Well Wisconsin Radio

Interviewer: 

Hello and welcome to Well, Wisconsin Radio, a podcast discussing health and well-being topics with experts from all around the state of Wisconsin. I’m your host, Alexis Kraus, and today my guest is Jillian Baden Hanisch. Jillian is a nurse practitioner specializing in geriatrics at UW Health. She treats acute and chronic conditions of older adults in geriatrics primary care. In her practice, Jillian strives to help patients enjoy high quality lives. She places a strong focus on preventative medicine and healthy lifestyle habits. She takes the time to get to know people and their specific health and lifestyle goals so that she can support them in achieving their goals.  

Interviewer: 

Alright, well thanks Jillian for joining today. I’m super excited to have you on the podcast.  

Guest: 

I am happy to be here. Thank you so much for the invitation.  

Interviewer: 

Yes. Well, let’s dive right in. So today we’re talking about chronic conditions. And with chronic health conditions, we know that they’re the leading cause of illness and disability and death in America. I just wanted to start us off by understanding what is meant when we say chronic condition and what are the most common ones.  

Guest: 

Yeah, this is a really important question. I think, you know, we want to understand what we’re talking about first. So, um, really chronic conditions, um, or chronic diseases are defined by the CDC as conditions that last one year or more and require ongoing medical attention or limits the activities of a person’s daily living or both. So, some of the most common chronic conditions are high blood pressure, heart disease, diabetes, COPD. pain, cancer, and dementia, but of course there are others, and according to the CDC, about six in ten people have at least one chronic condition, while four in ten people have more than one. So, as you can see, chronic conditions are really common. 

Interviewer: 

Wow, that’s really high. That’s unfortunate to hear. But that means there’s a lot of people that are facing this, right?  

Guest: 

Exactly. So, if you, you know, look to someone to your left or to your right, or someone in your community almost, um, you know. At least one of those people will have some sort of chronic condition. 

Interviewer: 

Wow. Yeah, that’s a lot to take in. Um, are there some common risk factors for these conditions? And if so, what are they?  

Guest: 

There are a number of risk factors for chronic conditions. Uh, the most common risk factors include things like smoking, poor nutrition, physical inactivity, and excessive alcohol use. In fact, the Surgeon General just released an advisory on the impacts of alcohol use on increasing an individual’s cancer risk. So, these are the most common risk factors.  

Interviewer: 

Yeah, that’s interesting you bring that up about alcohol being a factor. We’re actually doing an episode on that later this year to dive into that a bit more. So that’s huge, right? That’s a big one especially in Wisconsin here that big drinking culture. I’m sure you see that with a lot of your patients  

Guest: 

Absolutely. 

Interviewer: 

As I was doing some research for this episode, I found that the CDC says some groups are more affected than others, um, because of factors that limit their ability for healthy choices. Could you shed some light on what some of those limiting factors are or could be?  

Guest: 

Yeah, thank you so much for this question. We know that there are non-medical factors that might impact our health and medical professionals usually term this the social determinants of health. So, some examples of these factors include things like our age, where we’re born, where we live, where we work, and as you can imagine, each of these factors can have either a positive or a negative impact on our health. For example, someone might live in an area where it’s really challenging to get to the grocery store for fresh fruits and vegetables. Another example might be that someone might not have access to a safe space to exercise, whether within or around their home. I guess another example might be that a person may live really far away from a health care provider or have difficulty accessing health care services. So there, as you can imagine, are a number of factors that impact our health, um, that are not really related to medical conditions. But there’s also a lot of research being done in this area. Um, there’s actually one study at the UW Madison School of Medicine and Public Health. Um, they have a Center for Health Disparities Research, and one of these initiatives has been and to create a neighborhood atlas to help identify some of these disadvantaged neighborhoods. It’s a very, very cool tool. Um, anyone can search it online and you can type in your zip code just to see if perhaps your neighborhood might be one of the more disadvantaged neighborhoods. 

Interviewer: 

That’s really great. I mean, what an interesting resource to take advantage of. I’ll definitely link that in the show notes for this episode as well. When someone is first diagnosed with a chronic condition, what are some of the initial tips that you tell them on how to prepare for the future?  

