chronic ILLNESS
ssigned readings:
Dion, K. A., & Jacelon, C. S. (2019). Home Health Care. In P.D. Larson (Ed.), Chronic illness: Impact and intervention (pp. 469 – 489). Burlington, MA: Jones & Bartlett Learning.
LeBlanc, R. A. (2019). Self-Managment. In P.D. Larson (Ed.), Chronic illness: Impact and intervention (pp. 311 – 331). Burlington, MA: Jones & Bartlett Learning.
Pierce, L.L. & Lutz, B.J. (2019). Family Caregiving. In P.D. Larson (Ed.), Chronic illness: Impact and intervention (pp. 191 – 226). Burlington, MA: Jones & Bartlett Learning.
Explore www.caregiver.org
Explore www.improvingchroniccare.org
Explore https://www.ahrq.gov/professionals/prevention-chronic-care/improve/self-mgmt/self/index.html
Explore https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program
Explore https://www.caregiver.org/caregivers-count-too-toolkit
Key Points:
The number of unpaid persons caring for family members with chronic illness is already vast and expected to grow.
Serving as a family caregiver has the potential to be rewarding. It also has the potential to contribute to compassion fatigue, strain, grief, shifting roles, financial stress, and abuse of either the person with chronic illness or the caregiver.
The relationship between informal and formal caregiving networks is critical for the health of both the caregiver and the person living with chronic illness.
A family centered care model acknowledges the family as the unit of care in chronic illness situations.
Nurses are typically the most appropriate member of the health care team to provide family caregivers with the support and education they need.
Family caregiving is linked to a variety of outcomes for the caregiver, the dependent person, and society at large.
Self-management is a important for successful management and control of chronic illness.
Unique patients; health care professionals with appropriate knowledge, skills, and attitudes; and an organized system of care must come together to promote self-management.
Nurses are in an excellent position to serve as patient coaches and care coordinators.
A variety of outcomes are associated with self-management including: condition outcomes; individual outcomes; family outcomes; and environmental outcomes.
Outcomes of self-management may be categorized as: health status outcomes; quality of life outcomes; and cost of health outcomes
Home care included both skilled healthcare providers and supportive community service
Home care typically relies on informal caregivers
Coaching to promote self-management is an important role of the home health care nurse
Goals include preventing rehospitalization
The home care nurse plays an important role in coordination of care Mauk, K. L. (2019). Long – Term Care. In P.D. Larson (Ed.), Chronic illness: Impact and intervention (pp. 491 -523). Burlington, MA: Jones & Bartlett Learning.
Mauk, K. L. (2019). Rehabilitation. In P.D. Larson (Ed.), Chronic illness: Impact and intervention (pp. 561 -594). Burlington, MA: Jones & Bartlett Learning.
Peruse the following website:
www.improvingchroniccare.org
Key Points
Nurses are in an excellent position to design and implement effective long-term care services.
The continuum of care in long term care is extensive
Long-term care recipients are a vulnerable population
Challenges in long term care include: organization of services, care transitions, gaps in public policy, funding, staffing, and standards
Ethical issues in long-term care include: client autonomy versus dependence; mental health issues; end-of-life decision making; abuse/neglect of vulnerable adults
Outcomes vary along the LTC continuum.
For community-based clients, desired outcome may be to remain in their homes as long as possible.
For resident in an LTC facility, examples of desired outcomes are reductions in exacerbations of a chronic illness.
Main goal of rehabilitation is to achieve highest level of independence possible for the clients
Challenges facing rehabilitation efforts include: rising care costs; inequities among disabled Americans; stigma of disability; ethical and legal issue
Assignment: below
Be sure to review the grading rubric for discussions that is included in appendix B of the syllabus. Please respond to one of the following questions: Remember to synthesize information from a minimum of two professional sources.
1) What potential ethical dilemmas arise when evaluating quality of life in family caregiving or long term care situations?
2) Expound on the statement, Managing chronic illness raises the nursing practice bar, challenging nurses to apply a patient-focused, systematic, outcome-based, cost effective, quality care model (Gies p. 144 – in your Larsen text).
3) Explore the advantages, disadvantages, and costs of family caregiving on the caregiver and on society.
4) Investigate the role of the nurse specifically as it relates to transitions of care and coordination of care.
5) Many issues impact long term care at this time. What issues (choose at least three) are the most essential to address first.
6) Discuss the ethical principles of autonomy and beneficence as they might arise in a long term care setting.
