Chronic or long term illness refers to correcting demands of

Chronic or long term illness refers to correcting demands of the illness and the treatment used to treat the condition. Any disease that last for more than three months, is persistent or habitual, and has meaningful impact on a person health status. The word "Chronic" is used in medicine to refer to any ailment or disorder that continues over time or commonly recurring. Chronic illness can also impact your ability to work. Morning difficulty, declined range of motion and other physical limitations that may force you to change your activities and environment.

This illness can change family members' roles and responsibilities. Many of us are familiar with this saying "A family that prayers together stays together" However, there are many different ways that chronic illness can affect a family. How a family reacts to chronic illness depends on the person age and the development stage of the ill individual, the strength and coping mechanisms of the family and the family life- cycle.

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There are many ways chronic illness can challenge the relationship among family members.

In recent years chronic diseases such as heart disease, cancer, diabetes, stroke, and arthritis are the leading causes of disability and death in the world. Although chronic illnesses are common and costly, many diseases are also unnecessary. Many lingering diseases are linked to lifestyle selections that is within your own hands to change, however, some chronic illnesses are genetic also. A combination of factors is seen as contributing to the cause within this vulnerable group, such as poor diet and a lack of physical activity.

As a result the study hopes to explore and describe the issue as one that warrants an active response in reaction to control hence a program developed that aims at promoting such.

Diabetes within the Elderlies

Diabetes mellitus is one of the major public health challenges for Trinidad and Tobago in the twenty-first century. "This aliment refer to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It's also your brain's main source of fuel." Mayo Clinic (2017). Diabetes is a serious disease and it can lead to dangerous health problems such as your blood glucose (often called blood sugar) is too high. So too much glucose in the blood isn't good for your health. NIH Senior Health, (2014). Diabetes is also refer as a grave health concern in the elderly population.

Diabetes is most common in older adults who require a high frequency in long-term care facilities. The first known indication of diabetes signs was in 1552 B.C., when 'Hesy-Ra, an Egyptian physician, documented frequent urination as a symptom of a mysterious disease that also caused skinniness'. Also around the time, ancient healers noted that ants seemed to be attracted to the urine of people who had this disease (Mc Coy, n.d.). There has been a widespread of acknowledgement that aging is a major factor for the development of diabetes. About one in four persons over the age of 60 have diabetes, which makes managing the disease more difficult as people enter into their 60's, to 80's, as well as diabetics having a greater risk of disabilities related to mobility and daily tasks among elderly people.

Elderly individuals with diabetes have higher rates of premature death, functional disability, and coexisting illnesses, such as hypertension, coronary heart disease, and stroke, than those without diabetes. Chronic diabetes conditions include type 2 diabetes which accounts for 90-95% usually begins as insulin resistance, a disorder where cells do not use insulin properly. However, as the need for insulin rises, the pancreas may lose its ability to produce it. Persons with Type 2 diabetes do not always require insulin, since lifestyle modification such as diet control; weight loss and exercise can control the disease. American Diabetes Association (2010).

However, like in all chronic or progressive illnesses living with diabetes can be extremely challenging, it is important that we pay attention to the physical aspect, psychological aspect, social aspect and spiritual aspect. Though, persons diagnosed with diabetes are at a higher risk of long-term medical and physical problems that affect their eyes, kidneys, heart, brain, feet and nerves. It is suggested that persons suffering from diabetes, visit an ophthalmologist, which is a medical doctor or an osteopathic doctor that specializes in eye and vision care for a dilated eye exam. Symptoms include are cataracts, glaucoma, and retinopathy with symptoms such as blurred vision, watery eyes, loss of vision and eye discomfort. It is important that a urine test for protein takes place once per year if protein is detected in the urine or the blood pressure level is above normal, it is an indicator that a person may have a kidney disease, symptoms may include weight gain, swelling of the hands or feet. Dealing with the issue an elderly long term care plan must include proper food choices and physical activities. Nutritional assessment and diet should be part of your individual care plan. "Personal food preferences are important in any diet plan and older people with diabetes should be able to continue to enjoy a wide variety of foods. It helps to keep active by strengthen muscles, maintaining mobility and balance which improves insulin sensitivity. It can help you to continue to self-care, can improve your mental well-being and prevent falls. You can aim to be as active as you are able". Endocrineweb (2016).

Diabetes is a major life stressor that requires individuals to deal with psychological challenges such as denial, anxiety, depression, shame and guilt. The elderly with diabetes may have to refrain from certain groups or associates who may over eat or consume foods that are unhealthy, due to monitoring or maintaining their blood sugar level, which in return may lead to stigmatization or group isolation. The spiritual aspect of diabetes is commonly employed as coping mechanisms, similarly, relaxation response, include, yoga, meditation and exercise can and has been used as coping strategies to maintain mental peace.