Self-Care Deficit Nursing Theory In Adult Gerontology Nursing

Published on: 19 October 2023 Last Updated on: 08 January 2024
Self-Care Deficit Nursing Theory

Any Adult Gerontology Nurse Practitioner (AGNP), or individual considering moving into this booming area, will probably be aware that it involves more than supporting patients through short term illnesses or meeting their needs in a hospital or nursing home.

As a rule, the older a patient gets, the more likely they are to experience chronic health complications which interfere with their day-to-day tasks. For much of history, such patients were written off, encouraged to take to their beds and be supported entirely by others, doing very little. They often didn’t live very long. But all that changed on account of one remarkable nurse, Dorothea Orem, whose legacy continues to shape the nursing profession today. This article examines her groundbreaking self-care deficit theory and looks at how AGNPs might use it for their nursing career.

Dorothea Orem

Dorothea Orem was born in Baltimore in 1914 and studied nursing in the late 1930s. This was a time when nursing schools were still a new phenomenon and there was a lot of experimental thinking in the nascent profession. Though she spent time on the wards as a staff nurse, she also worked as an administrator and consultant over the course of her career, spending her later years focusing on theory.

A naturally focused and attentive person, she soon began recording observations about the patients she worked with, leading to her self-care deficit theory of nursing, for which she strongly advocated for her entire life. It was theory which, in its early years, transformed the way nurses thought about patients and their duties. It laid the foundations for nursing today.

Universal Self-Care Requisites

Orem’s theory recognizes eight universal self-care requisites, or SCRs. Here, universal refers to things every human needs, regardless of circumstance. Air is needed for respiration. Water is needed to maintain a healthy level of hydration. Food is needed to maintain healthy energy levels and prevent starvation. Elimination or toileting, a polite way of referring to the expulsion of urine and feces from the body, is required too.

In addition to these four things, Orem posits that every patient needs a balance of physical activity and rest. Everyone needs social interaction, but also some alone time. People need to manage their lives to avoid or remove hazards, and, finally, they need to promote normality. This means that they need to achieve and maintain a way of living and relating to the world which is normal for them as individuals and does not involve psychosis.

Health Deviation Self-Care Requisites

When patients are recovering from injury or illness, or living with a chronic illness or disability, they can be described as experiencing a health deviation. This is not pejorative – it simply establishes that they differ from the norm. Health deviations are more common in older demographics, as they have additional self-care requisites.

These requisites include following doctors’ instructions (taking medicine on time), identifying problems caused by their conditions and attending to them effectively (sitting down until a dizzy spell passes), and knowing when and how to seek help from a caregiver or healthcare professional.

It is also important that these patients can understand and accept that their bodies have changed and can adjust psychologically to cope with it.

What Is A Self-Care Deficit?

A self-care deficit occurs when people are no longer able to carry out basic tasks. This can be because a disability makes them physically impossible to perform, or a number of other reasons. For example, some people get so overwhelmed by the way their bodies have changed that they stop trying to live. This doesn’t mean that they don’t deserve sympathy – it is an understandable response to an extreme situation – but it might mean that there is potential for improvement.

For some people, self-care deficits are permanent or are likely to worsen due to progressive illnesses. For others, however, they can be temporary, even in extreme old age. Self-care deficits stemming from a broken arm, for example, will normally dissipate after the arm heals, but this is less likely if the patient has learned to feel helpless in the meantime.

Assessment, Diagnosis, And Implementation

When using Orem’s theory, nurses have three steps to work through. The first is undertaken during the initial assessment of a new patient and involves identifying any self-care deficits. These are not always obvious from looking at a patient and the process may require gentle but persistent questioning. Some people may be embarrassed and hesitant to talk if they are unable to care for themselves.

The second involves full diagnosis of the deficits, including establishing causes. The third step is to draw up a treatment plan based on these diagnoses. In her work, Orem stressed the importance of recognizing that every patient is a unique individual, so there is no one-size-fits-all approach to this type of planning. In each case, AGNPs will need to work with the patient to establish the most effective way forward.

Five Ways Nurses Can Help

There are five strategies nurses can use to address self-care deficits when establishing patient care plans:

  • For the most severely incapacitated patients, it may be necessary to perform actions on their behalf, such as washing or dressing them.
  • Patients struggling mentally or who lack confidence can be guided through actions, ideally to the point of independence.
  • Patients can be taught new ways of approaching day to day tasks which make them easier to accomplish, such as taking a break to have a shower in the afternoon if it is too hard to find the energy at other times.
  • AGNPs can focus on the patient’s environment, making it easier for them to carry out self-care activities, such as suggesting kitchen gadgets to reduce the physical effort involved in preparing meals.
  • Finally, AGNPs can train a family caregiver to provide appropriate support.

