Helping people sustain their independence

1. Helping patients with Long Term Conditions maintain
independence.

2. 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

3. 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]

4. Do it yourself care!!
What do you think?
Using your own words define Self Care

6.  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.

7.  “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.”

8.  “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.”

9.  “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)

10.  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.

11.  “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

12.  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 personalised
care, 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

13.  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/

14.  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

16.  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.

17. 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

18.  https://www.youtube.com/watch?v=NYevwIEyDxY
 https://www.youtube.com/watch?v=-b1YFzeQtFs
 Learning from our patients

19. Taking medications
Monitoring and interpreting symptoms
Keeping appointments
When and how to contact health care

20. 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

21.  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

22. 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

23.  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?

24.  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?

25.  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)