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The Chronic Disease Management Teams are part of WA Health’s Ambulatory Care (Healthy@Home) program. The metropolitan wide program provides free community-based services to improve the health, well-being and independence of people with:
- Diabetes
- Chronic Obstructive Pulmonary Disease (COPD)
- Chronic Heart Failure (CHF)
Services provided by the Healthy@Home program aim to help clients stay in control of their health and prevent unnecessary hospitalisation by:
- increasing knowledge of their condition
- helping to address barriers to making lifestyle changes
- helping take control of symptoms by monitoring them and responding appropriately
- encouraging clients to actively share in decision making with health professionals
- managing the physical, social and emotional impact of the condition on their lives
- living a healthy lifestyle
The Chronic Disease Management Teams work with people in the community over a 3-6 month period.
Features of the service include:
- individual client assessment and plan of care
- a multidisciplinary team including Clinical Nurse Specialists, Physiotherapists, Podiatrists, Dietitians, Occupational Therapists and Social workers
- group education and exercise programs
- self management support and training
- phone follow-ups and links to local services, programs and supports
For further information please contact the Chronic Disease Management Teams on 1300 855 841.
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