Caring for the Chronically Ill

What is a chronic illness?

Chronic conditions are health conditions that either have symptoms on a constant basis or flare up episodically. Such as: diabetes, heart disease, pulmonary conditions, hypertension, mental disorders, stroke and cancer (Bedroussian, 2007).

In the United States 162 million people have one or more chronic conditions, which is more than 1 in 3 Americans (Bedroussian, 2007).

Eighty percent (80%) of older adults have at least one chronic condition, and 50% have at least two (CDC, 2009).

Chronic diseases are among the most prevalent, costly and preventable of all health problems. According to the Centers of Disease Control and Prevention, seven in ten Americans who die each year die of a chronic disease.

Behavioral and social factors either cause or contribute to nearly every cause of death, illness, and disability and directly cause approximately half of annual deaths (Journal of the American Medical Association, 2004).

Who pays the bills for chronic illness?

In 2003, the combined economic cost of treatment and lost productivity related to chronic health was $1.3 trillion dollars (Bedroussian, 2007).

A person with a chronic condition spends $6,032 annually on medical expenditures, and as much as $16,245 if that person also has a functional limitation, according to a report by the Alliance for Health Reform (2001).

Major sources of health care spending for people with chronic conditions are Medicare, Medicaid, private insurance, and out-of-pocket dollars (Alliance for Health Reform, 2001).

What are the psychosocial needs of the chronically ill?

According to a 2008 report by the Institute of Medicine, people with a chronic illness need help to:

Cope with intense emotions related to their illness.
Change behaviors in order to minimize the impact of their disease and maximize treatment protocol.
Manage the disruptions their illness may cause to their work, school, and family life.

What role do Psychologists play in treating the chronically ill?

Psychologists provide important psychosocial health services to patients.

A recent report from the Institute of Medicine (2008) defines psychosocial health services as psychological and social services and interventions that enable patients, their families, and health care providers to optimize biomedical health care and to manage the psychological, behavioral, and social aspects of illness and its consequences so as to promote better health.

Psychologists have many different roles in the management, treatment and study of chronic illness and psychosocial needs (Belar et al, 1995):

Health Service Provider: Psychologists provide certain patient services such as psychological assessment, intervention, and consultation activities.
Teacher: Psychologists provide education regarding psychosocial influences on health may help patients develop better self-care and self-management skills, which may decrease the impact of disease and prevent future health complications.
Researcher: Psychologists create new knowledge in the areas of prevention, treatment, and rehabilitation that is essential to the patients’ successful management of their illness.

References

America's Most Ignored Health Problem: Caring for the Chronically Ill. Washington: Alliance for Health Reform, June 2001. Issue brief

Bedroussian, Armen, DeVol, Ross. An Unhealthy America: The Economic Burden of Chronic Disease Charting a New Course to Save Lives and Increase Productivity and Economic Growth. Milken Institute. October 2007

Belar, Cynthia D.; Geisser, Michael E.Nicassio, Perry M. (Ed); Smith, Timothy W. (Ed). Managing chronic illness: A biopsychosocial perspective. (pp. 33-57). Washington, DC, US: American Psychological Association (1995) vii, 439 pp.

Center for Disease Control. Chronic Disease Prevention and Promotion. Retrieved on February 4, 2009 from: http://www.cdc.gov/nccdphp

Institute of Medicine (IOM). 2008. Cancer care for the whole patient: Meeting psychosocial health needs. Nancy E. Adler and Ann E. K. Page, eds. Washington, DC: The National Academies Press.

National Center for Chronic Disease Prevention and Health Promotion. Healthy Aging: Improving and Extending Quality of Life Among Older Americans. At A Glance 2009. Center for Disease Control.

Contact: Nina Levitt -- American Psychological Association -- 2009