Adults with sickle cell disease: an interdisciplinary approach to home care and self-care management with a case study.

The complexity of caring for adults with sickle cell disease (SCD) strains the confines of a care-segregated medical system. As treatment protocols have dramatically improved since 1990, many patients with SCD are now living well beyond their 6th decade of life. This improved survival rate presents opportunities and challenges for the home healthcare nurse in the management of adult patients with SCD. The home healthcare nurse is essential in the coordination of interdisciplinary health team members to reduce pain episodes and the potentially catastrophic complications of renal failure, pulmonary disease, and cardiovascular events. In addition, the home healthcare nurse serves as patient advocate for the transition from acute care to home, as well as advocate for healthcare maintenance of vision, musculoskeletal involvement, and social and psychological support. This article seeks to provide a viable network for home healthcare nurses to establish self-care management and support of the adult patient with SCD.