What's self-management really mean?
Self-management is one of health’s big buzzphrases at the moment but trying to unpick what it means to you can appear tricky.
In essence it is the means by which patients with long term conditions can look after themselves and it starts from the idea that the food you eat and the exercise you take – in short, the decisions you make throughout the day – have an effect on how well you feel now and how well you will be in three months’ time and beyond.
In two fundamental ways this approach to healthcare makes perfect sense: many people already make behaviour and lifestyle choices to help themselves feel well without calling it self-management, and no-one knows better how a sufferer from a particular condition feels than that person. Being an expert in something is a very good starting point for success.
But without the knowledge and skills to manage a condition, self-management cannot work – and this is where resources such as crowdhealth come in.
This health hub aims to foster three things: understanding of the principles of self-management, active participation in it by those who need to and collaboration with the fellow patients and health professionals who, together, can help make it work.
There is no single way of doing this. We’ll talk about the evidence behind managing a condition yourself in our next post, but for the moment it’s fair to say that studies suggest patients who do have this knowledge and these skills – and who have confidence in what they’re doing – will get a better health outcome than those who don’t.
They will also cost health authorities less – and here is one of the key criticisms levelled against self-management: that it is purely about saving money and keeping people out of hospital.
Actually, saving patients from unplanned admissions is good for everyone and certainly should save money. But this doesn’t mean you are left at home to self-manage with a set of charts, some pills and just told to get on with it.
Support is a vital part of the equation: you will and must still see health professionals. In fact, there is an argument that doctors will need to form more of a genuine partnership with you, running skills workshops to help, assessing risks and problems, and setting goals to encourage you. Ideally, they will be your mentors.
So, doctors get patients who are empowered and can live independently. Patients will feel better and live longer.
But anyone pretending that there aren’t challenges to all this is deluding themselves: patient engagement will not happen overnight, and certainly not easily even over time in many cases. Co-ordinating health and social care services which are not all configured for this will take discipline and effort.
There will be a number of bumps in the road: the theory of following sometimes complicated treatment regimes can look very different to the practice, while facing up to the reality of having to lose weight may be unappealing.
Self-management simply won’t be suitable for everyone. But making just these sorts of decision is increasingly the way in which many of us will interact with the healthcare environment.
In some ways imagining self-management is simple: it’s what the future will look like.
January Thu, 1970 - 12:01 AM
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