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An Introduction to Lifestyle Management working with the person not the condition

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Support in managing medical aspects of the long term condition ... Lifestyle management - moving on with life. Support to make health behaviour changes ... – PowerPoint PPT presentation

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Title: An Introduction to Lifestyle Management working with the person not the condition


1
An Introduction to Lifestyle Management-working
with the person not the condition
  • Ross Grieve
  • Lifestyle Management Service
  • Thistle Foundation, Edinburgh
  • rgrieve_at_thistle.org.uk

2
Self Management as a Process
  • Transformative
  • Regaining Purpose
  • A process of moving towards acceptance of their
    current health condition
  • Moving on in life in new and rewarding ways
    despite limitations
  • Greater control, coping and confidence

3
What people want Medical needs
  • Knowledge of condition
  • Support in managing medical aspects of the long
    term condition
  • Rehabilitation long term review/ ongoing
    contact

4
What people want -Non medical needs
  • Psychological support
  • Assistance with coping with change/ emotional
    impact
  • Lifestyle management - moving on with life
  • Support to make health behaviour changes
  • Advocacy
  • Peer support -group based/ individuals/
    volunteers
  • Support groups
  • Exercise classes
  • Relaxation classes
  • Walking
  • Weight management
  • Smoking
  • Support for carers

5

Management of People with Long Term
Conditions
Medical Management of Long Term Conditions
6
Questions
  • What could a LTC management facility look like ?
  • What would the service designed specifically
    around the person rather than the condition look
    like ?
  • Can this service really fit all ?
  • Can the service be adapted to become disease
    specific eg cardiac/ pulmonary rehab ?
  • What are the core competencies required of
    workers to deliver this service ?

7
Questions
  • Can non-health professionals deliver these
    programmes ?
  • Which approaches can be most easily taught to
    non-health professionals such that the spirit
    of the approach ( collaborative, non expert ) is
    ensured
  • From multi to inter disciplinary teams containing
    both health and non health professionals ?

8
Thistle Foundation Long Term Conditions
Management Facility
  • Facility
  • Gym
  • Pool
  • Café
  • Yoga rooms
  • Relaxation rooms
  • Seminar rooms
  • Therapy rooms
  • Physiotherapy
  • Lifestyle management service
  • Non medical needs
  • Individual, group services
  • Support for maintenance groups
  • Peers support training
  • Carers

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20
Lifestyle Management in Practice
Co- Facilitation
Referral/ self referral
Individual meeting - menu
Lifestyle courses
Peer Training
Individual support
Ongoing support groups
Use of facilities
Open access
21
Lifestyle Management Courses
  • 10 weekly, 3 hour sessions
  • Review, change based discussion
  • Exercise
  • Relaxation
  • Discussion topics -
  • Lifestyle management philosophy, sleep, stress,
    energy management,
  • relaxation, getting active/ goal setting,
  • time management/ planning, communication skills,
  • mind body connection, preventing, minimising,
    recovering from relapse,
  • review and forward planning

22
Biopsychosocial Model of Illness
  • It is not just the extent of physical impairment
  • but cognitive, behavioural and other psychosocial
    factors
  • which most closely correlate with poor prognosis,
    long term disability and quality of life

23
Spiralling to Disability
Impairment
Disability
24
Disability spirals
25
Who can benefit from our service?
  • People who
  • Are struggling to come to terms with diagnosis
  • Are struggling with the physical, mental and
    emotional effects of living with a LTC
  • Are at risk of increasing disability due more to
    psychosocial factors rather than
    physical/biomedical factors
  • Are trying to cope with health issues and extreme
    life situations
  • Have mild to moderate mental health problems
    perhaps who are on a long waiting list for
    psychological services
  • Are hoping to cope better, gain more control and
    build confidence to move on in life in more
    effective ways
  • Have not responded well to other treatment
    options orientated toward that of learning more
    about illness, compliance with medications, and
    behaviour changes

26
Outcomes
  • 75 completion rate
  • Independent review 2007
  • Self- efficacy questionnaires
  • Research and evaluation a priority for 2008/9

27
Our Team
  • Salaried - includes individuals with backgrounds
    in physiotherapy, occupational therapy, mental
    health, fitness management and Magic!!
  • Volunteer Peer Facilitators

28
General Competencies the non expert stance
  • We dont
  • Assume an expert/ authoritative role leaving the
    participants in a passive role
  • Lecture, teach - do most of the talking, or
    function as a unidirectional information delivery
    system
  • Offer direct advice or prescribe solutions to the
    problem without the persons permission or
    without actively encouraging the person to make
    his/her own choices
  • Argue that the participants have problems which
    should be fixed by the facilitators/ manuals
    ideas
  • Impose diagnostic labels, including labelling of
    personality traits
  • Behave in a punitive or coercive manner

29
General Competencies
  • We do
  • Offer participants an experience of empathy,
    respect and genuineness
  • Work with participants hopes for the course,
    their stage of coming to terms with illness and
    their readiness to change aspects of their lives

30
Principles of Lifestyle Management Recovery and
the Solution Focused Approach
  • Adopting a non expert stance, workers focus on
  • what the client wants
  • evidence of resource, coping, control, confidence
  • signs of strength, achievement
  • Competency, qualities that might help
  • descriptions of clients preferred outcomes
  • change

31
Group Facilitation
  • Basic communication/ counselling skills
  • Engagement
  • Solution Focused Approach
  • Principles of adult education and group
    facilitation
  • Relaxation training and mindfulness practice
  • Principles of exercise prescription

32
Specific Competencies in Individual meetings
  • Engage successfully with clients
  • Manage psychological distress/ anxiety if present
  • Negotiate clients goals, hopes, motivation
  • Create a future orientation/ expectant attitude
  • Highlight and amplify
  • Psychosocial predictors of recovery emphasising.
  • Health beliefs and adaptive coping behaviour
  • Internal, external resources (including)
  • Clients existing knowledge
  • Engage clients in change based conversations
  • Related to clients goals
  • Related to (workers defined/ negotiated?) health
    behaviours
  • Review progress, manage relapse
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