I previously worked in a care home where I provided care to an 89-year-old female patient with moderate Alzheimer’s disease (AD) progressing to the severe stage. The patient’s basic ADLs were gradually getting impaired, including her ability to eat, dress, groom, bathe, and toilet independently. The client’s relatives were worried that their patient had lost her capacity to care for herself, which led to significant psychological distress in the patient. Consequently, the patient would insist on dressing and going to the bath herself because she believed that she was not as incapacitated as the providers perceived. In this case, I would have applied the Activities of Living Model to assess the patient to establish what the patient could and could not do in each of the activities of living considering the physical, physiological, sociocultural, environmental, and politico-economic factors influencing the patient.
During the patient assessment, I would have documented the activities the patient could perform independently and those activities she could not perform without assistance. All the activities that could not be performed independently would have been treated as problems during the assessment. Besides, I would have identified nursing actions to address the identified problems by assessing how I would promote the patients’ independence in the activities of living (Motamed-Jahromi & Kaveh, 2021). In addition, I would have applied the worldview by implementing comforting activities to prevent complications like infections and slow AD progression.
How the Worldview and Nursing Theory Will Assist in Further Developing Future Practice
The worldview and Activities of the Living Model will help to develop my nursing practice further by guiding me on actions to promote independence in the activities of living with patients. The model recommends a problem-solving process that nurses can use, which includes: Assessment of the patient; Identification of the patient’s problems and developing a statement of expected outcomes; Planning of care; Implementation of care; Evaluation of the outcomes of care (Williams, 2018). In my future practice, I can apply the model to identify patients’ health needs and establish their ability to perform ADLs. Based on the assessment results, I will identify patients who need total, partial, or no assistance in ADLs. Besides, I will identify the interventions to implement to help patients achieve independence, which will align with my worldview of promoting independence.
Conclusion
My worldview is based on independence, and I believe that progress in the lifespan influences individuals’ capacity for independence, but progress is unidirectional. The Activities of Living Model focuses on the patient as a person engaged in living throughout his/her lifespan and moving from dependence to independence based on age, living circumstances, and environment. The model and my philosophy of practice support nursing interventions that enable patients to carry out preventive health activities independently to avoid illness. I can apply the model in future practice to assess patients, identify problems in carrying out ADLs, and identify interventions to enable them to attain independence.
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