Textbook of Medical-Surgical Nursing 3e

Chapter 10

Chronic illness, disability and rehabilitation

K E Y T E R M S

L E A R N I N G O B J E C T I V E S

Chronic health problems affect people of all ages—the very young, the middle aged, and the very old. The frequency of chronic conditions tends to increase with age, and older people often have multiple chronic disorders, commonly referred to as a comorbidity . Chronic illness occurs in all socioeconomic groups, but people who have low incomes and disadvantaged backgrounds are more likely to report poor health. Factors such as poverty and inadequate health insurance decrease the likelihood that people with chronic illness or disability receive healthcare and health screening measures such as mammography, choles­ terol testing and routine check-ups (National Health Priority Action Council [NHPAC], 2006). Definition of chronic conditions Chronic conditions are defined as medical conditions or health problems (illness, injury or disability) that are long term, last more than 6 months, and have a significant impact on a person’s life. Chronic conditions can also be defined as illnesses or an illness that have a prolonged course, that do not resolve spontaneously, and for which complete cures are unlikely or rare (Australian Department of Health and Ageing [ADHA], 2012). Lubkin and Larsen (2013) also include in the 7 Discuss the interdisciplinary approach to rehabilitation. 8 Describe the significance of continuity of care and community re-entry from the healthcare facility to the home or extended care facility for patients who need rehabilitative assistance and services. On completion of this chapter, you should be able to: 1 Define ‘chronic conditions’. 2 Identify factors related to the increasing incidence of chronic conditions. 3 Describe characteristics of chronic conditions and implications for people with chronic conditions and for their families. 4 Describe the phases of chronic conditions. 5 Discuss the concept of disability and describe its impact on society and individuals. 6 Describe the goals of rehabilitation.

disability habilitation impairment instrumental activities of daily living (IADLs) rehabilitation secondary conditions or disorders

activities of daily living (ADLs) adaptive device assistive device assistive technology chronic conditions chronic illness comorbidity

definition of chronic illness, the human experience and the suffering encountered by the individual. Although some people take on what might be called a ‘sick role’ identity, most people with chronic conditions do not consider themselves to be sick or ill and try to live as normal a life as is possible. Only when complications develop or when symptoms become severe enough to interfere with performance of daily life activities do most people who are chronically ill think of themselves as being sick or disabled (Boogaerts & Merritt, 2008). Phenomenon of chronicity Although each chronic condition has its own specific physio­ logical characteristics, chronic conditions do share common qualities such as pain and fatigue. Many people with chronic illness and resultant disability function independently with only minor inconvenience to their everyday lives; others require frequent and close moni­ toring or placement in long-term care facilities. Certain condi­ tions require advanced technology for survival, as in end-stage renal illness, or intensive care or mechanical ventilation for periods of weeks or months. Some chronic conditions have little effect on quality of life, but others have a consider­ able effect. Some degree of disability (the lack of ability or

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