Chronically Ill
Definition: The chronically ill are people who suffer from permanent, long lasting or re-current
illness. For example, cancer, arthritis, chronic fatigue syndrome, diabetes, asthma, cardio vascular
disease, cystic fibrosis, hypertension, emphysema
Needs:
Factors Affecting Access To Resources:
Self esteem
Health
Education
S
H
E
Housing
Access to services
Safety and security
H
A
S
Sense of Identity
Employment
Financial Support
Soup
Each
Friday
S
L
E
D
A
G
E
Socio-economic Status
Location
Education
Disability
Age
Gender
Ethnicity/culture
Characteristics:
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Person who has an illness that persists over an extended period of time. Initially it may not be severe
but as it progresses it can become more serious or fatal.eg cancer, multiple sclerosis, emphysema,
asthma, diabetes
Chronically ill people may have a diminished life span and a poorer quality of life
The incidence of chronic illness increases with age and can affect almost every aspect of a person’s
life
¾ of the population have reported having one or more long-term health conditions.
The cost of being chronically ill are quite high: they can include hospital costs, specialist costs, and
the cost of medicines and equipment
Priority of Needs
Highest priority:
Lowest priority:
Health
Access to Services
Financial Support
Self-Esteem
Sense of Identity
Education
Housing
Security and Safety
Employment
Needs:
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Health - May experience remissions in their condition that gives some experience of a good quality
life. Can experience highs and lows in their condition. Day to day health can be affected by
medication and treatments. Need quality and affordable health care. Access to specialised
diagnostic procedures and equipment like CT scans, can allow the patient’s medical specialists to
diagnose and treat some illnesses more effectively. There is a need for specialised services in
community centres and nursing homes. Some chronic illness can be prevented or improved by stop
smoking, the effective control of blood pressure, diet and alcohol. Regular exercise can also help.
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Access to Services - Many rely on a variety of health services. Many cannot afford private health
insurance (or aren’t eligible for it). When someone has been ill over a long period of time,
considerable money would have been spent seeking treatment. Public system has long waiting
periods for treatment and lower priority. Home care and respite care helps carers of people with
chronic illness. Services that may be required include transport and access to government
departments or agencies, such as the Dept of Aging, Disability and Home Care (DADHC) and
Centrelink. If the illness is terminal, a patient may require support from palliative care teams.
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Financial Support - High bills due to ongoing medical treatment, transport to services, carers and
living costs. Need alterations to home. These all place a significant burden on individuals and
families. Many have difficulty maintaining or gaining employment so don’t have an income, rely on
government support. Financial support assists with the cost of medication and other resources.
Examples include: Sick Leave paid by employer, Disability Pension, Sickness Benefits paid by
Centrelink, Mobility Allowance paid by Centrelink to fund taxi fares to and from medical
appointments, and subsidised medications on the Pharmaceutical Benefits Scheme (PBS), Carer
Payment for a carer who foregoes employment to look after a dependent,. Medicare does not cover
all treatments
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Self-Esteem - May experience physical changes through weight gain or loss or skin problems.
Change in body image can affect self-esteem. Thus, combined with losing some independence
(inability to maintain education or employment), can lead to a lower level of self-esteem. Chronically
ill should be treated as capable, valuable and contributing members of society. This helps remove
feelings of dependency, helplessness and isolation.
Factors affecting access to resources:
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Education - Education can empower some individuals. Teaching people how to look after
themselves and their condition can empower the chronically ill by making them feel in control.
Service providers, sufferers, family and friends need to be educated in order to understand what an
individual is feeling and facing in terms of their prognosis. They need to know about relevant support
groups and, if possible, new trends in research and treatment. Through the Internet, many patients
have a higher level of knowledge than they had in the past. However, patients can wrongly diagnose
their problem and, without a medical background, they may not have the ability to understand the
relevant literature. The Internet also increases their access to social support, which can be valuable
if the person is housebound.
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Ethnicity/Culture - Language barriers can make communication difficult. Differences in beliefs and
traditions can limit or create opportunities to access health resources in their community or the
benefits of a support group.
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Gender – Some resources are gender specific. Men and women communicate differently. Men may
find it difficult to express their feelings and emotions to be able to ask for help. Women are
historically more confident than men in accessing health services, such as doctors or counselling.
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Socio-economic Status - Many children who suffer a chronic illness come from lower SES
backgrounds and less likely to have preventative health care. Limited money and other resources
impact on the individual’s ability to access resources. Alternative therapy is expensive; some
treatments are only available overseas (which also limits accessing those resources). Those with a
high SES may have private health insurance and use private hospitals. They may be able to have
different treatments and travel overseas for surgery instead of being on a hospital waiting list.

