Chronic Diseases in Late Life

Chronic Diseases in Late Life - Chronic Diseases in Late...

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Chronic Diseases in Late Life
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Chronic Disease in Late Life Life expectancy has increased over the last 100 years Longer life frequently means living with a chronic illness By the time one reaches 50 years of age that individual usually has one chronic condition The most common chronic conditions for individuals older than 65 years are arthritis and hypertension
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Acute vs. Chronic Illness Acute Illness Occurs suddenly and often without warning Treated aggressively when they occur Stroke, MI, hip fracture, infection Chronic illness Chronic illnesses include those sequelae of acute illnesses and conditions in which one experiences periodic acute exacerbations Managed rather than cured Always present but not always visible If not triggered by an acute event, onset may be insidious and identified only during health screening
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Theoretic Frameworks for Chronic Disease Maslow’s Hierarchy of Needs Most basic needs (maintaining biological integrity) to most complex needs (associated with self-actualization) Higher level needs cannot be met without first meeting lower level needs Moving toward healthy aging is an evolving and developing process
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Theoretic Frameworks for Chronic Disease Chronic Illness Trajectory Patient’s perception of needs met and basic biological functional limitations are paramount to predicting movement along the illness trajectory Phases Pre-trajectory (preventative) Trajectory onset (definitive phase) Crisis phase Acute phase Stable phase Unstable phase Downward phase Dying phase
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Key Points in Chronic Illness Trajectory Framework Majority of health problems in late life are chronic Chronic illness may be lifelong and entail lifetime adaptations Chronic illness and management profoundly affect lives and identities of individual and family members or significant others Acute phase of illness management designed to stabilize physiological processes and promote recovery from acute phase Other phases of management designed to maximize and extend period of stability in home with help from family; augmented by visits to and from health care providers Maintaining stable phases is central in managing chronic illness Primary care nurse is coordinator of multiple resources needed to promote quality of life along the trajectory
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Common Chronic Disorders Cardiovascular Disease Cerebrovascular Disease Endocrine Disorders Gastrointestinal Disorders Respiratory Disorders Rheumatological Disorders
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8 Leading causes of death in women older than 65 years (Data from The National Vital Statistics System. Redrawn from the Data Warehouse on Trends in Health and Aging [website]: www.cdc.gov/nchs/agingact.htm . Accessed July 1, 2006.)
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Chronic Diseases in Late Life - Chronic Diseases in Late...

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