Activities of daily living

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The activities of daily living ( ATL , also ATLs ) are a basic concept of the health and nursing care . They describe recurring activities to meet the physical and psychological basic human needs that can cause difficulties in illness and in old age. The ATLs are rooted in the needs-based considerations of Abraham Maslow and are the approach of Liliane Juchli (1983), who thus refers to Nancy Roper , Winifred W. Logans and Alison Tierney’s theory ( care model of life activities , 1976), and thus also in the tradition of Virginia Henderson ( 14 basic needs ) is available. Monika Krohwinkel has also worked on Roper's model and thus comes to her activities and existential experiences in life . By Henry Schipperges , Edward Seidler and Antje Grauhan was after the Second World War at the University of Heidelberg sister school the old Hippocratic tradition of medicine with modern nursing theories, including the one with the theory of Nancy Roper, Winifred W. Logan and Alison Tierney and ATLs connected.

background

The first paper, which dealt with the classification of ATL (English: ADL, Activities of Daily Living), was written by a team at the Benjamin Rose Hospital in Cleveland, Ohio. Katz et al. published the first ADL index for a standardized assessment of the ADL in 1963. This index of activities of daily living is still used today to assess the course of illness. With ADL, a basic distinction can be made between basic / physical activities (basic ADL) and instrumental activities (IADL). The basic ADL includes all activities that are part of self-sufficiency. These are e.g. B. bathing or showering, getting dressed in the morning, eating and drinking. These basic ADLs (sometimes also referred to as BADLs) can be hierarchically structured based on their complexity. When the disease progresses, more complex activities such as bathing or using the toilet are the first to be restricted. Furthermore, basic ADL are activities that result from habit and are therefore generally viewed as free from cultural influences. The IADL include, among other things, the preparation of food, shopping, housework, operating a telephone and the use of means of transport such as the car or public transport. IADL are generally more complex than basic ADL and mostly require objects from the environment or social interactions with fellow human beings. For example, the preparation of food requires the ability to use various modes of transport, to manage money properly, to purchase the food and to prepare it properly. The ability of how the food is prepared depends on the environment and cultural experience. This example shows that disease-related or random changes show up first and foremost in the IADL. Since IADL requires skills such as planning and judgment, changes in mental performance can usually also be determined based on changes in the IADL.

Overview of important ADL scales
abbreviation year designation application
Katz ADL 1963 Katz Index of Independence in Activities of Daily Living General geriatric assessments
Barthel 1965 Barthel ADL Index Stroke, neuromuscular disorders, brain tumor
Lawton IADL 1969 Lawton Instrumental Activities of Daily Living General geriatric assessments, Alzheimer's
Lawton PSMS 1969 Lawton Physical Self-Maintenance Scale General geriatric assessments, Alzheimer's
RLT 1980 Roper – Logan – Tierney model of nursing General geriatric assessments
FAQ 1982 Functional Activities Questionnaire (pepper) Dementia, Alzheimer's
FIM 1987 The Functional Independence Measure Rehabilitation for brain injuries
DAFS 1989 Direct Assessment of Functional Status dementia
NOSGER 1991 Nurses' Observational Scale for Geriatric Patients Geriatric medicine, dementia, depression, Alzheimer's
CSADL 1992 Cleveland Scale of Activities of Daily Living dementia
FAM 1993 Functional Assessment Measure Rehabilitation for brain injuries
BADLS 1996 Bristol Activities of Daily Living Scale dementia
ADCS-ADL 1997 Alzheimer's Disease Cooperative Study Alzheimer
DAD 1999 Disability Assessment for Dementia Dementia, Alzheimer's
W-ADL 2013 Waisman Activities of Daily Living Scale Developmental Disorders, Autism, Down Syndrome
Classification of ADL into basic and instrumental activities

The aim of care, rehabilitation and therapy is therefore to maintain or restore a patient's independence in individual areas. With the criteria catalog of the ATLs nursing diagnosis , planning and evaluation are possible.