These five strategies involve numerous actions, skills, and tools that nurses can use. Patients may need particular assistance with the following tasks.

Helping With Eating

Patients should always be encouraged to do as much for themselves as is reasonably possible. When it comes to eating, nurses should start with encouragement. Many older people lose their appetite and don’t feel motivated to eat, especially when it requires effort. So, an AGNP can point out that they have more energy when they manage to eat regular meals.

If the patient can get food to their mouth by themselves, nurses should resist the temptation to assist, even if they sometimes drop the food. Instead, nurses can reassure them that this is not uncommon and all they need to do is take a little more time. Nurses should also be alert to the possibility of choking issues and arrange X-rays if concerned. If some food proves difficult to eat, they can discuss the possibility of dietary adjustments.

Helping With Toileting

Nurses should reassure patients that, awkward as they may feel, there is nothing to be embarrassed about. The nurse must ensure they can transfer on and off the toilet safely and consider options like raising the height of the seat or installing grab. If there is a risk of falling, AGNPs may suggest bedpans for use when no caregiver is present. If adult diapers are needed, nurses should ensure that patients know how and when to change them (even if they are not soiled) and how to protect their skin against rashes or bruises caused by wearing them. Finally, nurses can also discuss medical options for softening stools or speeding up or slowing down digestive transit.

Helping With Dressing And Grooming

A balance must be struck between helping patients be more independent in dressing and grooming themselves and enabling them to maintain a style or standard of appearance that is natural for them. Some older men prefer to be clean shaven but end up growing beards because it is easier to trim a beard than it is to shave safely and neatly, for example. Some clothing options can be easier to get into than others, depending on a patient’s particular mobility difficulties. Simple devices such as a stick with a hook on the end can make adjusting the back of a garment or doing up a zip much easier. Nurses should pay particular attention to footwear to make sure patients can stand or walk safely.

Reducing Hazards

Whether a nurse is helping a patient to move around and complete self-care tasks in a hospital ward, a care home, or their own home, they must always pay attention to hazard prevention. Hazards can include mess, a layout created without regard for disability, or other people or pets moving around. Nurses can start by ensuring that the patient is aware of the risks and can recognize dangerous situations.

They should discuss simple measures like installing handrails or changing routines to make it easier to keep the area tidy. Nurses can also ensure that the patient can summon help if something goes wrong, by persuading them to install an alarm system or carry a charged mobile phone at all times, for example.

Care With Communication

Often, older patients who have self-care deficits also have difficulty with communication, whether due to physical or cognitive disability. Depending on their lifestyle in recent years, they may also be unfamiliar with modern technologies, but shy about admitting this. It is important for nurses to make sure that when they are addressing issues around essential needs, the patient understand them properly and vice versa.

It can be helpful to use pictures in communication, which are often available in support materials. When meeting a patient in the place they are going to be living, the nurse and patient can explore it together (in stages, if necessary) so both parties can directly identify issues.

Seeing Each Patient As An Individual

An essential tenet of Orem’s theory is that patients must be treated as individuals. This increases the chance that they will stick to treatment plans, as well as directly improving their psychological wellbeing.

Any nurse that’s interested in Orem’s theory and is considering joining this field will be looking into gerontology nurse practitioner programs online. The best courses place a lot of emphasis on adaptability and on learning how to manage different types of patients in different environments. The program at the University of Indianapolis, for example, encourages students to develop the patience and listening skills essential to getting to know patients and making them a part of the process. This communication and relationship building is essential to developing plans which will really benefit patients over the long term. The course at the University of Indianapolis is an eight-semester program designed for working nurses, involving part-time study and an intensive clinical placement.

The Nursing Profession Continues To Benefit

Thanks to Orem and her self-care deficit theory, patients are no longer left to waste away as they begin to struggle with old age. Generations of nurses who have practiced this theory have observed that, even in later life, patients can often improve and regain their self- care abilities with the right support. Advances in assistive technologies continue to make this even easier.

The right support, focused on facilitating and encouraging independence, enables seniors to go on living satisfying lives on their own terms for much longer. Even when they need extensive practical support, giving them more control helps to maintain their morale and ability to navigate the final chapter of their lives. In the process of providing this support, AGNPs also get what they really want; to see their patients thrive, no matter what they must overcome to achieve it.

