Chronic Disease Self Management Program

Tomando Control de su Salud Washington State

Maureen Lally, MSW

WA Aging and Disability Services Administration

The Chronic Disease Self-Management Program

To underscore the belief that individuals can manage their chronic health conditions. By taking control of their symptoms people can be healthier and happier.

My Goal Today

What problems do you have because of your health condition?

Have You Experienced Fatigue? Depression? Stress? Other symptoms?

Even with different chronic conditions, many of the concerns are the same.

The Vicious Symptom Cycle

Chronic Condition

Stress/Anxiety

Pain

Tense Muscles

Fatigue

Difficult Emotions

Depression

Shortness of Breath

Symptom Cycle Often fatigue and difficult emotions are common

problems experienced by people with chronic conditions.

One symptom can lead to a series of other problems which often creates more symptoms

Which becomes a vicious symptom cycle

No known cure for many chronic conditions

Self management or what you can do to manage your chronic condition is very important.

It involves the use of various methods or tools to manage the problems you experience.

What is Self-Management?

“The tasks that individuals must undertake to live with one or more

chronic conditions.”

“What people do 99.9% of the time.”

What Can You Do? Keep informed; ask questions Take part in planning your treatment, communicate

your preferences/goals Inform your health care team about

problems/changes you experience Try new things and give activities at least a 2 week

trial before deciding what works best for you Set goals and work towards them

You Can Break The Symptom Cycle

Explore a variety of ways to: Regain control of your life to do the things that matter Have energy to do more and get relief from fatigue,

pain, and other symptoms Meet new people, share what you know, and learn

new ways to improve your life Feel better by… Participating in the 6 week workshop “Living Well with

Chronic Conditions”

Program Overview Six, weekly, 2.5 hour sessions Small group setting (10-15 people) Practical, interactive curriculum Led by pair of lay leaders, at least one of whom is a peer

with a chronic condition Convenient locations Action oriented discussion and problem solving Supportive atmosphere Low cost

Program Principles

Regardless of the chronic condition, People have similar challenges.

Deal not only with their condition,

also with the impact of that condition on their lives.

Lay Leaders can teach the workshop

as effectively if not more effectively,

than health professionals.

Patient Education compared to Self Management Support

Patient Education • Information and skills are taught

• Usually disease-specific• Assumes that knowledge

creates behavior change

• Goal is compliance• Health care professionals

are the teachers

Self Management Support Skills to solve patient

identified problems are taught

Methods are applied across conditions/needs

Assumes that confidence yields better outcomes

Goal is increased self-efficacy

Teachers can be professionals or peers

Target Populations

Adults 55 and older across the state Eight tribes-Nooksack, Lummi, Swinomish

Quinault, Quileute, Makah, Puyallup & Samish

Hispanic elders African American elders Asian communities Senior housing communities Rural and urban communities

The Self-Management Toolbox

Physical activity

Medications Managing

fatigue Action

Planning Better

breathing Understanding

emotions

Problem-solving Using your mind Managing pain Communication Healthy eating Working with

health professionals

Action Planning

•Something you want to do

•Achievable•Action-specific

• Answers the questions: What? When? How much? and How often?

• Rated on a Confidence level of 7+ (out of 10)

Problem Solving

1. Identify the problem2. List ideas3. Select one4. Assess the results5. Substitute another idea6. Use other resources

Evidence-Base Program Outcomes

Research indicates participants spend

• Fewer days in the hospital

• Fewer outpatient and ER visits

Participants report

• Improvement in self-reported health and health distress

• Improvement in social life/activities

• Improved energy/less fatigue

Lorig, Ritter, et al. 2001: Sobel, Lorig & Hobbs, 2002

Testimony

“I learned how to cope with things in my life that I couldn’t handle before”

“This class kept me on track” “I was tired. My pain was my boss.

It was telling me what I could and couldn’t do. This workshop put ME back in charge.”

“I learned we’re all in the same boat, but the boat isn’t sinking.”

Contact Information

Maureen Lally Aging and Disability Services Administration

• 360-725-2449• lallym@dshs.wa.gov

Living Well in Washington http://livingwell.doh.wa.gov

Stanford Patient Education Resource Center http://patienteducation.stanford.edu