The twelve activities of daily living

  • Rest and sleep - this may include skills in the area:
    • Renew and clean the bed every day or if necessary
    • Positioning the patient
    • Use of storage aids
    • Observation of sleep
  • Wash and dress
  • To eat and drink
    • Observation of body weight and body length
    • Assistance with eating and drinking
    • Determine diets appropriate to the patient
    • Aspiration prophylaxis
    • Feeding tube and tube feeding
  • Regulation of body temperature
    • Observation of body temperature
    • Care for fever
  • Ensure security
    • Prevention of Dangers
    • Personal hygiene
    • Handling medicines and sterile items
    • Prevention of nosocomial infections
  • To keep oneself busy
    • Occupational therapy and physiotherapy
    • rehabilitation
  • Communicate
    • with patients, relatives and within the care team
    • Handover
    • visit
  • Find meaning
    • Coping with fear
    • Days of reflection and meditations
    • Observation of pain and pain management
    • Accompanying the dying
  • To feel like a man or a woman
    • Protect privacy
    • Change from medication

See also

literature

  • Liliane Juchli: Holistic care - vision or reality. 3. Edition. RECOM, Basel 1993, ISBN 3-315-00076-X .
  • Liliane Juchli ( founder ), Edith Kellnhauser (ed.): Thiemes care - experience professionalism. 10th edition. Thieme, Stuttgart 2004, ISBN 3-13-500010-9 .
  • Carola Otterstedt: The verbal dialogue. For companions of seriously ill, stroke, coma and dementia sufferers. modern learning, Dortmund 2005.
  • Carola Otterstedt: The non-verbal dialogue. For companions of seriously ill, stroke, coma and dementia sufferers. modern learning, Dortmund 2005.

