Being the leading cause of disability, ill health, and death, chronic diseases can have a significant impact on one’s life. Its consequences go far beyond frequent visits to the doctor and recurring medical bills. Over time, chronic diseases can exert severe side effects, causing or worsening other diseases, resulting in loss of productivity, impaired mental health and even premature deaths.
This article features the essential aspects of effective management of chronic diseases, including how to utilise home care to improve chronic conditions, how to manage coexisting chronic illnesses, and latest financial schemes you can tap into.
1. What is a Chronic Disease?
According to CDC, chronic disease is defined as a health condition that lasts one year or more. It requires ongoing medical attention and limiting activities of daily living. Most of us are familiar with the “three highs” as common chronic diseases. However, many more other illnesses are categorised as chronic. Some chronic illnesses can linger throughout an individual’s life but are not always the cause of death, for example, arthritis. Others persist over time and require comprehensive management, such as type 2 diabetes. A number of chronic diseases can result in life-threatening situations such as stroke or heart attack. The common Chronic Diseases are:
- Cardiovascular: Stroke, heart failure, heart attack
- Joint/Bone Diseases: Joint pain, arthritis, rheumatoid arthritis, osteoarthritis
- Mental Health/Brain Disorders: Depression, schizophrenia
- Neurological Diseases: Dementia, Parkinson’s disease
- Others: Hypertension (high blood pressure), hyperlipidaemia (high blood cholesterol), obesity, chronic kidney disease (CKD)
2. Comorbidity Of Chronic Diseases
Comorbidity is defined as a group of two or more diseases or conditions that occur in an individual at one time. Comorbidity complicates treatment plans and puts extra burden on the patient’s treatment outcome, healthcare cost and even mortality, especially among the elderly. Understanding the risk and existence of comorbidity can improve treatment, management, and prevention of chronic diseases.
In some cases, a chronic disease acts as a risk factor or a precursor for other chronic conditions. For example, hypertension and diabetes are known to be a major contributor to the development of cardiovascular disease. Similarly, people with asthma are at greater risk of having chronic obstructive pulmonary disease.
In other cases, two or more chronic diseases occur as a result of the same risk factors. They are associated, but unrelated. For example, obesity can lead to arthritis due to wear and tear. Furthermore, obesity can lead to cardiovascular disease due to increased risk of diabetes, hypertension and hyperlipidaemia.
3. Chronic Disease among the Elderly
80% of adults over the age of 65 are estimated to suffer from at least one chronic condition, while 68% suffer from 2 or more. According to a local survey, the number of seniors suffering from 3 or more chronic illnesses almost doubled in Singapore from 2009 to 2017. The same study found that an increasing number of seniors struggled with activities of daily living (ADL).
Although the numbers are worrying, researchers hypothesise that it does not reflect a worsening health condition. Instead, this could be the result of greater access to healthcare and better health screening for Singaporeans in their senior years. More elderlies are aware of their chronic conditions now compared to 10 years ago.
Nevertheless, it is important to note that elderlies are disproportionately affected by chronic conditions. They need support from family and healthcare professionals to manage their health and daily lives. In the following sections, we cover treatment plans for chronic illnesses, including the role of home care, family support and financial assistance.
4. Treatment For Chronic Diseases
There is no one-size-fits-all solution when it comes to the treatment of chronic diseases. It is because a patient with a chronic illness may experience different symptoms or may be in a different stage of the disease than other patients. Therefore, a highly individualised approach is required for the management of chronic diseases.
Most chronic diseases will need medication. However, other therapeutic options may be needed such as physiotherapy, psychological therapy or surgery. A holistic approach is essential to prevent long term complications. This involves:
- Early detection and treatment through regular health screening and follow-up with a GP.
- Healthy nutrition
Early access to palliative care in chronic disease will help improve patient’s quality of life.
5. The Role Of Home Care In Chronic Disease Management
Home-based care has been playing a significant role in providing compassionate and cost-effective care to patients living with chronic diseases, particularly in the Singapore context since the start of Covid-19 pandemic. Providing patients with home care confers a convenient and cost-effective care for the patients in the comfort of their own homes.
