (beyond legacy patient education-based approaches), and evidence-based health coaching applying validated approaches such as motivational interviewing.

External links

• National Diabetes Education Program
• BMJ Education and Debate
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• [2]
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• American Hospital Association Chronic Care Management
• Sleep Care Program
• Chronic Care Professional (CCP) Certification