Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
권호 표지

Self-Care in Elders with Dementia: A Concept Analysis

  • Yeom Hye-A (University of Rochester School of Nursing)
  • Published : 2004.12.01
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to analyze the concept of self-care in elders with dementia through a review of nursing literature and to provide more understanding of the definition and perspectives of the concept of self-care notion in elders with dementia. Methods: The technique developed by Walker and Avant was used as a guide in analyzing the concept of self-care. Results: Attributes of self-care in dementia may include a single or group of actions needed for sustaining life, a personal effort to maintain functional independence while minimizing other's assistance, an outcome behavior from the person's interaction with inter-personal and/or contextual environment, and a functional ability that may decline in parallel to cognitive impairment. Antecedents of self-care in dementia may include at least presence of a certain degree of cognitive appraisal for the self-care needs, self-willingness for the self-care action, spatial and visual orientation, cultural pre-conception of the self-care behavior, presence of environmental context/equipment available for self-care, and sufficient time available. The consequences may include sustaining of life, feel of satisfaction, achieving independence, extended life expectancy, increased self-confidence, decreased caregiver distress and/or burden, savings in health care costs. Discussion: Defining attributes and antecedents and consequences of self-care in dementia identified in this study provided empirical ground of a middle-range theory of self-care for a clinical population with dementia and generated possible hypotheses to be tested in future studies.

Keywords

References

  1. Ayd, F. J, (2000), Lexicon of psychiatry, neurology, and the neurosciences, Philadelphia, PA: Lippincott Williams & Wilkins
  2. Blessed, G., Tomlinson, B. E., & Roth, M. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects, Br J Psychiatry, 114, 797-811
  3. Bums, T., Mortimer, J. A., & Merchak, P. (1994). Cognitive performance test: A new approach to functional assessment Alzheimer' s disease. J Geriatr Psychiatry Neurol, 7, 46-54
  4. Dawson, P., Wells, D. L., Reid, D., & Sidani, S. (1998). An abilities assessment instrument for elderly persons with cognitive impairment: Psychometric properties and clinical utility. J Nurs Meas, 6, 35-54
  5. Donaldson, C., Tarrier, N., & Burns, A. (1998). Determinants of carer stress in Alzheimer' s disease. Int J Geriatr Psychiatry, 13, 248-256 https://doi.org/10.1002/(SICI)1099-1166(199804)13:4<248::AID-GPS770>3.0.CO;2-0
  6. Duke University Center for the Study on Aging. (1978). Multidimensional Functional Assessment: The OARS methodology. Durham, NC: Duke University Press
  7. Easton, K (1993). Defining the concept self-care. Rehabilitation Nurs, 18, 384-387
  8. Edwards, D. F., & Baum, C. M. (1996). Functional performance of inner city African-American older persons with dementia. Top Geriatr Rehabilitation, 12, 17-27
  9. Forbes, D. A (1998). Strategies for managing behavioral symptomatology associated with dementia of the Alzheimer type: A systemic overview. Can J Nurs Res, 30(2), 67-86
  10. Ford, G. R., Goode, K. T., Barrett, J. J., Harrell, L. E., & Haley, W. E. (1997). Gender roles and caregiving stress: An examination of subjective appraisals of specific primary stressors in Alzheimer' s caregivers. Aging Ment Health, 1, 158-165 https://doi.org/10.1080/13607869757254
  11. Gelinas, I., Gauthier, L., Mcintyre, M., & Gauthier, S. (1999). Development of a functional measure for persons with Alzheimer's disease: The Disability Assessment for Dementia. The Am J Occup Ther, 53, 471-481
  12. George, J. B. (1980). Nursing theories. Englewood Cliffs, NJ: Prentice-Hall
  13. Gitlin, L. N., & Corcoran, M. A. (1996). Managing dementia at home: The role of home environmental modifications. Top Geriatr Rehabilitation, 12(2), 28-39
  14. Green, C. R., Mohs, R. C., Schmeidler, J., Aryan, M., & Davis, K. L. (1993). Functional decline in Alzheimer' s disease: A longitudinal study. J Am Geriatr Soc, 41, 654-661
  15. Jirovec, M. M., & Kasno, J. (1993). Predictors of self-care abilities among the institutionalized elderly. West J Nurs Res, 15, 314-324 https://doi.org/10.1177/019394599301500304
  16. Japp, M., Carroll, M. C., & Waters, L. (1993). Using self-care theory to guide nursing management of the older adult after hospitalization. Rehabilitation Nurs, 18(2), 91-94
  17. Kuriansky,J. B, & Gurland, B. J. (1976). The performance test of activities of daily living. Int J Hum Dev, 7, 343-352
  18. Lowenstein, D. A., Amigo, E., Duara, R., Guterman, A., Hurwitz, D., Berkowitz, N., Wilkie, F., Weinberg, G., Black, B., Gittelman, B., & Eisdorfer, C. (1989). A new scale for the assessment of functional status in Alzheimer's disease and related disorders. J Gerontal, 44, P114-121
  19. Mahurin, R. K., DeBettignies, B. H., & Pirozzolo, F. J. (1991). Structured assessment of independent living skills: Preliminary report of a performance measure of functional abilities in dementia. J Gerontal, 46(2), 58-66
  20. McCracken, A., Gilster, S., Connerton, E., Canfield, H., & Painter-Romanello, M. (1993). Developing a tool to measure functional changes in advanced dementia. Nurs Connections, 6(2), 55-66
  21. Moore, J. T., Bobula, J. A., Short, T. B., & Mischel, M. (1983). A Functional Dementia Scale. J Fam Pract, 16, 499-503
  22. Orem, D. E. (1991). Nursing Concept of Practice. Savannah, GA: Mosby Year Book
  23. Padula, C. A. (1992). Self-care and the elderly: Review and implications. Public Health Nurs, 9(1), 22-28
  24. Patterson, M. B., Mack, J. L., Neundorfer, M. M., Martin, R. J., Smyth, K. A., & Whitehouse, P. J. (1992). Assessment of functional ability in Alzheimer' s disease: A review and a preliminary report on the Cleveland Scale for Activities of Daily Living. Alzheimers Dis Assoc Disord, 6, 145-163
  25. Reisberg, B. (1988). Functional assessment staging (FAST). Psychopharmacol Bull, 24, 653-659
  26. Skurla, E., Rogers, J. C., & Sunderland, T. (1988). Direct assessment of activities of daily living in Alzheimer's disease: A controlled study. J Am Geriatr Soc, 36, 97-103
  27. Tappen, R. M. (1994). Development of the Refined ADL assessment for patients with Alzheimer' s and related disorder. J Gerontol Nurs, 20(6), 36-42
  28. Vogelpohl, T. S., Beck, C. K, Heacock, P., & Mercer, S. O. (1996). 'I can do it!' dressing: Promoting independence through individualized strategies. J Gerontal Nurs, 22(3), 39-42
  29. Walker, L. O., & Avant, K.C. (1995). Strategies for Ttheory Construction in Nursing. Norwalk, CT: Appleton & Lange
  30. Woods, B. (1999). Promoting well-being and independence for people with dementia. Int J Geriatr Psychiatry, 14, 97-105 https://doi.org/10.1002/(SICI)1099-1166(199902)14:2<97::AID-GPS941>3.0.CO;2-X