Summary This chapter provides an overview of common chronic and

Summary This chapter provides an overview of common chronic and disabling conditions that affect long-term care consumers, as well as a model for understanding the delivery of chronic care services. Issues affecting individuals with multiple chronic conditions, as well as the onset of frailty and chronic conditions, are discussed. Emerging issues such as the connection between diet, nutrition and sleep, as well as management of chronic conditions and hospital readmissions concludes the chapter. For Discussion Briefly describe the concept of population health and the 4 pillars of population health. How is the concept different from public health? What is Healthy People 2030, and how do older adults and people with disabilities benefit from this framework? What is wellness, and why is it helpful to integrate wellness activities into care plans for older adults and people with disabling conditions? Why is it important for an administrator to have an understanding of chronic conditions that occur in their clients or residents? Explain the connection between chronic health conditions and frailty in older adults. What are some chronic conditions that can lead to hospital readmissions? Describe the interaction of behavioral health diagnoses and substance use problems. What health issues might individuals with intellectual disabilities face as they grow older? Why are older adults often less aware of HIV risk factors than younger adults? Why is it important to screen older adults for vision and hearing problems? Which chronic conditions can lead to high rates of disability and reductions in quality of life, and why? Case Study End of Chapter 7: Structure and Governance for Sustainability (Questions and Answers) 1.What are the roles of the state and local public health departments in monitoring infectious diseases? What are their roles for chronic conditions? 2. What are the economics of HIV/AIDS programming for WHS? Does the health system make or lose money by participating in a community-wide effort to reduce HIV/AIDS? 3. What is care coordination? What mechanisms might PRI and WHS use to coordinate the care for a single individual client? How is care coordination related to institutional partnerships, if at all? 4. How, if at all, does addressing HIV/AIDS at a community level vary from addressing the subpopulations most affected? Differentiate messages, interventions, and outcome measures for programming at a community level from those for programming for the subpopulations at high risk of HIV/AIDS. 5. If a vaccine for HIV/AIDS is developed and becomes widely available at an affordable price, how will the activities of PRI change?

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