Managing long-term illness and chronic conditions

A long-term illness or chronic health condition is any condition lasting six months or longer, such as asthma, arthritis, cancer, obesity, diabetes, chronic pain or heart disease. The number of people living with long-term illnesses and chronic conditions is increasing around the world, due to a range of factors including ageing populations and lifestyle issues such as smoking and poor diet. Modern treatments also mean that people are living longer with diseases that previously caused premature death.

Many long-term illnesses and chronic conditions last for a long time, are caused by a number of health factors occurring together, and can lead to other health problems. Chronic conditions are rarely cured completely, so looking after yourself is about good medical advice, a healthy lifestyle and a positive attitude.

Maintaining your quality of life#

To maintain your best quality of life, you or your carer can help by:

• finding reliable information about the condition, its treatment and management, which can help you feel you are taking a positive step and give you a sense of control over your illness
• understanding your medication, including what it is for, any special instructions and potential side effects
• getting emotional support by speaking to others going through the same thing, and leaning on family and friends when you need to
• setting yourself goals, as short-term goals give you a sense of how you are progressing
• developing skills to manage your pain and fatigue
• planning for the future by being realistic about your future health and discussing it with your doctor

Pain management#

Managing the pain associated with a chronic illness may include pain-relieving medication, physical therapies (such as physiotherapy) and other therapies, such as cognitive behavioural therapy. Pain-relief medication includes non-prescription (over-the-counter) options such as paracetamol, prescription medication such as morphine, and may include complementary medicines.

There are also many non-drug treatments available to help you manage pain. A combination of treatments and therapies is often more effective than just one. Some non-drug strategies include:

• cognitive behavioural therapy – to help you change how you think about pain, and in turn how you feel and behave
• physical therapies – stretching, walking and other exercise can help relieve pain, depending on the cause
• transcutaneous electrical nerve stimulation (TENS) – a small electrical current passes through the skin via electrodes, prompting a pain-relieving response from the body
• heat or cold – heat packs can relieve pain from musculoskeletal injuries, while ice packs can help reduce swelling immediately after an injury
• massage – more suited to soft-tissue injuries, and best avoided if the pain originates in the joints
• acupuncture – inserting thin needles into specific points on the skin to encourage the body to heal itself and release endorphins, the body’s natural pain-relieving compounds
• relaxation and stress management techniques – including meditation and yoga

Always be guided by your doctor or healthcare team, and follow their instructions carefully to avoid making your pain worse.

Looking after your mental health#

The symptoms of chronic disease, such as tiredness and aches and pains, are often not visible, so others cannot always appreciate their effects. It is not just physical symptoms that take a toll. The limits on lifestyle and living with constant pain can affect a person mentally as well. Worrying or thinking negatively about possible situations adds to anxiety and stress, which can affect your overall health.

Ways to reduce worrying include:

• when you find yourself starting to worry, write down your concerns and the possible consequences, even if they are negative
• find information about your prognosis and likely outcomes, which may help you feel more in control
• talk to a friend, join a support group, or seek specialist help through a psychologist or psychiatrist, who can help you realistically assess your worries
• focus on a variety of things each day by giving yourself daily tasks and making time to read, walk or watch a film
• do activities that challenge your mind, such as crosswords or other puzzles

Research shows that poor mental health can actually make your physical symptoms worse. Some hospitals offer specialist services to help prevent, diagnose and treat mental health problems in patients who are being treated for a physical health condition. Ask your doctor about what is available. If you feel your condition is overwhelming you emotionally, it is important to speak to your doctor or another healthcare professional about your feelings.

Healthy lifestyle choices#

Staying as well as you can while living with a chronic condition or long-term illness gives you the best quality of life. Research tells us that maintaining a healthy lifestyle helps, including eating well, doing as much physical activity as your condition allows, and getting good rest.

A healthy diet can be supported by:

• choosing nutritious foods that you enjoy
• having small amounts of food often, even if you do not feel like eating, rather than three heavy meals
• avoiding sugar-, salt- or fat-laden snack foods
• telling your family and friends about your dietary needs so they can support you

Trying to do some physical activity each day, even a small amount, can help with managing pain and lift your mood. Speak with your doctor or physiotherapist about exercise that may help your condition.

Sleep is also very important. To help you get enough good sleep:

• avoid napping during the day
• avoid excessive bed rest whenever possible
• avoid stimulants, such as caffeine, before bed
• if you are able, exercise during the day so your body is tired at night

Dealing with multiple conditions#

Living with multiple conditions may mean dealing with a number of healthcare professionals. The most important thing is to let each one know who else you are seeing and for what condition, and to tell them what other treatments and medication you are having. Sometimes medication can have a negative effect if taken at the same time as another, and this includes complementary medicines such as herbal supplements.

Your care can be better coordinated if your health professionals talk to each other directly, but you need to give them your permission first. Allowing all members of your healthcare team to share information helps them gain a more holistic view of you and your needs. It can also help you understand which professional to ask about which problem, avoid repeating your health information for each practitioner, and avoid re-taking medical tests such as scans and blood tests.

To help coordinate your health information:

• give consent for all members of your healthcare team to share information about your care
• appoint one professional, usually your local doctor, to oversee all your care, including drawing up a treatment plan that can be shared
• write down your health professionals’ names and what they do in your care, and give each of them a copy
• ask the other members of your team to tell your primary doctor about tests, medicines, treatments, physical therapy or food limitations they have suggested or prescribed
• ask questions about your care and keep notes on the answers in a notebook, then take this notebook to all appointments for easy reference

Support from others#

Social support can help you maintain your quality of life when you have a long-term health condition. To find and maintain both practical and emotional support:

• plan to catch up with family and friends, and keep a regular schedule of contact throughout each week
• tell your family and friends about your condition, and let them know how they can help you
• consider new sources of support, such as support groups, clubs, interest groups and volunteer opportunities

Support groups allow you to both get and provide advice and support, connecting you with people experiencing what you are going through. They can increase your knowledge about your condition and help you learn to live more comfortably with it.

There are many support groups, and their arrangements vary. Many are centred on regular meetings held in a healthcare facility, community centre or local hall. Others are online, offering ways to connect such as message boards and chat forums. To find a support group, you can ask your doctor or specialist, ask someone you know who has experience with the same condition, or search online.

Key points#

• Modern treatments mean that people are living longer with diseases that previously caused premature death.
• There are many non-drug treatments available to help you manage your pain, and a combination of treatments and therapies is often more effective than just one.
• Research shows that poor mental health can actually make your physical symptoms worse.
• Sleep is very important when you have a health condition.
• Social support helps you maintain your quality of life while living with a chronic condition.

Where to get help#