Embed Size (px)
Citation preview
Summer Webinar Series Week 7: Customers with Chronic Medical
Conditions
Welcome & Introductions
Henry Villarreal, RN, MSNMobility Assessment EvaluatorMTM, Inc. TriMet Mobility Center
Christopher Hunter, BS, CTRSProgram DirectorMTM, Inc. TriMet Mobility Center
Chronic Conditions Can Cause Disability
Chronic conditions can affect & limit a person’s functioning
Disabilities can be congenital or acquired• Affected by mental, vision & hearing impairments• Can be a result of lack of sleep, fatigue, pain, or
trauma Disabilities may reflect as impairments in gait,
balance, ambulation & stamina
Neuro-Muscular Conditions
Spinal cord injury Brain injury
(acquired or traumatic)
Multiple sclerosis Parkinson’s disease
Cerebral palsy Spinal bifida Muscular dystrophy ALS
Per the National Institutes of Health, Medline Plus
Mental/Cognitive Conditions
Severe anxiety Unstable manic
depression Unstable
schizophrenia PTSD Agoraphobia
Panic disorder Separation anxiety Evaluate severity of
disabling effects
Per the National Institutes of Health, Medline Plus
Prevalence of Mental Illness/Physical Disability
43.8 million adults in US, or 18.5% of the population, experience Any Mental Illness (AMI)
10 million adults in US, or 4.2% of the population, experience Serious Mental Illnesses (SMI)
Physical disabilities affect approximately 35.2 million adults, or 15% or the population
Based on 2013 data
Chronic Conditions
Diabetes• Complications • Amputations &
phantom pain• Low vision• Neuropathic pain• Numbness• Lack of sensation
Low vision• Late diabetic
retinopathy• Late macular
degeneration• Retinal detachment• Trauma• Legally blind
Prevalence of Diabetes
2010: 25.8 million Americans, or 9.3% of population• 1.9 million new diagnoses• Seventh leading cause of death
2012: 29.1 million Americans, or 9.3 % of population• 1.7 million new diagnoses
1.25 million cases are Type IPer the American Diabetes Association
Pain Syndromes
Arthritis Rheumatoid arthritis Sports injuries Osteoarthritis Joint pain• DJD• “Bone on bone”• Rigorous PT post joint
replacement
Chronic pain Back pain Spinal stenosis Compression fractures Trauma: vertebral or
nerve injuries, falls, MVA, MCA, PHBC
Structural deformities: CP/MD
Per WebMD
Neuropathic Pain Nerves that carry pain signals to & from the brain
can be triggered by trauma, compression, or swelling
Healing nerves may over-fire, causing increased sensation, tingling & pain
Examples:• Sciatica• Bulging or slipped discs• Diabetic neuropathy• Carpal tunnel syndrome
National Institutes of Neurological Disorders & Stroke
Respiratory Conditions Lack of O2 leading to SOB Asthma COPD: Inflammation &
thickening of airway• Emphysema: Alveoli• Chronic bronchitis:
Bronchial• Third leading cause of
death• 11 million Americans have
COPD, but 24 million don’t know they have it
Chronic wet cough SOB w/ ADLs Frequent respiratory
infections Cyanosis of lips &
fingernail beds Fatigue Wheezing
American Lung Association & Canadian Lung Association
COPD Prevalence, Adults 45-65
COPD Prevalence, Adults 65+
Cardiac/Cardiovascular Conditions
HeartCongestive Heart Failure: Back-up of blood flowCoronary Artery Disease: Decreased blood flowValvular Diseases: Decreased or back-up of flowMyocardial Infarction: Sudden blockage of flow
BrainCardiovascular Accident: Blockage of flow to brainHemorrhagic: Vessel bleed, compression of brainIschemic: Blockage of blood flow to brain
World Heart Federation
Prevalence of Cardiovascular Disease
MenNumber one cause of deathApproximately one in four male deaths50% of men who die have no previous symptoms70-89 % of sudden cardiac events occur in men
WomenBiggest killer, number three cause of death globally8.6 million annual deaths
World Heart Federation & the CDC
Fibromyalgia Widespread musculoskeletal pain accompanied by fatigue • Muscle & connective tissue• Hypersensitive pressure points • May affect energy, wellbeing, sleep & joint stiffness
Neurochemical brain imbalances leads to inflammation, which leads to abnormal brain processing
Associated with depression, anxiety, PTSD & chronic fatigue; can be associated with genetics, childhood & environmental factors
Treatment: Co-morbidities, antidepressants, anxiolytics, analgesics & psychotherapy
National Institutes of Neurological Disorders & Stroke
Question 1When working with an individual who
has a chronic medical condition or disability, what is the proper
terminology to remain respectful?
Question 2How do you individualize an
assessment for individuals with chronic medical conditions &
disabilities?
Question 3An applicant reports history of COPD &
severe SOP. They report they don’t walk at all secondary to symptoms &
fear. How would you assess this applicant?
Question 4A client comes in with low vision.
What questions can you ask? What would you observe?
Question 5A client presents a history of Multiple Sclerosis. How would you begin the
assessment?
Resources National Institutes of
Mental Health American College of
Rheumatology National Institutes of
Health National Institutes of
Arthritis www.MedicineNet.com American Diabetes
Association
American & Canadian Lung Associations
National Institutes of Neurological Disorders & Stroke
Centers for Disease Control www.macular.org www.diabetes.org World Heart Federation American Heart
Association
Contact Information
Henry Villarreal, RN, MSNMobility Assessment EvaluatorMTM, Inc. TriMet Mobility [email protected]@mtm-inc.net
Christopher Hunter, BS, CTRSProgram DirectorMTM, Inc. TriMet Mobility [email protected]@mtm-inc.net
Questions?
