Chronic Illness Trajectory and its Influence on the Plan of Care

Question

   Describe the chronic illness trajectory for the selected illness based on the patient’s age. 
 
How does the chronically ill patient’s illness trajectory influence the plan of care?
Answer
1. Introduction
Chronic illness can be a life-altering incline of suffering and disability. It can affect every stage of a person’s life, from juvenile to old age, and can lead to a heavy burden on the families and caretakers of those with such illnesses. As chronic illnesses progress, there often comes a time when a patient’s living conditions worsen to the point where a healthcare proxy such as kindred or enduring power of attorney is required to make sure the patient’s wishes are respected. Understanding the disease trajectory for an enduring illness is a precarious part in being able to control the course of both the illness and the patient’s life. There are fixed key factors and patterns that need to be taken into account when looking at disease trajectory. The most perilous step in a patient’s trajectory is putting in writing the degenerative course of a chronic illness. As a disease progresses, new supportions and capabilities need to be discovered, practiced, and shared with others. Each phase of the illness course requires necessary adjustments to be made regarding both the patient’s and the caretaker’s daily routine and activities. This article will discuss what a chronic illness is, how it is characterized, and the physical, psychological, and societal consequences of such movement.
1.1. Definition of Chronic Illness
Chronic illness is a persistent condition that lasts a long time, sometimes for the entire life of the patient. An illness is considered chronic if it is persistent and constantly recurring over time. Examples of chronic illness include osteoporosis, diabetes, stroke, hypertension, obesity, and heart disease. Chronic illness not only causes physical disability but also affects mental and emotional health of the sufferers. The most common factors contributing to chronic health problems are lack of adequate physical activity, poor nutrition, tobacco use, and drinking too much alcohol. They are associated with a number of preventable health risks and result in a dramatic increase in the number of people suffering from chronic illness and death. This type of illness can be very complex to treat. Patients’ daily functions can be affected and this generates any number of issues, from the future to the way people live their lives, and even how they define themselves. For that reason, it is crucial to help patients evolve from a take-it-as-it-comes notion of time to a forward-looking and proactive use of time, which signifies that patients should strive for health regardless of the presence or absence of any symptoms. This transition is exemplified by the mutation in their awareness of their bodies and self, no longer as residents of an indifferent form but as partners which illnesses are not so much suffered as waged over. Such changes in thinking and living will have beneficial effects for how patients understand the meaning of their lives and themselves. This transformation in the patient’s self-understanding is the overarching therapeutic goal in chronic illness care. Adoption of the word “chronic” takes on a remarkable reality for all parties involved, for this is indicative of a historical, progressive, and dynamic form of illness that is now perfected in the present. Every moment that the patient experiences is not just a repetition of the same symptoms but a radical rethinking and revision of the meaning of time and the subject’s place in it. Thus, chronic illness care poses a unique challenge for all those involved. It mandates not only medical attention and therapeutic intervention but also a fundamental redirection in the patient’s sense of time and self, and in that, the patients will find that they are not just living with their illness but leading their lives in health. Because of the imposing and oftentimes overpowering aspects of chronic illness, patients are usually unaware of the external stigmas being associated with their condition. Every year, just around 900,000 individuals encounter untimely death because of a chronic illness. However, the public is more prone to be sympathetic toward diseases such as cancer and acute illness, in comparison to chronic disorders. Public awareness towards chronic ailments is essential to minimize the discrimination that patients with chronicity may experience. Alleviating stigmas would have the effect of allowing the patient to better integrate their life worlds with the environment and foster more meaningful relationships with others.
1.2. Importance of Understanding Illness Trajectory
Chronic illness is a great burden for the patient population, and few patients tolerate chronic illness well. When these patients are admitted to a hospital, they require an effective plan of care that will be able to manage their chronic illnesses as well as the acute exacerbation of their diseases. Understanding the chronic illness trajectory is central to the patient and family-centered plan of care design. As mentioned by Corbin and Strauss (1988), the illness trajectory is defined as “the unique course that the disease or illness takes in each individual; it unfolds over time and is characterized by a series of stages such as onset, acute, stable, unstable, and a return to wellness or a deteriorating process.” If the illness trajectory of a specific chronic illness is unknown, it may be difficult for a nurse to understand why patients make seemingly unexplainable decisions and why their condition changes over time. Moreover, in a situation of unplanned care or chronic illness exacerbation, the prior knowledge of the illness trajectory can help the hospital staff differentiate the temporary and long-term treatment needs. In this respect, integrating the illness trajectory of the specific chronic illness into care planning becomes significant. The knowledge of the illness trajectory can enable the care plan to cope and manage with the chronic illness and also minimize the acute exacerbation of the chronic illness. Also, it has great significance to the palliative care coordination and management. If the symptoms of a chronic illness change and worsen over time, the patient may move into the later stage of the illness. At this stage, the focus of the care shifts from treatment-oriented to comfort-oriented care. The understanding of the illness trajectory can help create a peaceful and comfortable environment for those who are dying of the chronic illness. In the parents of care, the patient and the family members are at the center of the care design according to the Chronic Care Model developed by Wagner et al. (1996). The care should be individualized and mindful of the needs of the patient and his/her family members. So when developing the care plan, the first step is to comprehensively understand the illness trajectory and its link to the patient’s current conditions. The individual experiences of the patient can guide the customization of the care plan as well as the synchronization of the patient’s participation in the care plan. Also, the family members may also be involved in the care planning process and facilitate the care activities because of the comprehensive understanding of the illness trajectory in such a family-centered plan of care (Ferrell & Coyle, 2008).
2. Chronic Illness Trajectory
2.1. Overview of the Illness Trajectory
2.2. Factors Influencing the Trajectory
2.3. Stages of the Illness Trajectory
3. Patient’s Age and Illness Trajectory
3.1. Impact of Age on the Trajectory
3.2. Age-Related Challenges in Managing Chronic Illness
3.3. Variations in Trajectory Based on Age
4. Plan of Care for Chronically Ill Patients
4.1. Importance of Tailored Care Plans
4.2. Assessing the Patient’s Needs and Goals
4.3. Collaborative Approach in Developing the Plan
4.4. Adjusting the Plan as the Trajectory Evolves
5. Integrating the Illness Trajectory into Care
5.1. Monitoring and Managing Symptoms
5.2. Addressing Physical Limitations and Functional Decline
5.3. Emotional and Psychological Support
5.4. Palliative and End-of-Life Care Considerations
6. Enhancing Patient and Family Education
6.1. Providing Information on the Trajectory
6.2. Educating about Self-Management Strategies
6.3. Promoting Health Literacy and Empowerment
7. Interprofessional Collaboration in Care
7.1. Role of Healthcare Professionals in the Plan of Care
7.2. Communication and Coordination among Providers
7.3. Engaging Other Disciplines for Holistic Care
8. Conclusion
8.1. Recap of the Importance of Understanding the Illness Trajectory
8.2. Key Considerations for Effective Care Planning