Location – When someone who lives in an urban area needs to see a doctor, they can often choose
which doctor they would like to see, whereas someone who lives in a rural or remote area might not
have a choice as there might be only one doctor available nearby. Need safe affordable transport for
medical visits. Visiting a specialist may mean an overnight trip, as many specialists only operate in
major cities or towns. This will have an impact on their economic wellbeing. Internet, transport and
technology could decrease the effects of isolation.
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Age - Young people have limited life experiences and may have difficulty identifying and confidently
using community resources, while older people may not be aware of services or lack the skills to
access them. Age cannot be used to determine entitlements to services. Chronic illness is more
likely as age increases. The number of people with arthritis, cardiovascular disease, dementia and
diabetes increases throughout the lifespan.
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Disability – Deterioration in physical condition may mean that the individual develops a disability.
May over time, or may have a disability before having a chronic illness. Harder to access resources
with a disability. Disability may allow a person to access the Disability Support Pension or obtain a
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Mobility Parking Scheme sticker. A chronically ill person may use the patient transport operated by
the ambulance service or access a taxi allowance
Chronically Ill – Questions
1. List 5 illnesses that could be considered as chronic.
2. What health related services are significant to this group?
3. Describe the Pharmaceutical Benefits Scheme?
Describe: provide characteristics and features of
Go to : Pharmaceutical Benefits Scheme (PBS) - About the PBS
www.pbs.gov.au/pbs/about-the-pbs
4. What is the PBS Safety Net?
Go to: Pharmaceutical Benefits Scheme (PBS) - About the PBS
www.pbs.gov.au/pbs/about-the-pbs
5. Describe the Medicare Safety Net?
Describe: provide characteristics and features of
Go to: Medicare Safety Net
www.humanservices.gov.au/customer/.../medicare/medicare-safety-n...
6. The chronically ill have significant needs. Select TWO of their most significant needs and
justify your choice.
Justify: support an argument or conclusion
7. Define the chronically ill and explain how the following factors affect its access to resources:
Define: state meaning and identify essential qualities
* location
* socioeconomic status
* education
8. Identify one support service for this group. Discuss how this support service helps this
group. (suggest Home and Community Care HACC or Meals on Wheels)
Identify: recognise and name
Discuss: Identify issues and provide points for and/or against
Go to: Commonwealth Home and Community Care (HACC) Program
www.health.gov.au/internet/main/publishing.nsf/.../hacc-index.htm
Go to: Meals on Wheels NSW - Meals on Wheels
www.nswmealsonwheels.org.au/
Chronically Ill – Answers
1. List 5 illnesses that could be considered as chronic.
Chronic illnesses may include: asthma, arthritis, diabetes, hypertension, emphysema, chronic fatigue syndrome, cardio
vascular disease, cystic fibrosis.
2. What health related services are significant to this group?
As the chronically ill suffer from permanent, long lasting or re-current illness a range of health services are important to
enhance their quality of life and improve their overall wellbeing. Health related services include: the pharmaceutical
benefits scheme (PBS), doctors, surgeons, physiotherapists, naturopaths, occupational therapists, audiologists, Home
Health Care, Respite Care
3. Describe the Pharmaceutical Benefits Scheme?
Describe: provide characteristics and features of
The Pharmaceutical Benefits Scheme (PBS) gives all Australian residents and eligible overseas visitors access to
prescription medicine in a way that is affordable, reliable and timely. Through the PBS, the Australian Government
subsidises the cost of prescription medicine, making it more affordable for all Australians. General patients will pay up to
$35.40 and concession card holders will pay $5.80
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4. What is the PBS Safety Net?
If you or your family needs a lot of medicines in a year, the Safety Net helps you with the cost of your medicines. Once
you or your family reach a Safety Net threshold, you can apply for a PBS Safety Net card—then your PBS medicine will
be less expensive or free† for the rest of the calendar year.
† If you choose a more expensive brand of medicine, or your doctor prescribes one, you may need to pay more.
Concession card holders pay $5.80 for each medicine purchased
Safety net threshold for General patients is $1363.30 † For concession card holders the safety net threshold is
$348.00.( If you choose a more expensive brand of medicine, or if your doctor prescribes one, you may need to
pay more—the extra amount you pay won’t count towards your PBS Safety Net.)