Additionals:

Barsha Bhattacharya is a senior content writing executive. As a marketing enthusiast and professional for the past 4 years, writing is new to Barsha. And she is loving every bit of it. Her niches are marketing, lifestyle, wellness, travel and entertainment. Apart from writing, Barsha loves to travel, binge-watch, research conspiracy theories, Instagram and overthink.

View all posts

Leave a Reply

Your email address will not be published. Required fields are marked *

Related

Old Coffee Beans

7 Fantastically Unusual Uses Of Old Coffee Beans

Coffee is the favorite beverage of a large number of individuals all over the world. But, there is more to coffee beans that just the coffee beverage. There are multiple uses of old coffee beans and some of them are stated in the below section. 1. Reducing Cellulite: Cellulite is a condition of obesity and a lot of people are suffering from it throughout the world and most of the treatments of cellulite are extremely pricey. You can use old coffee beans for treating this condition and witness significant results in no time. For preparing your own cellulite treatment cream with coarsely crushed coffee beans, mix used coffee beans with coconut oil and gently massage it on the affected area. 2. Painting: The original coffee color is ever so alluring and people try to create the same color by mixing and combining different shades of colors. You can use coffee beans for painting and get the exact coffee color on your canvas. You can use your old coffee beans and crush them to create a fine powder and then mix them in warm water to use it as a paint. 3. Repel Ant Colonies: Ants detest coffee beans, the specific reason behind the same is not yet discovered. It can either be due to the smell or the color or any other thing related to the coffee beans. The best thing that you do to repel the ants is to use the coffee beans at places where you find the trail of ants. 4. Get Soft And Shiny Hair: Very few people are aware of the wondrous effects that coffee leaves on the hair of the humans. It helps in maintaining shiny hair and also to remove the residual hair styling product that is left in your hair. You can use them for massaging your hair thoroughly using these ground coffee beans before washing your hair with shampoo. 5. Exfoliate And Rejuvenate Skin: Coffee can make a great skin exfoliator and can exfoliate even the deepest pores of your skin. Mixing coffee with a bit of lemon juice and then using it as an exfoliator or scrub over your skin will lead you to significant results in your skin. The rejuvenation properties of coffee are extremely strong and will elicit a natural glow on your face. 6. Use it in your compost: When it comes to compost, we all use different things but mostly the usual things in the compost. Old coffee beans are the ideal material to be used in the compost as they are completely biodegradable. 7. Use As Air Freshener: Most of the coffee lovers find its fragrance majestic and if you too are a caffeine addict then you surely are a big fan of the smell too. You can use the smell from the coffee beans to prepare your own room or air purifier by using the method mentioned here. Coffee beans are undoubtedly extremely beneficial and can be used for multiple purposes. Mentioned above are some of the major uses of coffee beans. Read Also : Monthly Best Coffee Subscription  