Guest: 

First, I think it’s really important to try to encourage patients, uh, that they have the power to make small changes that will help in managing their condition. One thing that healthcare providers cannot prescribe is a person’s engagement or their empowerment in maintaining their health. So I, I think about, you know, the next, you know, few things is, you know, What, why, where, when, who, what, when, where, why, um, kind of thing. So, um, it’s really important for a person to understand what their condition is and how it might impact their health. Knowledge is power, as many of you have heard before. Um, so why, why, um, Why is this condition important? How might it impact you now or in the future? What matters most to you? Um, what do you think will matter most to you in the future? Where? Can you set up your environment to help you and to support you in managing this condition? What tools might you need to monitor your condition? For example, those with high blood pressure might want to have access to a blood pressure machine to help monitoring it. Do you have access to healthy foods? Is there a safe location for you to exercise? You know, all of these are considerations that can help you prepare for the future and really set up your environment to support you. And last but not least, who? Who can support you? Identify your team. Um, think about who you might have as a support, like your family, your friends, your loved ones, and also your health care team. It’s also really important in long-term health planning to really think about, you know, those support people and how you might want them, might want them to help support you in making medical decisions for the future. So one thing that’s really important for all of us to consider is to think about creating a health care power of attorney or a living will. Your health care team can really help you in creating these legal documents, but essentially those documents help us to Identify a person who can help you in making those decisions in the event that you were not able to make them for yourself. So that can be really helpful in planning ahead, but hopefully, um, we all hope that we’ll never have to use those documents.  

Interviewer: 

Right. Kind of like an insurance policy on planning for that, right? A little bit.  

Guest: 

Exactly.  

Interviewer: 

Yeah. And now we’ll just take a quick break to hear about some of Well, Wisconsin’s program offerings. 

Ads: 

Health Coaching: 

You don’t have to travel far to find professional help. When you work with one of our WebMD health coaches, you’ll get one on one support in the comfort of your own home. They can help you create a personalized plan to better manage diabetes, asthma, COPD, heart failure, and coronary heart disease. Here’s what a fellow Well, Wisconsin coaching participant said about their experience. 

Coaching Testimony: 

It’s there, you know, coaching. It’s all right. At first, I was kind of skeptical about it, but, um, they do give you some pretty good information and, uh, some kind of sources where you can go in and kind of. Look up stuff yourself if you want to. Um, they seem to cover a lot of stuff. Um, they, you know, make sure, I think everybody pretty much had the dough inside and out, so that’s pretty good. Um, yeah. Other than that, like I said, I was skeptical, but I kind of like it now.  

Health Coaching Continued: 

WebMD Health Coaching connects you with a real person who cares about your well-being. Learn about coaching by calling 1-800-821-6591. You’ll get connected with the programs that are most impactful for you.  

MeQuilibrium: 

MeQ isn’t just another well-being app. It’s a program to help you build resilience, understand yourself better, and thrive in the face of change through interactive activities. Sign up for MeQ at www.webmdhealth.com/wellwisconsin and complete a short questionnaire to begin your personalized experience.  

Interviewer: 

And now we’ll head back to the Well, Wisconsin radio interview. So, talking a little bit more, how can a patient’s home and work life affect how they manage their chronic condition? For example, they live alone or with a caregiver, they need to manage those work demands, there’s so much going on in everyone’s individual life.  

Guest: 

Yeah, you’re exactly right, and I think we Indirectly touched on some of this a little bit before, but a person’s life can really impact how they manage their care, you know, work demands might make it more challenging to focus on, you know, treatments or interventions. It also can be really challenging for a person to manage their conditions if they’re spending a lot of their time caring for others, if they’re a caregiver. So, whether that be for, you know, family members, um, or children, um. A lot of us are caregivers for other people, so it can be really challenging for us to focus on our own health. Um, but as you may have heard before, it’s really important for us to put our oxygen, oxygen mask on before we are able to put the oxygen mask on other people. So, really important for us to take care of our own health so that therefore we can care for others around us.  

