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Helping people sustain their independence
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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)