330 Week 2: Disability and Chronic Illness

Chronic Disease

A diagnosable medical condition (e.g., COPD, diabetes)

Chronic Illness

The lived experience of managing symptoms, emotions, and lifestyle changes

Focus of Chronic Disease

Objective, biological, and treatment-focused

Focus of Chronic Illness

Subjective, emotional, and social impact

Acute Condition Characteristics

Sudden onset, short duration, often curable (e.g., Appendicitis)

Chronic Condition Characteristics

Gradual onset, lasts ≥ 3 months, managed not cured (e.g., COPD)

Multiple Chronic Conditions (MCC)

One of four adults has two or more; increases complexity and cost of care

Risks of Multiple Chronic Conditions

Conflicting medical advice, adverse drug effects, unnecessary tests, preventable hospitalizations

Management of Chronic Conditions involves

Prevention, Health Behaviors, Lifestyle, Symptom Management, and Quality of Life

Two key Nursing Considerations for Chronic Illness

Assess the Whole Person & Promote Dignity and Autonomy

Definition of Disability (WHO)

A physical, mental, intellectual, or sensory impairment that, in interaction with barriers, may hinder full participation in society

Cognitive Disability

Affects thinking, memory, or problem-solving

Developmental Disability

Appears early in life and impacts growth or behavior

Intellectual Disability

Affects learning and everyday living skills

Sensory Disability

Impacts one or more senses, like vision or hearing

Physical Disability

Impacts movement, strength, or coordination

Psychiatric Disability

Impacts mental health, mood, or behavior

Person-First Language Example

"Person with a disability" - respectful and widely accepted

Identity-First Language Example

"Disabled person" - preferred by many in the disability rights community

Term to Avoid (Differently Abled)

Considered patronizing by many; use with caution

Terms to Avoid (Outdated)

Handicapped, crippled, special needs - stigmatizing and infantilizing

Definition of Ableism

A system of beliefs that devalues people with disabilities by assuming able-bodiedness is the norm

Impacts of Ableism on Patients

Delayed diagnoses, psychological harm, decreased access to care, poor health outcomes

Inclusive Communication: DO

Ask before offering help, speak directly to the person, use their preferred language, respect personal space, be patient

Inclusive Communication: DON'T

Assume someone needs help, speak to a caregiver instead, use patronizing terms, touch mobility devices, interrupt

Nursing Considerations for Patients with Disabilities

Promote Autonomy, Adapt with Tools, Pace your Assessment, Prevent Complications, Advocate

Best question for a functional, patient-centered assessment for a wheelchair user

"Can you tell me how you usually get in and out of bed at home?"

Best action for discharge teaching for a patient who is deaf and uses ASL

Request an ASL interpreter for the discharge session

Most appropriate intervention for a client overwhelmed by a new RA diagnosis

Refer the client to a support group for individuals with chronic illness

Leading causes of death/disability and drivers of healthcare costs

Chronic Diseases like Heart Disease, Cancer, COPD, Stroke, Alzheimer's, Diabetes

Key lifestyle risks for chronic disease

Tobacco use, poor nutrition, lack of physical activity, excessive alcohol use