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“The capacity to do something useful for yourself or others is key to personhood, whether it involves the ability to earn a living, cook a meal, put on shoes in the morning, or whatever other skill needs to be mastered at the moment.”
—M. C. Bateson (1996, p. 11)
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LEARNING OUTCOMES
By the end of this chapter, readers will be able to:
14-1. Examine self-care activities within the domains of everyday occupations.
14-2. Explain relevance of activities of daily living (ADLs) for health, wellness, and quality of life.
14-3. Examine impact of health conditions on self-care performance.
14-4. Describe the theories related to self-care performance and perceptions of competence and control.
14-5. Compare the roles of the occupational therapist with other healthcare professionals’ role in self-care training.
14-6. Select common assessments of ADL used for older adults.
14-7. Apply evidence-based intervention strategies for enabling self-care performance.
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Mini Case Study
Mr. Macarthur is a 75-year-old man recently diagnosed with Parkinson disease and mild cognitive impairment. He lives alone in his three-story home and until recently was able to manage with occasional help from friends. Over the past few months, Mr. Macarthur has developed tremors and difficulty with gross and fine motor movements, which affect his self-care activities. He is able to walk without using adaptive equipment but is slow and unsteady. Stairs have been difficult as have showering and dressing.
Mr. Macarthur is a retired high-school French teacher on a fixed income. His funds have recently diminished due to various medical costs and need for home adaptation. Historically, Mr. Macarthur was very active, loved to play tournament tennis, and traveled the world with his ex-wife and various friends. He has expressed frustration at his decreased motor abilities and increased forgetfulness. He has one son who lives in the same city but no other family nearby for support. Mr. Macarthur’s physician has recommended he consider moving to a home where he can more easily move about, but he fears leaving his community and friends he values.
Provocative Questions
How would an occupational therapist address Mr. Macarthur’s health and personal well-being?
What are the current and potential future effects of Mr. Macarthur’s diagnoses on his ability to complete self-care?
What assessments and interventions would address Mr. Macarthur’s current needs?
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A complete understanding of the functional performance of older adults includes recognizing the importance of daily activities and how they contribute to overall health and well-being. Self-care skills are affected by declining function, including sensory limitations, cognitive declines, reduced strength and agility, and restricted mobility. These often accompany chronic disease and are expected physiological changes that occur throughout the aging process. Emphasis is placed on preserving function and developing strategies to maximize quality of life throughout the performance of ADLs. This chapter considers self-care, a special category of the domain of everyday human activity that has important implications for the health and well-being of ...