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Adopt New Approach to Coaching Patients With Multiple Morbidities

Analysis  |  By Christopher Cheney  
   March 12, 2019

Capacity coaching helps older patients with multiple health conditions who are overwhelmed by their illnesses and treatment.

A new approach to health and wellness coaching encourages patients to build the capacity to adapt, endure and function at the highest level possible with their illnesses and treatment.

About three quarters of Americans over the age of 65 are living with multiple chronic conditions. A recent systematic review of controlled trials and quasi-experimental studies found coaching interventions for chronic conditions had statistically significant positive impacts on patient health such as physiologic, behavioral, and psychological well-being.

In an article published last month in Mayo Clinic Proceedings, capacity coaching was presented as an effective intervention for the increasing number of older patients with comorbidities.

"Health and wellness coaching brings considerable strengths to the table in healthcare as a method for changing behaviors to prevent and treat chronic illness and in the physiologic, behavioral, psychological, and social outcomes for patients. However, the growing population of patients living with multimorbidity may need a slightly different approach to coaching—one that focuses on strengthening their capacity to adapt and thrive with chronic illness," the authors wrote.

'Help overwhelmed patients'

The lead author of Mayo Clinic Proceedings article told HealthLeaders that capacity coaching addresses an unmet need among older patients with multiple chronic conditions.

"Healthcare has not evolved to care for these patients in the ways consistent with their needs. Specifically, patients living with multiple chronic conditions are often overwhelmed by the work they must do to care for their illnesses—appointments, medication taking, dietary restrictions, and physical activity. These tasks exceed their capacity to cope with them alongside everyday life," said Kasey Boehmer, PhD, MPH, assistant professor of health services research at Rochester, Minnesota-based Mayo Clinic.

For this population of patients, healthcare providers should strongly consider capacity coaching rather than traditional health and wellness coaching, she said.

"Traditional health and wellness coaching was not designed for overwhelmed patients dealing with multimorbidity, which is why we developed capacity coaching. This type of coaching, offered within the healthcare setting, holds the potential to help overwhelmed patients by reducing their treatment burden and increasing their capacity for self-care and overall quality of life."

Capacity coaching and orienting care

This new form of health and wellness coaching can help orient a patient's care, Boehmer said.

"A capacity coach looks at the patient holistically, beginning by understanding what's going on in their life and what's going on in their healthcare. Then, they work simultaneously with the patient's healthcare team to reduce their treatment burden and the patient directly to increase his or her capacity for self-care."

A capacity coach can help orient care in several areas, she said. "Treatment burden is reduced by actions such as reducing numbers of appointments, simplifying medication taking, and improving overall coordination of the patient's care."

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


About three quarters of Americans over the age of 65 have multiple chronic conditions.

Capacity coaching is designed to help older patients with comorbidities strengthen their capacity to adapt and thrive with chronic illness.

Capacity coaches can help orient a patient's care such as reducing disease burden.

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