title: Unravelling the Tensions Between Chronic Disease Management and End-of-Life Planning.
abstract: An increasing appreciation for the burden that chronic conditions represent for people and for societies has triggered an evolving body of popular and professional conceptualizations of the nature of the chronic disease challenge. In this discussion article, we trace the trajectory of thinking about chronic illness care, surfacing underlying assumptions and drivers that have shaped current dominant models of service delivery. We note significant gaps in these conceptualizations, especially with respect to the reality that many chronic conditions are life limiting. Contrasting chronic disease theorizing with the conversations that have arisen around end-of-life care for other kinds of health conditions, we argue for a shift in our thinking to accommodate the implications of life limitation in our service delivery planning. We see significant leadership potential in optimizing the role nurses can play across the chronic disease trajectory by integrating the healthy optimism of self-care management with the profound compassion of a person-centered palliative approach.
authors.forename: Sally
authors.initials: S
authors.lastname: Thorne
authors.forename: Della
authors.initials: D
authors.lastname: Roberts
authors.forename: Richard
authors.initials: R
authors.lastname: Sawatzky
mesh_terms: D032722:Advance Care Planning; D001291:Attitude of Health Personnel; D002908:Chronic Disease / Q000451:nursing* / Q000523:psychology*; D019468:Disease Management; D006801:Humans; D009732:Nursing Care / Q000523:psychology*; D009740:Nursing Staff / Q000523:psychology*; D010166:Palliative Care / Q000458:organization & administration / Q000523:psychology*; D010687:Philosophy, Nursing; D013315:Stress, Psychological; D013727:Terminal Care / Q000458:organization & administration / Q000523:psychology*