Long Term Conditions

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Long-term Conditions

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This essay explores and reflects on the lived experiences of an elderly patient living with the long-term condition (LTC) of psoriasis. A case study is used to illustrate some of the key features of LTCs and the impact they can have on a patient’s physical, psychological and social state. It is also going to be looking at the effect some of the key features can have on a patients support network or family. In addition it will examine the nurses role in the management of LTCs and the health and social policies that may have an impact on the care received by patient with LTCs.

The Department Of Health (2009) describes long-term conditions as chronic illnesses that can limit lifestyles. In England two in five adults say they live with a LTC (Ipsos MORI 2009,p.5). Examples of LTCs include Chronic Obstructive Pulmonary Disease (COPD), diabetes and heart disease. Unlike acute illnesses such as; ear infections and pneumonia, chronic illnesses don’t have a cure but there are treatments available to help manage them.

LTCs are complex and patients that suffer with a chronic disease are likely to have more than one chronic condition (Department of Health 2009, p.4). The complications associated with LTCs can effect daily life and make activities of daily living (ADL’s) difficult. For example a person suffering with psoriasis may also have psoriatic arthritis (caused by inflammation of the joints) that can reduce mobility due to pain and discomfort, making walking to the kitchen, to make a cup of tea, a lot harder.

People can suffer with chronic illnesses for decades. Due to this they become intensive users of the National Health Service accounting for 80% of general practitioners consultations. 80% of hospital in patient beds and 40% of outpatient appointments [Office of National Statistics, 2002.] This has a huge impact of the primary and acute care budget. The Department of Health estimates that the treatment and care of people with LTCs uses up to 69 percent of these budgets.  

It is important to understand all of the aspects of an LTC to improve the quality of care given by the health care service. It is also important to consider that patients living with a long-term condition have a vast knowledge of their illness and this knowledge is key in promoting well-being and self-care.

In accordance with the Data Protection Act (1998) and the Nursing and Midwifery Council (NMC) code of conduct, on patient confidentiality, for the purpose of this case study the service user involved will be referred to as Anna. Anna has given the author her consent for her case to be used within this study. Anna is an 89-year-old female who lives alone. Anna has suffered with the long-term skin condition of psoriasis since her early twenties. Anna also has hypertension and she has been battling with depression since her late twenties.

Psoriasis is a chronic, non-contagious autoimmune disease that affects the skin and joints. It appears on the skin as inflamed, red, scaly patches (Nation Psoriasis Foundation 2009). These patches are the result of rapid skin cell growth caused by overactive T-cells releasing inflammatory chemicals and acting as if healing a wound (The Psoriasis Association 2008). Psoriasis can cause the skin to become very irritated and itchy. Psoriasis also requires the skin to need a lot more maintenance monitoring to prevent any further breakdown.

Psoriasis has caused Anna many problems since she was first diagnosed that have had a massive impact on her experience of life. Anna’s condition is extremely severe and plaques of inflamed skin cover her from head to toe. Having visibly intensely inflamed, itchy skin cause Anna many physical, physiological and social problems.

The physical problems caused by Anna’s psoriasis are pain, caused by the sensitivity and rawness of her skin, and severe itching, caused by the excess skin production. She also...
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