From the Philadelphia Gay News
By David Griffith, LGBT Elder Initiative
Oftentimes we hear the words “chronic disease” on television or in the news. But what do doctors really mean by this term?
Chronic disease is an umbrella term of various illnesses. In order to be chronic, conditions must last more than one year and require ongoing medical attention or limit activities of daily living. Using this definition, conditions such as high blood pressure, arthritis, diabetes, HIV, or heart disease are all chronic diseases.
Older adults are the population most impacted by chronic disease. According to the CDC, 85% of elders have at least one chronic health condition, and 60% have at least two. Many chronic diseases, such as heart disease and cancer, can increase the risk of premature mortality. Having multiple chronic conditions also increases the risk for dying prematurely as well as more frequent hospitalizations and greater loss of day-to-day functioning.
Managing a chronic health condition comes with many challenges. Navigating the healthcare system is complex and the expenses of proper medical care may be burdensome. Individuals who must rely on multiple healthcare providers to help manage their care may also receive conflicting information from medical professionals.
Dealing with the physical symptoms of chronic diseases and their treatments can be both mentally and physically draining. Older adults managing chronic health conditions are more likely to become isolated, especially when symptoms impact mobility.
Older adults universally report a preference for aging in place, rather than in institutions such as nursing homes. Unfortunately, chronic diseases and their impact on day-to-day function can often rob older adults of their independence and ability to grow older in their own homes.
Older adults who are part of the LGBT community experience both added risk factors as well as challenges in managing chronic health conditions. Statistically, LGBT people have higher rates of chronic conditions such as obesity, high blood pressure, high cholesterol, arthritis, cardiovascular disease, diabetes, and certain cancers. These disparities are largely tied to increased stress related to being part of a minority group, as well as more frequent experiences with discrimination in healthcare settings.
The 2015 Household Health Survey (HHS) conducted by the Public Health Management Corporation (PHMC) found that LGBT individuals were more likely to see their primary care provider five or more times annually and more likely to have been to the emergency department at least once in the past year, which may indicate more complex health conditions or poorer control of chronic health conditions.
Despite all of these challenges, older adults living with chronic health conditions also demonstrate tremendous strength and resilience in managing their care.
One resource for older adults managing chronic illness that has become increasingly popular over the past decade is the Chronic Disease Self-Management Program (CDSPM). First developed through Stanford University, the CDSMP is a six-session course for people living with any chronic disease.
The course has been demonstrated to help older adults better manage their chronic conditions, improve their quality of life, and lower their health care costs. The sessions are interactive and full of fun group activities. Content covered as part of the course includes techniques to deal with problems such as frustration, fatigue, pain and isolation. Workshop facilitators explore the importance of nutrition, being active, and strategies for communicating with friends, family, and healthcare providers. Participants are asked to create weekly action plans to practice disease self-management skills learned in each session.
Thomas Jefferson University Hospital, Center for Urban Health, the LGBT Elder Initiative, and the Philadelphia Corporation for Aging are currently collaborating to deliver a first-of-its-kind CDSMP for LGBT older adults. To learn about future opportunities to participate in a CDSMP course, contact the LGBT Elder Initiative at 215-720-9415.