READ MOREDetails

5 Ways You Can Be Inhibiting Your Fitness

When it comes to fitness, you might be your own worst enemy. If it feels like you’re doing everything right, but still not getting the results you want, why are you still sticking to the same routine? There are many ways you might be getting in your own way and getting to the bottom of it starts with honesty. Are you really being honest with yourself when it comes to diet and exercise? Are you diligently tracking these figures—or are you over-obsessing? Too much in either direction can be dangerous. Here are five ways you might be inhibiting your own fitness and what to do about it: Not counting every bite if you’re looking to reduce fat. It’s not as simple as calories in, calories out, but sometimes it is. If you’re sticking to a certain caloric intake every day, make sure you count every single bite—and beverage. Alcohol is packed with calories and lowers our inhibitions, which is all part of alcohol’s lethality when it comes to diet goals. Count those calories, but keep in mind that there is an emerging eating disorder in which people “save” calories for alcoholic beverages. It’s been dubbed “drunkorexia”, and can lead to even more dangerous eating disorders. Getting too obsessed with the scale. Unfortunately, the scale can lie. Like a watched pot, it’s not going to give you what you want if you’re checking it daily—or multiple times per day. Doing so is a slippery slope and can lead to dangerous habits. The scale can only tell you weight, which doesn’t account for muscle or water retention. If you really want some numbers to help guide you on your fitness journey, use a tape measure. Measure the biggest part of your upper arms, the largest part of your chest, the smallest part of your waist, widest part of your hips, and largest part of your thighs and calves. All of these areas, especially the belly, can also fluctuate throughout the day. However, it’s a much safer (and saner) number system than the scale. You don’t push yourself at your workouts. Many people aren’t honest with themselves when it comes to their workouts. Could you be doing a harder level on the cross ramp? When the spin instructor tells you to empty the engine on a power interval, are you? If you’re working on muscle mass, do you really tap out between eight and twelve reps or could you do more (and increase the weight)? Working with a personal trainer can help you avoid cheats, as can working out in a group setting. It can be too easy to compromise when you always workout solo. Plus, group settings or a personal trainer can bring out your competitive spirit. Not getting enough sleep. Lack of sleep has been linked to weight gain. Since most Americans are chronically fatigued (and overweight) there’s a clear correlation here. One of the best things you can do is get enough rest. This will depend on you and your body, but ideally, you’ll be able to wake up without an alarm. If that isn’t doable, see about squeezing in a power nap mid-day. It’s seemingly one of the easiest ways to keep your weight in check. It also helps you get the most out of your workouts. You can’t give your all when you’re exhausted. Be realistic with rest days and cheat days. These days don’t mean you can go all-out on a binge. Some people find a cheat meal is safer. Others re-learn how to gauge their fullness. Cheat days can be helpful because they give your body what it’s craving, but it still needs to be in moderation. A rest day doesn’t need to be a complete rest, either. You can go on a walk or take a gentle yoga class. Again, honesty with yourself is key. If you’re getting in your own way, you’re also the one who can stop it. Pinpoint your biggest struggles and see what you can do to put yourself first. Read Also : Your Guide To HRT For Men How Does Smoking Weed Affect The Society Things To Pay Attention To When It Comes To Servicing Ultrasound Probe

READ MOREDetails
GP

When Should You Turn to a Pharmacist Instead of a GP?

If you are suffering from a health condition and require intervention from your GP, it can be quite difficult to get a quick appointment even when you go to the nearest walk-in center. That’s why you may want to consider going to see a pharmacist instead to get an answer to your problem. Of course, you cannot go to your pharmacist in every situation, but here are the best times when you can and will still get the best medical service from them. When Should You Turn to a Pharmacist Instead of a GP: 1. When your symptoms are not really severe: If you are suffering from the flu or have some sort of infection, and already know what you’re suffering from, this may be a time to actually go to a pharmacist to see if they can recommend the best products. Although a pharmacist cannot diagnose your condition, they can help if you need advice on medications, and which ones would help the best ease your symptoms. They can also recommend products if you have allergies or are looking to avoid a certain medical ingredient. 2. When you need a specific health test: Another thing that you can get from your pharmacist, as well as your GP,  are specific tests. It’s important to remember that pharmacists do undertake a 6-8-year program to get qualified, so you are in safe hands if you need a specific medical service. So, if you have diabetes and need a blood or blood sugar level test, blood pressure monitoring or even advice on home monitoring tests, speaking to a pharmacist is a great place to start. 3. Your GP’s waiting time is too long: Sometimes we just can’t wait to get an appointment. You can go to as many walk-in centres as you like, but the waiting times are too long and sometimes you can just get turned away. However, if you understand your symptoms or just want to know what you can get to cure them, you don’t just need to wait for months on end to hear back from a doctor. Instead, you can speak to a pharmacist who can give you advice on medications to ease any painful symptoms. Try speaking to a pharmacist as soon as you can, but also make an appointment with your GP. That way you can get the best of both worlds and get treatment as you wait to see your doctor. 4. You need a prescription update: Seeing a doctor time and time again to get another prescription request for creams, pills or injections can be time-consuming. Sometimes your every-day commitments give you precious little time to spend at the doctors, especially if you cannot get an appointment in the evening. That’s why you can either speak to a pharmacist about a repeat prescription, or you can use an online pharmacy, by Lawsat Pharm, to quickly request your treatment. This way you can make sure you do not miss taking your prescription. 5. You do not have a GP in the area: If you have not signed up for a GP in your area, as you may not be local, this may be the perfect time to see a pharmacist. You may have just moved there or are on holiday in the area. Either way, visit a local pharmacist to make sure you can get some treatment before you return home. Read Also: How To Choose The Right Online Pharmacy Testosterone Replacement Therapy What To Expect Early Symptoms And Signs Of Breast Cancer How Can Art Help Medical Students Become Better Doctors?

READ MOREDetails