Here’s some of the documented benefits of home care for patients living with chronic illnesses:
- Decreased Hospital Stays: When caregivers provide care to patients living with chronic illnesses, it reduces the need to stay in hospitals. It has been reported that patients receiving home care spend 29% fewer days in rehabilitation facilities and 31% fewer days in acute care hospitals.
- Improved Quality Of Care: Patients utilising in-home care services are at reduced risks of incidents, such as medication mismanagement or risk of fall, thus having improved quality of care.
- Control Over Health: Home care helps patients to take ownership and responsibility of their own health. This empowers them and hence improves their compliance with medical treatment.
- Improvements In Activities of Daily Life (ADL): Patients receiving care in the comfort of their home become active in performing activities of daily living, including bathing, dressing, and grooming. This supports their emotional health especially for the elderly, which can be negatively affected by the stress of having a chronic disease.
- Cost Effective Care: Home care of patients with chronic diseases decreases the need for hospital-based care, which will reduce costs to the caregivers.
6. How To Effectively Manage Chronic Diseases At Home
Living with a chronic condition can be debilitating and stressful, but taking charge and self-managing the disease is the best way to have a healthy life. Here are some ways that can help you cope with a chronic illness:
- Manage Your Medications: It can be a daunting task to manage various medications, especially if you have comorbidity.
- Modifying Your Lifestyle Habits: Almost every patient knows that a part of their treatment always requires lifestyle changes. Making lifestyle changes involves healthier eating habits, exercising more, losing extra body weight, and quitting smoking. Making lifestyle changes increases your chances of successfully managing the condition, thus helping you feel better and live longer.
- Follow-Up Regularly With Your Doctor: Make your doctor a partner in your self-management care plan. Go for regular checkups, discuss your condition with your doctor, and discuss home monitoring with them. Home monitoring will help you track changes in the body. For example, you will need to check your blood pressure if you have hypertension. Regular follow-ups with your doctor can help prevent any complications of your chronic disease.
7. Saving Cost when Managing Chronic Disease
Enhancements to the Chronic Disease Management Programme (CDMP) which took effect in Singapore from 2021 allow for Singaporeans to better tap into MediSave to manage their chronic condition. According to the new policy, patients can claim up to $500 from MediSave per year per person when they visit public hospitals, polyclinics and thousands of participating GP and private specialist clinics nationwide for a wide range of chronic diseases. Individuals with complex chronic conditions can claim up to $700 per patient year. The MediSave claim is subject to a 15% co-payment in cash. More about the MediSave 500/700 scheme is available on MOH website here.
In addition, CHAS and Pioneer Generation or Merdeka Generation cardholders are eligible for additional government subsidies of up to $500 per year and $540 per year respectively. Make sure you tap into the appropriate financial schemes for yourself or your elderly loved ones next time you visit a hospital, clinic or GP for a chronic illness.
Below is the list of 20 chronic conditions covered under CDMP:
- Diabetes Mellitus/ Pre-diabetes
- Hyperlipidemia (Lipid Disorders)
- Chronic Obstructive Pulmonary Disease (COPD)
Mental health conditions:
- Major Depression
- Bipolar Disorder
- Benign Prostatic Hyperplasia
- Parkinson’s Disease
- Chronic Kidney Disease (Nephrosis/Nephritis)
- Rheumatoid Arthritis
- Ischaemic Heart Disease
8. Takeaway Message
Having one or more chronic diseases is undoubtedly taxing. But active management, combined with effective home care and self-management can improve your quality of life and health while reducing your chances of getting other chronic diseases. It is also advisable to keep in touch with a regular family doctor for guidance and medical intervention when required.
As one of the leading home care solution providers in Singapore, Ninkatec brings chronic disease management service to your doorstep, so you can heal in the comfort of your home and the care of loved ones. Check out our services related to chronic diseases here. For a private and personal consultation, reach out to us via phone, WhatsApp or website contact form below.