Chronic care

This entry traces the ethical topography and presents concepts entailed in chronic illness and chronic care. There is no authoritative definition of chronic illness or chronic care. However, a consensus definition for purposes of this entry can be found on the Public Broadcasting System (PBS) web site (Fred Friendly Seminars, 2001b), where chronic illness is defined as "a condition that lasts a year or longer, limits activity, and may require ongoing care." Some persons describe chronic as "illnesses or impairments that cannot be cured" (Institute for the Future, p. 260; Summer, p. 2). An incurable chronic condition can be manifest at birth, as in Down's syndrome.

Chronic illness is contrasted with acute episodes of illness or injury that will either result in death or will be treated and the person restored to health. Although chronic diseases differ from acute diseases, they can have acute episodes or flare-ups. Persons with chronic conditions may experience accidents or comorbidity in addition to their ongoing problem(s).

Paradoxically, as various public health measures, pharmacological agents, and other medical interventions become more effective in either preventing or curing diseases and postponing death, the number of persons with chronic conditions increases in both absolute and relative numbers. "Over the past century, the economically more developed countries of the world have gone through considerable change in their population structure and the types of diseases which afflict them—the so-called demographic and epidemiological transitions" (Harwood and Sayer, p. 1).

Care of a person with chronic illness should involve productive interactions between patients and providers; the latter may include medical and social support. Responsive providers and services are key in such care, as are the financial resources to enable the person to utilize them. Three elements seem to differentiate sound chronic care, at least in emphasis, from ordinary, good medical practice in general: continuity over time; management of any accompanying frailty and dependency; means to pay for the extraordinary costs of drugs, prosthetic devices, and care both in the home and in alternate living situations.

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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