Individual evidence

  1. ↑ Pschyrembel - Clinical Dictionary. 258th edition. De Gruyter, ISBN 3-11-014824-2 .
  2. ↑ Nicole Menche (Ed.): Care Today. Elsevier, Urban & Fischer, Munich. 2011, p. 94 ff.
  3. ↑ Christine R. Auer: A free-thinking nurse. Antje Grauhan MA is 80 years old, a celebration for her birthday. Self-published Heidelberg 2010.
  4. ↑ Multidisciplinary studies of illness in aged persons 1II. A new classification of functional status in activities of daily living . In: Journal of Chronic Diseases . tape 9 , no. 1 , p. 55-62 , doi : 10.1016 / 0021-9681 (59) 90137-7 ( linkinghub.elsevier.com [accessed April 30, 2017]).
  5. ↑ Sidney Katz, Amasa B. Ford, Roland W. Moskowitz, Beverly A. Jackson, Marjorie W. Jaffe: Studies of Illness in the Aged: The Index of ADL: A Standardized Measure of Biological and Psychosocial Function . In: JAMA . tape 185 , no. 12 , September 21, 1963, ISSN  0098-7484 , p. 914-919 , doi : 10.1001 / jama.1963.03060120024016 .
  6. ^ A b Sidney Katz: Assessing Self-maintenance: Activities of Daily Living, Mobility, and Instrumental Activities of Daily Living . In: Journal of the American Geriatrics Society . tape 31 , no. 12 , December 1, 1983, ISSN  1532-5415 , pp. 721-727 , doi : 10.1111 / j.1532-5415.1983.tb03391.x , PMID 6418786 .
  7. ↑ David A. Loewenstein, Alfredo Ardila, Monica Rosselli, Sherri Hayden, Ranjan Duara: A Comparative Analysis of Functional Status Among Spanish-and English-speaking Patients With Dementia . In: Journal of Gerontology . tape 47 , no. 6 , November 1, 1992, ISSN  0022-1422 , pp. P389-P394 , doi : 10.1093 / geronj / 47.6.P389 .
  8. ^ Carla Graf: The Lawton Instrumental Activities of Daily Living Scale . In: AJN, American Journal of Nursing . tape 108 , no. 4 , April 2008, p. 52-62 , doi : 10.1097 / 01.naj.0000314810.46029.74 .
  9. ^ MP Lawton: Scales to measure competence in everyday activities . In: Psychopharmacology Bulletin . tape 24 , no. 4 , January 1, 1988, ISSN  0048-5764 , p. 609-614 , PMID 3074322 .
  10. ^ Romola S. Bucks, Judy Haworth: Bristol Activities of Daily Living Scale: a critical evaluation . In: Expert Review of Neurotherapeutics . tape 2 , no. 5 , September 1, 2002, ISSN  1473-7175 , p. 669-676 , doi : 10.1586 / 14737175.2.5.669 .
  11. ↑ Stephen T. Chen, David L. Sultzer, Charles H. Hinkin, Michael E. Mahler, Jeffrey L. Cummings: Executive Dysfunction in Alzheimer's Disease . In: The Journal of Neuropsychiatry and Clinical Neurosciences . tape 10 , no. 4 , November 1, 1998, ISSN  0895-0172 , p. 426-432 , doi : 10.1176 / jnp.10.4.426 .
  12. ^ Florence I. Mahoney, Dorothea W. Barthel .: Functional evaluation, the Barthel index. A simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill . In: Maryland State Medical Journal . tape 14 , February 1, 1965, ISSN  0025-4363 , OCLC 851234229 , p. 61-65 , PMID 14258950 .
  13. ^ A b M. Powell Lawton, Elaine M. Brody: Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living . In: The Gerontologist . tape 9 , 3_Part_1, October 1, 1969, ISSN  0016-9013 , p. 179–186 , doi : 10.1093 / geront / 9.3_Part_1.179 .
  14. ^ Nancy Roper, Winifred W. Logan, Alison J. Tierney: The elements of nursing . Churchill Livingstone, Edinburgh 1982, ISBN 0-443-01577-5 .
  15. ↑ RI Pfeffer, TT Kurosaki, CH Harrah, JM Chance, S. Filos: Measurement of functional activities in older adults in the community . In: Journal of Gerontology . tape 37 , no. 3 , May 1, 1982, pp. 323-329 , PMID 7069156 .
  16. ↑ a b Fuhrer, Marcus J., National Association of Rehabilitation Research and Training Centers., National Institute of Handicapped Research .: Rehabilitation outcomes: analysis and measurement: Annual conference: Papers . Brookes, 1987, ISBN 0-933716-77-X .
  17. ↑ DA Loewenstein, E. Amigo, R. Duara, A. Guterman, D. Hurwitz: A new scale for the assessment of functional status in Alzheimer's disease and related disorders . In: Journal of Gerontology . tape 44 , no. 4 , July 1, 1989, pp. P114-121 , PMID 2738312 .
  18. ^ R. Spiegel, C. Brunner, D. Ermini-Fünfschilling, A. Monsch, M. Notter: A new behavioral assessment scale for geriatric out- and in-patients: the NOSGER (Nurses' Observation Scale for Geriatric Patients) . In: Journal of the American Geriatrics Society . tape 39 , no. 4 , April 1, 1991, ISSN  0002-8614 , pp. 339-347 , PMID 2010583 .
  19. ^ MB Patterson, JL Mack, MM Neundorfer, RJ Martin, KA Smyth: Assessment of functional ability in Alzheimer disease: a review and a preliminary report on the Cleveland Scale for Activities of Daily Living . In: Alzheimer Disease and Associated Disorders . tape 6 , no. 3 , January 1, 1992, ISSN  0893-0341 , p. 145-163 , PMID 1485930 .
  20. ↑ RS Bucks, DL Ashworth, GK Wilcock, K. Siegfried: Assessment of Activities of Daily Living in Dementia: Development of the Bristol Activities of Daily Living Scale . In: Age and Aging . tape 25 , no. 2 , March 1, 1996, ISSN  0002-0729 , p. 113–120 , doi : 10.1093 / aging / 25.2.113 .
  21. ↑ D. Galasko, D. Bennett, M. Sano, C. Ernesto, R. Thomas: An inventory to assess activities of daily living for clinical trials in Alzheimer's disease. The Alzheimer's Disease Cooperative Study . In: Alzheimer Disease and Associated Disorders . tape 11 , Suppl 2, January 1, 1997, ISSN  0893-0341 , p. S33-39 , PMID 9236950 .
  22. ^ I. Gélinas, L. Gauthier, M. McIntyre, S. Gauthier: Development of a functional measure for persons with Alzheimer's disease: the disability assessment for dementia . In: The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association . tape 53 , no. 5 , September 1, 1999, ISSN  0272-9490 , p. 471-481 , PMID 10500855 .
  23. ↑ Matthew J. Maenner, Leann E. Smith, Jinkuk Hong, Renee Makuch, Jan S. Greenberg: Evaluation of an activities of daily living scale for adolescents and adults with developmental disabilities . In: Disability and Health Journal . tape 6 , no. 1 , January 1, 2013, ISSN  1876-7583 , p. 8–17 , doi : 10.1016 / j.dhjo.2012.08.005 , PMID 23260606 , PMC 3531884 (free full text).