Promoting autonomy and independence for older people within nursing practice: an observational study

Abstract

Although autonomy and independence are widely held to be important goals of care for older people, these terms lack precise definition and operationalization in the literature. This paper reports on observational data gathered as part of an evaluation of educational programmes in the nursing care of older people. Strategies which appear both to promote and inhibit autonomy and independence of older patients in a range of care settings are described. Recommendations are made for further research to explore the extent to which autonomy and independence are appropriate goals of care for older people with cognitive impairment.

Perceptions and Performance of Function and Physical Activity in Assisted Living Communities

“…Providing care for (eg, bathing or dressing an individual) as opposed to with (ie, helping the individual to complete as much of his or her own care as possible) older adults in AL may actually facilitate functional decline and a decrease in PA and cause further deconditioning and disability. [14][15][16][17][18][19] Other factors contributing to functional decline and decreased PA in AL residents include impaired cognitive function, depressed mood, poor perceived health status, 5 lack of motivation, 20,21 cultural expectations, 22,23 environmental barriers, [23][24][25] coexisting disease states, 5,26 pain, 27,28 and fear of falling. 29,30 The functional decline that occurs increases the cost of care and need for relocation to a NH setting.…”

Developing the Supporting Choice Observational Tool (SCOT): A Formative Assessment Tool to Assist Nursing Home Staff in Realizing Resident Choice

“…These concepts were derived from other researchers’ findings in qualitative work and survey. To identify areas of daily life, sensitizing concepts included the when, where, what, with whom, and how of (a) eating and drinking, (b) engaging in recreational activities, (c) socializing, (d) mobilizing (e.g., walking), and (e) receiving technical care (e.g., receiving medications) (Davies, Ellis, & Laker, 2000; Duncan-Myers & Huebner, 2000). To identify staff words and actions that promoted resident choice, sensitizing concepts included staff explaining reasoning for their decisions and soliciting feedback regarding their actions (Davies et al, 2000).…”

Exercise for depression in care home residents: a randomised controlled trial with cost-effectiveness analysis (OPERA)

“…[86][87][88][89][90][91][92] Hence, any intervention to increase exercise participation should include approaches to create the culture change needed to effectively address these barriers. 92,93 A whole-home intervention, using an organisational approach to encourage all residents and staff in efforts to increase the residents' level of physical activity, is more likely to achieve the positive effects sought than simply providing group exercise sessions.…”