Skip to main content

Healthcare reform is a hot topic around the nation, and everyone has an opinion about it. Healthcare reform has been an industry and political issue for decades, but it regained national attention with the Affordable Care Act. Healthcare does need a transformation, but the real change must start with self-care disease management.

With the rising costs of healthcare and growing number of patients with chronic disease, a call to action is of the essence to change this trend. The entire healthcare community, the givers and receivers of healthcare, must cooperate to create a better future.

According to the American Association for Clinical Chemistry (AACC), in 2009 more than 133 million Americans were reported to have at least one chronic disease. This staggering statistic represents 45 percent of the population. Another 26 percent of the population has multiple chronic diseases. According to the AACC’s 2009 study, chronic disease is the leading cause of death and disability in the United States. The financial burden associated with these conditions is roughly $1.7 trillion a year. This represents 75 percent of all healthcare monies spent.

With chronic diseases increasing, death and the cost of care also increases. This trend must be changed to improve quality of life, and reduce healthcare costs through management and prevention of chronic disease. An effective self-care disease management program is the answer.

Self-care disease management is a patient-centered program designed by clinical professionals and ailing patients to learn and effectively self-manage their conditions with success. Home health is instrumental in disease management education programs. These programs use effective, best-practice care strategies for adult patients with chronic disease. This self-care management model empowers the patient to understand their disease, implement effective care strategies, and demonstrate the learned information and interventions to ensure permanent desired health outcomes.

The program’s three key focus areas are education on disease pathophysiology, therapeutic interventions and self-management strategies. The education is performed by licensed home health nurses and therapists who consistently instruct the patient during the course of care. The effectiveness of the plan is dependent on active patient participation. Patient engagement is essential to ensure they embrace and work towards desired outcomes, while preventing disease complications, health decline and hospitalizations.

Effective education starts with an effective teacher. The home health professional should be equipped with clinical expertise and also be an effective teacher. Adults have different learning needs than children. In order for the information to be translated into education, these techniques must be understood and incorporated into patients’ clinical care for desired outcomes to occur.


First, the home health patient must be internally motivated and self-directed about the health topic or needed change. If the patient feels that the presented health information is being imposed on them, it will most likely be resisted and result in no change. It is important to understand that information is not education.

Education occurs when the given information is disseminated into meaningful pieces so the learner can take these pieces and effectively implement them. Effective implementation allows the learner to then turn this education into habits. These habits result in permanent changes. The patient also learns from life experiences and knowledge they have acquired. The home health nurse has to “meet” the patient “where they are.” This means being able to understand patients’ perception of the fear, obstacles and expectations in achieving the desired goal.

It is essential for the educator to gain the confidence of the learner. This allows for effective collaboration on a self-management plan with valid expectations of the patient and clinical educators. This plan turns into new health habits and desired health outcomes.

This is important because the adult learner is goal-oriented, practical and motivated by relevancy. A successful care plan must address the patient’s goals and priorities for health, or true success will not occur because the patient will be unable to understand the relevance. An additional component that the clinical educator must incorporate is equality between themselves and the learner. Effective education cannot occur without respect. Nurses have the privilege of understanding disease and disease management, and this expertise lends to effective education of patients so they too can be experts in disease management. Once this occurs, patients are able perform self-care management and conquer chronic disease for good.

The effective self-care management model is proven. Patients know more about themselves than any clinical provider will ever know about them. This is why it is essential for all able patients to be educated, motivated and in control of self-managing their afflictions, which will effectively manage their health. This knowledge and control creates desired health results, preserves and improves quality of life, lowers healthcare costs and conquers the detriment of chronic disease. Healthcare reform starts with being informed, then doing something about your health and your future. You are in control.

Leave a Reply