In many ways, we’ve got more to look forward to than any generation in the past.
The average 65-year-old woman in Bermuda can expect to live until she’s 87, and the average 65-year-old man until he’s 83 – roughly a decade older than the life expectation just 30 years ago.
Yet if you’re incapacitated by serious health issues such as diabetes, heart problems or respiratory diseases, living longer certainly doesn’t equate to better quality of life.
For many people, however, chronic disease management can make a big difference.
Instead of enduring relentless pain and discomfort as they grow older, they can look forward to more time practising the golf swing, gardening or playing with the grandchildren and great-grandchildren.
Chronic disease management is a relatively modern term that means dealing with your health condition through a systematic approach of medical treatments, lifestyle changes and self-care strategies. It does not aim to cure you but will limit the impact of your illness and help you feel better physically, mentally and emotionally by incorporating help from multiple health professionals with different areas of expertise.
Joe Yammine, a consultant cardiologist at the Bermuda Hospitals Board, said: “Chronic disease management has become more prevalent in Bermuda due to the ageing population, relative decrease in communicable diseases and advances in medicine that enable cardiac and cancer patients to live years and decades with their chronic conditions.
“The most important goals of chronic disease management include reducing the risk of complications, improving quality of life, slowing disease progression, promoting self-management and reducing healthcare costs.
“It is a proactive approach that aims to improve the patient’s overall wellbeing, prevent complications and maintain a good quality of life.
“By investing time and effort in managing their condition, they can potentially avoid more severe health issues and costly treatments down the line.”
Here’s how chronic disease management can help meet those goals:
Reducing complications
People with serious physical illness can be prone to mental health issues such as depression. By continuously monitoring and managing your overall health you’re better placed to spot warning signs and prevent one illness leading to another.
Improving quality of life
Physical, cognitive and social factors all play a part in your overall health.
Consider what you need to do for all three: pain management helps your physical wellbeing; mental health support in the workplace improves your cognitive health; a good network of friends or family is crucial to the social side.
These factors all interconnect and support each other. Being pain-free means you can concentrate on tasks better; cognitive-behavioural therapy aids your decision-making; and good social support helps your ability to connect and engage – all of which help your performance in the workplace.
Slowing disease progression
Rehabilitation methods such as medicine management and a better diet and lifestyle can delay the debilitating effects of illnesses such as cancer, cardiovascular disease and diabetes.
You can also ease some symptoms by eating more healthily or doing more exercise. An arthritis patient can stave off surgery by building muscle to support their joints, for example, or fight inflammation by adopting the Mediterranean diet.
Promoting self-management
You don’t have to rely on doctors, nutritionists and personal trainers to tell you what to do.
Studies have shown patients feel better about themselves when they’re empowered to manage their own chronic conditions, which can in turn inspire cognitive improvements.
This means educating yourself on your disease and how to deal with it, learning how to self-administer medicine and tracking your own symptoms. You can even learn to adjust your own treatment plan as you go along.
If you go down this road, a health professional should help you develop your plan, but your support system is also crucial. Get help from your family or friends to manage your medicine schedule and make sure you’re eating healthily.
Reducing healthcare costs
A detailed health management plan inevitably leads to fewer costly surgeries and stays in hospital.
But once you factor in the support of all these health professionals, what is the overall cost?
It’s impossible to put a number on it, but Dr Yammine believes that financially it works out for the best.
“It is challenging to quantify the exact cost and value of chronic disease management in society,” he said.
“However, it is known that chronic diseases account for a significant portion of healthcare expenditures. As an example, in the United States, healthcare expenditure takes the highest portion in yearly budgets.
“Investing in chronic disease management can help reduce the overall burden through improved health outcomes, reduced complications, and decreased hospitalisations.”
The nature of your chronic disease management plan depends on your illness, but Dr Yammine summarised what it can involve for some of the most common chronic diseases in Bermuda:
Diabetes
- Monitor and control blood sugar levels through medication, insulin therapy, exercise and diet.
- Prevent complications such as diabetic neuropathy, retinopathy and nephropathy.
Cardiovascular diseases
- Adopt a heart-healthy lifestyle. Take regular exercise, adopt a balanced diet, quit smoking and manage stress.
- Control blood pressure and cholesterol levels through medication.
- Monitor heart health with regular checkups.
Cancer
- Surgery, chemotherapy, radiation therapy or other targeted therapies.
- Pain management, psychological support and palliative care for advanced stages.
Respiratory diseases
- Use inhaled medications such as bronchodilators or corticosteroids to manage symptoms.
- Pulmonary rehabilitation and oxygen therapy.
- Avoid triggers such as smoke or allergens.
Mental health disorders
- Pharmacological interventions such as antidepressants and anxiolytics.
- Psychological therapies such as cognitive-behavioural therapy.
- Promote mental wellbeing through stress management, mindfulness and social support.
Success depends on your condition and how well you adhere to the programme.
“The key to making it work lies in patient empowerment and education, multidisciplinary healthcare team involvement, personalised treatment plans and a strong patient-physician relationship,” Dr Yammine said.
So how do you start?
“Someone should begin organising their chronic disease management by consulting a healthcare professional for a comprehensive assessment, diagnosis and personalised treatment plan,” he advised.
“Although some aspects of chronic disease management can be self-managed, professional guidance and support are crucial.
“In some cases, a single doctor may be sufficient, while others may require a multidisciplinary team, including specialists, nurses, dietitians and psychologists.”
As chronic disease management strategies are designed and implemented moving forward, Dr Yammine hopes societal and cultural factors will be considered to ensure they are accessible, equitable and effective for diverse populations.
“It is essential to recognise that chronic disease management is a continuous and dynamic process that requires ongoing adjustments based on changes in the patient’s condition and emerging medical knowledge,” he said.
