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Self-management support for older adults with chronic illness: implications for nursing practice

27 January 2022
Volume 31 · Issue 2

Abstract

Self-management is a key skill that older adults with multiple comorbidities require. Self-management interventions include medication management, self-monitoring and self-awareness and self-management often requires the older adult to manage the emotional consequences of having multiple comorbidities. The benefits of self-management for older adults include reduced reliance on the health system, enhanced quality of life, empowerment of the individual and reduction in the burden associated with chronic illness. Many factors can influence an older adult's ability to self-manage, including health literacy, mental health difficulties and socio-economic factors. Self-management support is the provision of structures, services and programmes to support and enhance the skills of older adults in managing their own conditions. Nurses are in a pivotal position across the continuum of care, using both person-centred care and the ‘Making Every Contact Count’ approach, to support older adults to self-manage their conditions.

Self–management is increasingly promoted in healthcare policies and research (Wilkinson and Whitehead, 2009; Jones et al, 2011). Indeed, the World Health Organization (WHO) (2015) identified the importance of self-management for older adults given the ageing demographic profile globally, coupled with the increasing numbers of those living with chronic illness and multi-morbidity. Nurses aim to implement holistic person-centred care and work across the continuum of health care (Nursing and Midwifery Council (NMC), 2018) and are therefore ideally suited to the role of promoting self-management with older adults. The aim of this article is to provide conceptual clarity in relation to self-management by older adults living with chronic illness and multi-morbidity and to explore the implications of self-management support by nurses.

Ireland's Health Service Executive (HSE) (2017) has defined self-management as:

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