Finding Hope/Atul Gwande reflections
September 1, 2020
What approaches by nurses might be effective in reducing costs of chronic illnesses?
September 1, 2020
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chronic ILLNESS IN RURAL Setting

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

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. ASK A QUESTION TO YOUR PEERS AT THE END OF YOUR DISCUSSION

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.

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