Interviewer: 

It’s a good visual. I always love when people use that first because you do need to take care of yourself before you can take care of anyone else, right? Such a good reminder. Do you ever run into patients that have goals that are different from the provider’s goal? With you being a provider, um, how do you kind of meet in the middle with that?  

Guest: 

I think that this happens almost every time. Um, it’s, it’s challenging. Oftentimes, us healthcare providers have different goals and priorities than, um, a person might be, you know, when they’re coming in. So, when I’m talking with patients, I often try to really understand what’s important to them or what their motivations might be. I try to help them identify what things might be impacting their quality of life now and what things might impact them in the future. So, I would encourage every person to really try to be an advocate for your own health. Try to write down what’s most important to you, your goals, what symptoms you might have, and any questions. And this can really help your health care team to understand what matters most to you.  

Interviewer: 

So now that you’ve told us a bit about chronic conditions and um, more about various people who are affected by them, could you tell us a bit about the lifestyle changes that can help manage the condition? 

Guest: 

Yeah, so one of the most important things that I’ve learned in meeting with people is the importance of routine. So, the simple things that we build into our daily lives can truly impact our long-term health. You’ve heard these things before, um, but, um, daily physical activity is so important, and the current recommendations are to have at least 150 minutes of, moderate to vigorous activity per week with then two days of strength training and then building in more flexibility and balance training as well. Um, another thing to add into your daily routine is, you know, nutritious food. Um, how can you eat more? Um of a well-balanced and wholesome diet, um, one easy way that I think about remembering nutritious foods when I’m shopping at the grocery store, um, is, um, something, it’s a little term called fins, feathers, roots, and nuts. So, I kind of use that as a chant to myself when I’m shopping. Fins, feathers, roots, and nuts. So fins meaning fish, feathers meaning chicken, and, and, turkey, um, roots like fruits and vegetables and nuts and beans. And that really helps me to think about those most nutritious foods. The next thing, which you’ve probably heard before, um, is to get, uh, really high-quality sleep and try to get at least eight hours of sleep at night. Sleep is really the only way for us to refresh our body and to protect our brain over time. Another piece is hydration, so setting a goal to get at least six to eight glasses of fluid every day. Um, when we’re young, it can be really easy for us to sense when we’re thirsty. But as we age, we lose that thirst drive, so it’s really important if we’re able to build that into our routine when we’re younger, that really will help us to prevent, um, dehydration and other issues as time goes on. I have just a couple more things that come to mind, um, socialization. So, we know that when people are more socially engaged, they have a better, um, better health outcomes and a better quality of life as time goes on. So, create opportunities to connect with others on a regular basis. And then, you know, prepare for the future. We already talked a little bit about health care, um, powers of attorney, living wills, um, but creating that plan for the future can really help set you up. So, you know, in short, um. Be active, eat a well-balanced diet, um, stay hydrated, get really good sleep, and connect with others, which I know that all of that is much easier said than done. 

Interviewer: 

But if you got the ideal picture, then that’s the one you want to go for, right? Or at least heading in that direction with your arrow. I had never heard that before about as you age you lose that, uh, thirst feeling. That is incredible, and it makes me think about the older adults in my life, and they are not water drinkers. They’re, they want anything but water. So that’s really interesting to think about how that will be me one day. I will have to push myself to drink a little bit more.  

Guest: 

Yeah, exactly. So those, you know, reusable water bottles that we all have can actually be really helpful tools as time goes on, um, because it can help us to kind of really measure that, that daily goal of aiming for that, you know, at least six glasses of fluid.  

Interviewer: 

That is such a good tip. Yeah, I know how many ounces are in my water bottle and then I can try and aim to have as many that would equal those ounces. That’s a good idea. How can lifestyle changes be tailored to the needs of the individual?  

Guest: 

This is another really important question, and my priority as a healthcare provider is to truly get to know my patients, what’s important to them, what psychosocial supports they might have, and this really sets the stage for any recommendations that I might have for a person in managing their chronic conditions. So, um, I encourage any person to really partner with your healthcare provider to develop goals for Lifestyle changes that are tailored to you. 

