Helping patients with Long Term Conditions maintain independence.

This session is a key session therefore it is something that you MUST know in order to address the Module Learning Outcomes Three and Four

More than 15 million people in England live with at least one long-term condition

They represent 55% of GP appointments; 68% of outpatient, accident and emergency attendances and 77% of inpatient bed days

They account for around 70% of NHS spending

By 2018 nearly three million people will have three or more long-term conditions [Source: Department of Health]

Do it yourself care!!

What do you think?

Using your own words define Self Care

Self Care is an integral part of daily life and is all about individuals taking responsibility for their own health and wellbeing, with support from their health and social care professionals.

It includes the actions people take every day in order to stay fit and maintain good physical and mental health, meet their social and psychological needs, prevents illness or accidents, and care more effectively for minor ailments and long term conditions.

“Self care is about individuals, families and communities taking responsibility for their own health and wellbeing. It includes actions people take in order to stay fit and maintain good physical and mental health, meet their social and psychological needs, prevent illness or accidents and care more effectively for minor ailments and long term conditions.”

“People living with a long term condition, disability or a minor illness, as well as carers, can benefit enormously from being supported to self care. They can live longer, suffer less pain, anxiety, depression and fatigue, have a better quality of life, and be more active and independent.”

“is defined as a naturalistic decision-making process that patients use in the choice of behaviours that maintains physiological stability (symptom monitoring and treatment adherence) and the response to symptoms when they occur. Making decisions based on the situation let the content influence the decision making process and based on practical decisions on the information available in that moment.” (Riegel et al 2006)

Self care was highlighted in the NHS Plan as one of the key building blocks for a patient-centred health service. More recently self care featured as a key component of the model for Supporting People with Long Term Conditions. Research shows that supporting self care can improve health outcomes, increase patient satisfaction and help in deploying the biggest collaborative resource available to the NHS and social care - patients and the public. Helping people self care represents an exciting opportunity and challenge for the NHS and social care services to empower patients to take more control over their lives.

“Self management means different things to different people for most people it means developing an understanding of how their condition affects their lives and how to cope with their symptoms”

http://www.kingsfund.org.uk/time-to-think-differently/trends/disease-and-disability/long-term-conditions-multi-morbidity

The proactive management of people with long-term conditions, including the promotion of self-care by patients, is a key priority for the NHS.

General practice has a central role in delivering more integrated and personalisedcare, and in implementing policies that target 'at-risk' individuals with appropriate interventions.

http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/self-management-long-term-conditions-patients-perspectives-sara-corben-rebecca-rosen-kings-fund-26-july-2005.pdf

People with long-term conditions spend an average of just three hours per year with their healthcare team.

The rest of the time, they are effectively self-managing.

Self management support enables and encourages patients with long-term conditions to take a more proactive role in managing their health and wellbeing

“Self management is about giving people living with long-term conditions the tools, skills and support they need to improve their own wellbeing.”

http://selfmanagementuk.org/

Self management programmes are delivered by trained peer facilitators who are experienced at managing their own long-term condition.

Peer-led programmes provide the optimal environment for patient engagement and education.

Patients are more responsive to learning from people who have first-hand knowledge of the challenges they face.

https://www.youtube.com/watch?v=ac13iuGByRQ

Self care information on health and human body systems, lifestyle and healthy eating.

Support to capture, manage, interpret, and report observations of daily living the tracking of trends, and the use of the resulting information as clues for self care action and decision making.

Information prescription providing personalised information and instructions to enable an individual to self care and take control of their health

Self care and self monitoring devices and assistive technology

Self care skills and life skills training programmes and courses for people

Aid from spiritual care givers

Advice from licensed counselors, clinical social workers, psychotherapists, pharmacists, physiotherapists and complementary therapists

Self care support networks which can be face to face or virtual, and made up of peers or people who want to provide support to others or receive support and information from others.

Self care is a decision making process that demands that patients:

Recognise change in their condition

Evaluate the change

Decide to take action

Implement the treatment

Evaluate the response

Self care is not synonymous with treatment adherence or compliance but instead subsumes treatment adherence as one component of self care

https://www.youtube.com/watch?v=aM9sMhuOQ18

https://www.youtube.com/watch?v=NYevwIEyDxY

https://www.youtube.com/watch?v=-b1YFzeQtFs

Learning from our patients

Taking medications

Monitoring and interpreting symptoms

Keeping appointments

When and how to contact health care

It encourages people with LTC’s to:

find out more about their condition

learn new skills and tools to help them manage their health

work better, and in partnership, with healthcare professionals

take charge of their healthcare

Supported self management enhances:

Patient engagement and activation

Shared decision making

Personal care planning

Appropriate information and education

Personalised health goals for patients

Outcomes focused approach

Partnership between patients and their health, social care and careers professionals to improve health outcomes

Three key areas for service development are:

improving health professionals' skills to help patients manage their own conditions

improving the provision of information about long-term conditions and the local services available

increasing the flexibility of services to fit in with patients' other commitments.

http://www.kingsfund.org.uk/publications/delivering-better-services-people-long-term-conditions

Adopt the self care philosophy therefore use self care strategies to promote independence

Reflect upon your chosen Gallagher

Identify

What is available to enable the patient self care

What skills are needed to enable the patient adopt this strategy

How would this promote independence?

Conflicting instructions

Impaired cognition

Anxiety and depression

Comorbidities ( makes interpreting symptoms difficult)

Taking medication

Monitoring and interpreting symptoms

Keeping appointments

Managing new routines

How would you determine self care is effective?

http://www.kingsfund.org.uk/time-to-think-differently/trends/disease-and-disability/long-term-conditions-multi-morbidity

http://www.kingsfund.org.uk/publications/delivering-better-services-people-long-term-conditions

http://www.skillsforcare.org.uk/Skills/Self-care/Self-care.aspx

http://www.nhs.uk/Planners/Yourhealth/Pages/Whatisselfcare.aspx

http://selfmanagementuk.org/

Department of Health (2008) Long Term Conditions Compendium of Information (Gateway reference 8734)