Once this limit has been reached General patients will pay $5.80 and Concession card holders prescribed
medicine will be free.
5. Describe the Medicare Safety Net?
Describe: provide characteristics and features of
The Medicare Safety Net provides families and individuals with financial assistance for high out-of-pocket costs for
out-of-hospital Medicare Benefits Schedule (MBS) services. Once you meet a Medicare Safety Net threshold, you
may be eligible for additional Medicare benefits for out-of-hospital MBS services for the rest of the calendar year.
6. The chronically ill have significant needs. Select TWO of their most significant needs and
justify your choice.
Justify: support an argument or conclusion
The chronically ill are people who suffer from permanent, long lasting or re-current illness. For example,
cancer, arthritis, chronic fatigue syndrome, diabetes, asthma, cardio vascular disease, cystic fibrosis,
hypertension, emphysema. Hence health and access to services are two significant needs.
Health – the chronically ill can experience highs and lows in their condition. Day to day health can be
affected by medication and treatments. They need quality and affordable health care. Access to specialised
diagnostic procedures and equipment like CT scans, can allow the patient’s medical specialists to diagnose
and treat some illnesses more effectively. There is also a need for specialised services in community centres
and nursing homes.
Access to services – the chronically ill rely on a variety of health services. Services that may be required
include transport and access to government departments or agencies, such as the Dept of Ageing, Disability
and Home Care (DADHC) and Centrelink. Many cannot afford private health insurance (or aren’t eligible for
it). When someone has been ill over a long period of time, considerable money would have been spent
seeking treatment.
7. Define the chronically ill and explain how the following factors affect its access to resources:
* location
* socioeconomic status
* education
Define: state meaning and identify essential qualities
Explain: relate cause and effect; make relationships between things evident; provide why and/or how
The chronically ill are people who suffer from permanent, long lasting or re-current illness. For example, cancer, arthritis,
chronic fatigue syndrome, diabetes, asthma, cardio vascular disease, cystic fibrosis, hypertension, emphysema.
Location - When someone who lives in an urban area needs to see a doctor, they can often choose which doctor they
would like to see, whereas someone who lives in a rural or remote area might not have a choice as there might be only
one doctor available nearby. Need safe affordable transport for medical visits. Visiting a specialist may mean an
overnight trip, as many specialists only operate in major cities or towns. This will have an impact on their economic
wellbeing. Internet, transport and technology could decrease the effects of isolation.
Socio-economic Status - Many children who suffer a chronic illness come from lower SES backgrounds and less likely to
have preventative health care. Limited money and other resources impact on the individual’s ability to access resources.
Alternative therapy is expensive; some treatments are only available overseas (which also limits accessing those
resources). Those with a high SES may have private health insurance and use private hospitals. They may be able to
have different treatments and travel overseas for surgery instead of being on a hospital waiting list.
Education - can empower some individuals. Teaching people how to look after themselves and their condition can
empower the chronically ill by making them feel in control. Service providers, sufferers, family and friends need to be
educated in order to understand what an individual is feeling and facing in terms of their prognosis. They need to kno w
about relevant support groups and, if possible, new trends in research and treatment. Through the Internet, many
patients have a higher level of knowledge than they had in the past. However, patients can wrongly diagnose their
problem and, without a medical background, they may not have the ability to understand the relevant literature. The
Internet also increases their access to social support, which can be valuable if the person is housebound.
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8. Identify one support service for this group. Discuss how this support service helps this group.
Identify: recognise and name
Discuss: Identify issues and provide points for and/or against
Home and Community Care (HACC)
Help around the home
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Housekeeping - including regular or 'spring' cleaning and laundry
Home maintenance - such as cleaning gutters and spouts
Minor works - such as the installation of grab rails and smoke alarms.
Personal, nursing and health care
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Personal care - such as assistance with mobility, showering, grooming, dressing
and undressing, toileting, eating, prescribed exercise and monitoring of prescribed
medication.
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Nursing care and therapy, and information on the management of health
problems like diabetes or incontinence.
In some areas, allied health services - such as dietetics, occupational therapy,
physiotherapy, podiatry and speech therapy - are available.
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Assistance with shopping, cooking, paying bills and attending appointments
Delivered meals and group meals at senior citizens' centres or community venues
Friendly visiting and group activities via the telephone.
Day groups sharing the company of others.
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Planned and overnight respite in the home or in the community. This provides a
break or an outing for the person who is being cared for and a break for the carer.
Information and referral to other services.
Help to get out and about
A break for everyone
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