DR.TERRY STUART

1
DR.TERRY STUART

• A Relaxed Guide to
• Managing Anxiety, Stress and Depression
• in Chronic Disease

2
What are we going to do?

• Why me?
• Who does chronic disease affect?
• Why is chronic disease difficult?
• What are the effects of chronic disease?
• What can we do to help?

3
LTC- Everybody's problem?

• 30
• 80
• 66

4
Who does chronic disease affect?
5
How many?

• Sufferers?
• Carers?

6
Why is chronic disease difficult?
7
Modern medicine..

• Medication is most likely intervention
• 80 over 75yrs on prescription medicine
• 36 on 4 or more!
• 50 not taken as prescribed
• Up to 17 hospital admissions
• 17 adverse reactions in hospital

8
The patient.
9
(No Transcript)
10
Physical Progression of COPD
FEV1
Exacerbation
Accelerated progression
FEV1
Exacerbation
Accelerated progression
FEV1
11
Psychological Progression of COPD
FEV1
Exacerbation
Accelerated Frustration
FEV1
Exacerbation
Accelerated anxiety/depression
FEV1
12
Living with COPD (BLF Survey)

• Climbing stairs 79
• Gardening 75
• Housework 70
• Washing and dressing 60

13
?

• What does this do to patients?

14

• WORRY ANXIETY/STRESS
• ANGER GUILT
• UNCERTAINTY
• ISOLATION
• EXHAUSTION
• DESPAIR DEPRESSION
• 
  HOPELESSNESS

15

• F.A.D.

16
The carer
17

• WORRY ANXIETY/STRESS
• ANGER GUILT
• UNCERTAINTY
• ISOLATION
• EXHAUSTION
• DESPAIR DEPRESSION
• 
  HOPELESSNESS

18
?

• What can we do to help?

19
The Professionals
20
MULTIDISCIPLINARY
21
Pulmonary Rehabilitation
22
Pulmonary Rehabilitation

• Improves quality of life by improving exercise
  levels, and levels of normal daily activities,
  decreasing sensation of breathlessness AND
  raising confidence and overall feeling of
  Well Being.

23
MULTIDISCIPLINARY

• Health professionals
• Social care professionals
• Counsellors
• Acupuncturists
• Occupational therapists
• Psychologists
• Osteopaths
• Aromatherapists
• Physiotherapists
• Psychiatrists
• Chiropractors
• Dieticians

24
What sort of help?

• Counselling
• Cognitive Behavioural Therapy
• Family / Group Therapy
• Self Help Groups
• Complimentary Therapies..

25
Complimentary Therapies

• Acupuncture
• Aromatherapy
• Reflexology
• Pilates / Yoga
• Hypnosis
• Relaxation Techniques.

26
What do patients think?

27

• We find most of our patients with COPD exhibit
  fairly high levels of anxiety and/or depression.
  They feel FRUSTRATED with their condition and how
  it affects their lives. This then impacts on
  their coping mechanisms. Most have NEVER EVER
  considered relaxation and it comes as a surprise
  when we offer them relaxation as an option. They
  are sometimes quite resistant to the idea.
  Quirky alternative stuff! But when they try it..
  they find they like it. It can certainly help
  with breathing control and just giving them time
  out from their disease.
• H. Matthews Respiratory Nurse Specialist 2006

28

• A wise person learns from experience
• An even wiser person learns from the
• experience of others
• SOCRATES

29

• The aim is for humans to die young
• But as late as possible!

30

• We need to add life to years
• as well as years to life

31

• Life is a great bundle
  of little things
• Oliver Wendell
  Holmes

32
Thankyou for listening!