In recent years, there’s been growing momentum behind the person-centred care agenda. Increasingly, supporting people with long-term conditions, such as stroke, to manage their own health and wellbeing whilst minimising the treatment burden that they experience in doing so is seen as the right thing to do and is a key component of long-term service provision in addressing the complexity of patient need associated with our ageing and multimorbid population in our resource and time-stretched healthcare system.
Broadly, the concept of self-management is supported in health policies across the UK’s devolved nations. Whereas at one time, policy conceptualised self-management as something that professionals do to people i.e., giving them education, knowledge and the tools to look after themselves. Contemporary notions of supported self-management, position it as being a move away from traditional perceptions of education, compliance with professionally driven treatment plans and goals, and focussed on function and level of impairment. There’s now a growing acknowledgement that true person-centred self-management is a collaborative partnership between professionals, where people should be firmly at the driving seat of their own self-management, deciding what works for them, how they want to be supported or facilitated to self-manage, and co-producing this support or personalised plan.
The traditional biomedical approach to self-management doesn’t fit with how people with long-term conditions perceive their own engagement in self-management. People with long-term conditions are self-managing everyday themselves in their own way. They are the experts in hooking us into understanding what their lives are like in the context of illness, or for example, issues to do with continence, and whether and how they want to be facilitated to engage in self-management.