1. Living Well with Chronic Conditions Chronic Disease Self-Management Program/Tomando Control de Su Salud Presentation for ADRC, I & A, and 211 Staff June 24, 2013

2. Webinar Presenters CDSMP/Tomando Control de su Salud Overview Maureen Lally, Project Coordinator, ALTSA NWRC Perspective of CDSMP/Wisdom Warrior Program Melody Coleman, ADRC Specialist, NWRC Perspective of CDSMP on the Olympic Peninsula Kathy Jones, I & A Specialist, O3A 2

3. Webinar Objectives Raise awareness & inform staff of 1 evidence based program offered in WA- Living Well with Chronic Conditions/Tomando Control de su Salud (Spanish version) Learn about the Living Well website to refer callers interested in CDSMP workshops 3

4. What’s a chronic condition? A general term that includes chronic illnesses, impairments, or conditions lasting a year or longer; limits what one can do, may require ongoing medical care.

5. Source: Medical Expenditure Panel Survey, 2006 5

6. 6 Once a chronic disease is present, one cannot NOT manage, the only question is ‘how.’ (Bateson 1980, Lorig, 2003)

7.  Smoking  Poor diet & nutrition  Physical inactivity  Falls  Alcohol & substance abuse  Stress  Social isolation Key Risk Factors for Chronic Illness

8. Question Do callers mention they have…. Memory loss, limited mobility, diabetes, arthritis, osteoarthritis, cardiac conditions, high blood pressure, respiratory conditions, spinal cord injury, fibromyalgia, depression, stroke, asthma, multiple sclerosis, visual impairments, drug or alcohol dependence, Parkinson’s disease…

9. Question Do callers talk about how they feel ? Scared? Frustrated? Fatigued? Angry? Depressed? Anxious? Sad? Confused? Uncertain? Isolated? Fearful?

10. Question What are they doing about it?

11. Stanford University’s Chronic Disease Self-Management Program(CDSMP) Designed for people with chronic conditions learn to take better control of their lives. Participants learn strategies, techniques, tools to gain a greater sense of control over living with their condition(s).

12. Who Participates? Adults ages 18 and older who have one or more chronic conditions Family members, friends or caregivers of a person who has a chronic condition 12

13. Workshop Overview 2 ½ hours /week for 6 weeks People with different chronic conditions in the same group Rationale: similar concerns and self management tasks Opportunities to share and discuss, focus on action planning, problem solving, increases self confidence People deal not only with their condition, also its impact on their emotions.

14. Living Well Workshops Small group (10-15 people) people learn from each other, share what helps, what improves health and well being Two trained peer leaders with either a chronic health condition or they are close to someone who does Workshop is taught with carefully scripted and structured materials-over 20 years of proven impact as an evidence based program.

15. The Symptom Cycle Chronic Condition Stress/Anxiety Pain Tense Muscles Fatigue Difficult Emotions Depression Shortness of Breath

16. The Self-Management Toolbox Oregon Living Well Physical activity Pain & fatigue management Getting good night’s sleep Action Planning Better Breathing Dealing with difficult emotions Medication management Problem-solving Mind-body connection/distraction Communication skills Making Healthy Food Choices Improving balance/preventing falls Relaxation approaches Working w/your health care professional

17. Why attend a Self-Management Workshop? When you’re in charge: – You have more control over your life – You build more confidence to make healthy choices and be active in your own self care Self management tools practiced in the workshop continue to be used in daily life after the workshop ends

18. Participant Guidelines Come to every session Respect others & their ideas Maintain confidentiality Give new activities at least a 2 week trial Make a weekly action plan Contact your buddy weekly 18

19. Action Planning An important self management tool Anything you want or decide to do Action-specific Achievable-you can expect to be able to do this next week You rate how sure you are of completing the action plan for the coming week from 1 to 10 Each week you make a new action plan The success of previous weeks action plans builds self-confidence

20. Problem Solving If problems completing your action plan, you’re asked for ideas on how to solve the problem If you agree, other participants in the workshop help brainstorm additional ideas You select one of the ideas You’re then asked to try it out the following week(s) Didn’t work? Try another idea from the list

21. Why these techniques work…  Peer educators  Tap into the wisdom of the group Brainstorming Feedback & Sharing  Skill Building Components Goal setting Action planning Problem-solving

22. You get to try self management tools and techniques for 6 weeks and find the ones that work best for you You learn what works for other workshop participants You become more confident which helps you to BETTER manage your health Why Refer Someone to a Living Well Workshop?

23. Evidence-Based CDSMP Participants report (3 months-3 years after workshop completion) Improved self-reported health Improved social life/activities Improved energy/less fatigue

24. Workshop Participants Report Trying New Things Aerobic Activity Stretching and Strengthening Better Communication with Health Professionals

25. Workshop Participants Report Medical Savings Health care costs are less - because - Workshop participants take an active role in self managing their health Fewer ER visits, fewer days and overnight stays at hospital

26. What Participants Say “ This program has given me the confidence that I can have a future worth living. I have learned there are people like me, not living life to the fullest because of a chronic condition and that we can move forward.” “I learned how to cope with things in my life that I could not handle before” “This class kept me on track” “I learned how to make action plans” The distraction techniques are remarkable. Counting backward by 3’s from 100….I’m usually pain free by 79.”

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28. Visit us Online at http://livingwell.doh.wa.gov

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31. Coming Attractions of other EBPs under CDSM Education Diabetes Self Management Program Chronic Pain Self Management (available on Olympic Peninsula now) Better Choices Better Health (online CDSMP through Pierce County Community Connections) 31

32. Contact Information Refer Callers to the Living Well in Washington website http://livingwell.doh.wa.gov If staff have questions, contact Maureen Lally, ALTSA 360-725-2449 lallym@dshs.wa.gov

33. Questions? 33