Chronic illness not only affects the lives of infants,
children, adolescents, young adults, older adults, elderly, and the old-old, but also the physical, emotional, intellectual, social, and spiritual functioning of multiple family members. Wide variations exist in the ways chronic illness affects physical and men- tal health, employment, social life, and longevity. Chronic illness for an individual can entail single or multiple illnesses or conditions that last or are per- sistent over time. For example, a person that is newly diagnosed with type 2 diabetes may also have hypertension, hyperlipidemia, and neuropathy that are often linked with this diagnosis. The person could also have a condition that is unrelated, such as arthritis, asthma, or even Alzheimer disease as they age.
Differences in the ways families accommodate a chronic
condition are inuenced not only by the level of disability and associated symptoms, but also by the individual and family perception about the disability. Care needs can also differ depending on whether the symptoms are constant (e.g., those associated with cerebral palsy), episodic (e.g., those associated with migraine headaches), relapsing (e.g., those associated with sickle cell anemia), worsening or progressive (e.g., those associated with multiple sclerosis or cer- tain types of cancer), or degenerative (e.g., those linked with Alzheimer disease and Rhett syndrome).
Regardless of the type of chronic illness experi- enced,
family members are involved at several levels, depending on the age of the individual, the condition being cared for, previous family experiences, levels of expertise, unique relationships, and behavioral patterns. Over time, family is the biggest resource for care of individuals with chronic illnesses. Family members are the most enduring care providers, and offer the constancy and continuity of care needed. Professionals come and go, offering medical manage- ment, education, and counseling as needed, whereas family members provide ongoing and persistent care across time.
Increased hospital and medical center care has shifted the
primary focus of care delivery from care of acute conditions to care of acute complications of chronic diseases such as heart attacks and strokes, and the delivery of episodic care related to chronic illnesses. Although this trend has signi- cantly reduced infectious diseases, the incidence of new diagnoses and new complications of chronic illnesses has continued to increase. This is partly due to our aging society, but it is also linked to treatment of illness conditions and complications as they occur rather than focusing on prevention of the occurrence or delay in the onset of the chronic conditions (e.g., heart disease, Alzheimer disease), or the prevention of preventable complications (e.g., kidney failure with diabetes). Many clinicians agree that much of the chronic-disease burden is preventable through management and modication of lifestyle behaviors (Glasgow et al., 2001).
An- other contributing factor to the increase in chronic
illnesses is the growing concern about low health literacy, with many lacking access and understand- ing of wellness and healthy lifestyle behaviors (e.g., healthy nutrition, activity, stress management) that can prevent or delay illness onset, inuencing the ef- fectiveness of health care for many families.
The alzheimer's caregiver & families guide: Coping with alzheimers disease, through the stages, including prevention, diet, safety to conventional & alternative healthcare options
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