Interviewer: 

That’s great. And then that kind of leads into the next question I have. So people that are just starting out with these lifestyle changes, and even if they’re not going to meet that ideal picture right away, cause that’s almost setting yourself up for failure, right? Like, doing everything all at once. What are some resources that you would recommend that might be helpful people to just kind of look to as they’re starting out?  

Guest: 

There are a wealth of resources. So, um, I think your point about, you know, starting small is really important. So try to set, you know, small goals for yourself every day. Um, that’s really more sustainable than trying to, you know, hit each of those goals of activity and sleep and hydration. You know? all at once. That can be really overwhelming. Um, so, um, and thinking about resources to help support you in making these changes. The first, uh, resource I think about is your healthcare organization. So, your healthcare organization can have a wealth of resources or programs that can support you. And I encourage you to ask your healthcare team if there are any resources available to you. For example, uh, the organization that I work with, UW Health, has the Center for Wellness that offers wellness consultations, health coaching, and group medical visits, amongst other things. The next place to really look for resources is through your health insurance. Your health care insurance may have some benefits that are either free or cost effective for you, um, that can really help you in managing your conditions. And another resource that can be really helpful is, um, reaching out to your county’s aging and disability resource center. They can really point to what other resources your community might have, like your local community center or your local senior center if you’re 65 years or older. There are oftentimes a lot of resources within our communities that can help support us as well. The Department of Health Services has more resources to support people in making changes. Um, there’s also the, uh, Wisconsin Institute for Healthy Aging that oftentimes has workshops, um, that can support people in managing their conditions. There’s even one workshop that’s titled Living Well with Chronic Conditions. So there are lots of resources. It’s just a matter of kind of picking one area to start looking and seeing what might be most beneficial to you.  

Interviewer: 

It’s good to keep in mind there’s so many different avenues, and it does just almost take, you know, take that moment to look into it a little bit if you have the time or energy to, right? That’s always the first barrier sometimes is finding that time and energy. 

Guest: 

Exactly, and I think if you have a conversation with your support team, so whether it be your loved ones, your health care providers, um, or whomever. I think partnering with your community can really help you in identifying what changes you might want to make first. 

Interviewer: 

And the Well Wisconsin program also offers a lot of different areas within the health coaching realm as well, different workshops. Even this podcast has different areas that we touch on, like chronic conditions right here. So yeah, there’s a plethora of information out there for you to tap into. Well, Jillian, as we wrap up today, what’s a piece of advice that you would like to give someone who is currently working to manage their own chronic condition? 

Guest: 

Yeah, I think, you know, the most important advice that I can give anyone is to really try to stay engaged and empowered. You really have the power to impact your health with the small changes that you make. And I also think it’s really important to partner with your health care team. It really helps you to promote your long-term health and your well-being when you’re able to find your support in either your health care providers or your community. 

Interviewer: 

I love that. Well, thank you so much, Jillian. We really appreciate your time and we can’t wait to catch up with you next time.  

Guest: 

That sounds great. Thank you so much for having me.  

Interviewer: 

Thanks for listening to Well, Wisconsin radio. I hope you enjoyed this show. You can find our survey and the Well, Wisconsin portal and our transcripts and previous episodes all at www.webmdhealthservices.com/WellWisconsinRadio. If you’re listening to this podcast on your platform of choice, be sure to subscribe so you can never miss an episode. 

• UW Madison School of Medicine and Public Health
• Center for Health Disparities Research
• Neighborhood atlas: anyone can search it online and you can type in your zip code
• Your healthcare organization and your healthcare team. Ask for resources.
• UW Health Center for Wellness: Offers wellness consultations, health coaching, and group medical visits, amongst other things.
• Look for resources through your health insurance.
• Your county’s aging and disability resource center (ADRC)
• Department of Health Services
• Advanced Care Planning
• Wisconsin Institute of Healthy Aging
• Workshop: Living Well with Chronic Conditions
• Talk to a health coach individually or sign up for group coaching today by calling 800-821-6591
• Sign up for MeQ at www.webmdhealth.com/wellwisconsin and complete a short questionnaire to begin your personalized experience.