Living with Chronic Illness

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Living with Chronic Illness

• William P. Wattles, Ph.D.
• Psychology 314

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Acute disease

• short-term
• less common than chronic
• either die or get well

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Chronic illness

• A disorder that persists for a long time and is
  either incurable or results in pathological
  changes that limit normal functioning.

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Chronic illness

• Virtually everyone will eventually develop some
  type of chronic condition.

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Chronic illness

• Must deal with
• Symptoms of the disease
• Stress of Treatment
• Feelings of vulnerability
• Loss of Control
• Threat to self-esteem

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Examples of chronic illnesses

• Cancer
• diabetes
• arthritis
• ALS
• asthma
• chronic obstructive pulmonary disease
• multiple sclerosis

• Parkinsons disease
• muscular dystrophy
• sickle cell anemia
• HIV

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Chronic disease

• long-lasting
• common
• 50 at any point in time
• 100 at one time or another
• Variable course
• never completely healthy

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Coping with Chronic Disease

• Attitudes and belief about illness
• personal traits such as depression and optimism
• coping strategies
• compliance with prescribed regimens
• social support.

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Attitudes and Beliefs

• According to both the Theory of Reasoned Action
  and Health Belief Model attitudes and beliefs
  predict adaptive behavior.
• Social norms
• attitudes
• affect
• facilitating conditions

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Personality

• Depression may take the energy away needed to
  adapt to the disease
• anxiety may interfere with sleep and other health
  processes.
• Optimism-a generalized expectation that the
  future looks good-associated with more adaptive
  behaviors.

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Social Support.

• Social support presumably serves to buffer the
  effects of stress for the cancer patient and may
  improve the prognosis.
• The most helpful behaviors seem to be emotional
  support, sympathy and caring.

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Impact of Chronic Illness

• Crisis theory
• individuals need a state of equilibrium
• chronic illness upsets this state
• people search for ways to restore homeostasis
• failure to do so results in
• anxiety
• fear
• stress

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Impact on the patient

• Psychological functioning
• social
• physical
• mental health
• Self-image
• positive and negative changes
• Coping strategies

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Opportunities for psychology

• Strategies to improve compliance
• Noncompliance is a substantial problem in the
  treatment of chronic illness.
• Creation of support groups
• Dealing with psychological repercussions
• Sustaining of personal relationships

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Impact on the family

• Adult children
• change in relationship
• Spouse
• Parents

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Diabetes

• Diabetes is a disease in which the body does not
  produce or properly use insulin

• Insulin acts to reduce levels of glucose in the
  blood by interacting in some unknown way with
  cell membranes.

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Diabetes

• Diabetes is a disease in which the body cannot
  properly store and use fuel for energy.The fuel
  that your body needs is called glucose, a form of
  sugar.

• Glucose comes from foods such as breads, cereals,
  pasta, rice, potatoes, fruits and some vegetables

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• The cause of diabetes continues to be a mystery,
  although both genetics and environmental factors
  such as obesity and lack of exercise appear to
  play roles.

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• Among states having data for 1994 and 2002, the
  age-adjusted prevalence of diagnosed diabetes
  increased more than 10 between 1994-2002 (see
  detailed tables for maps).

• In twenty-three states including South Carolina,
  age-adjusted prevalence was at least 50 higher
  in 2002 than in 1994.

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Incidence of Diabetes

• The prevalence of diabetes (diagnosed plus
  undiagnosed) in the total population of people
  who were 40-74 years of age increased from 8.9
  in the period 1976-1980 to 12.3 by 1988-1994.

• The increasing frequency of obesity and
  sedentary lifestyles in the population, make it
  likely that diabetes will continue to be a major
  health problem in the U.S.

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Diabetes is a life-long condition.

• High blood glucose levels over a long period of
  time can cause blindness, heart disease, kidney
  problems, amputations, nerve damage, and erectile
  dysfunction.

• Good diabetes care and management can delay or
  prevent the onset of these complications

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Type 1 diabetes

• Type 1 diabetes occurs when the body makes little
  or no insulin. It used to be called
  insulin-dependent or juvenile diabetes.

• There is nothing to be done to prevent type 1
  diabetes, even early diagnosis will not prevent
  it.
• It is not caused by eating too much sugar.

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Type 2 diabetes

• Type 2 diabetes occurs when your body cant use
  the insulin it makes.

• A person with type 2 diabetes, you may be able to
  keep your blood glucose levels in a target range
  by healthy eating, exercising and taking diabetes
  medication.

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Adjusting to Diabetes

• Type 1
• Insulin-dependent
• Before age 15
• underweight
• equal between men and women
• requires insulin
• imperils kidney

• Type 2
• Noninsulin dependent
• After age 30
• overweight
• affects more women
• affects poor more than middle class
• no injections
• imperils heart

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Incidence of Diabetes

• General Population 6.2
• African American 13
• Latinos 10.2
• Men 8.3
• Women 8.9

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The good news

• People can live a long and healthy life by
  keeping their blood glucose levels in the target
  range.

• They can do this by
• Eating healthy meals
• Exercising
• Taking diabetes medication, including insulin

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Insulin-dependent diabetes mellitus (IDDM)

• Management very demanding
• injections
• diet
• exercise
• Serious costs of failing to comply
• blindness
• kidney failure
• amputation

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Lifestyle changes

• Eat healthy
• Eat three meals and a bedtime snack each day.
• Include a food from each of the food groups at
  each meal.
• If you are thirsty, drink water or diet pop.

• If you are overweight, eat smaller portions.
  Reduce your intake of fat.
• Limit sweet and fatty foods.

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Cardiac Rehabilitation

• Fifty percent survive
• Major surgery and recovery
• Lifestyle changes
• diet
• exercise
• stop smoking
• Motivation

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Psychological reactions to CHD

• Depression
• Anxiety
• Anger
• Fear
• Guilt
• Interpersonal conflict

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Coping with Cancer

• Approximately 1.25 million people diagnosed with
  cancer in 1998

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Coping with Cancer

• Surgery
• Radiation
• Chemotherapy
• Hormonal treatment
• Immunotherapy

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Cancer treatment side effects

• Loss of hair
• burns
• nausea
• vomiting
• fatigue
• sterility

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Survival

• More than half of all cancer patients survive at
  least five years

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HIV and AIDS

• Relatively new disease
• The virus is not easily transmitted from person
  to person
• sex
• IV drug
• blood transfusion
• Preventable

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AIDS/HIV

• 1999-IN the U.S., HIV/AIDS fell from 8th to 14th
  among leading causes of death.
• It remained the leading cause of death for black
  persons aged 25-44.

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Alzheimers Disease

• Degenerative disease of the brain
• cognitive impairment
• memory loss
• personality change
• Sure diagnosis only by autopsy
• Cause unknown

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Alzheimers and the family

• Enormous cost to the family and society
• Financial and emotional resources exhausted
• Combines with loss of loved one

• Chronic stress of providing care for Alzheimers
  patients lowers immune system functioning and
  increases vulnerability to illness.

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The End