Activity of daily livingAssessment AspectsBreathing (and circulation)Respiratory rate & depth Pulse rate, strength, regularity Blood Pressure Peripheral Circulation – colour, warmth, peripheral refillExamples of aspects to consider: Current state and usual stateBiological – history (asthma, hypertension – treatment). Relevant trauma – Fractured ribs and pain might affect respiratory rate & depthPsychological – StressSocial & Cultural values – smoking history (how many per day, how ling for, how ling since they quit smoking)Environmental – pollutants, damp homes are linked to increased incidence of respiratory conditionsPoliticoeconomic – overcrowded homes are linked to increased incidence of respiratory conditionsPlace in lifespan – babies & children have higher respiratory rates. Children & elderly have a greater predisposition to chest infections Activity of daily livingAssessment AspectsEating and DrinkingDietry habits – what does the patient eat, food preferences/dislikes, level of independence Appetite Hydration habits – what does the patient drink, how often do they drink, fluid preferences/dislikes Alcohol – amount, frequency, time. Weight – current weight, recent loss or gain (amount and timeframe)Examples of aspects to consider: Current state and usual stateBiological – Decreased appetite in hospital, constipation causing decreased appetite. Special diet related to medical condition e.g. Diabetes. An injury might necessitate the need for assistance with eating and drinkingPsychological – Stress, mental health – patient not wanting to eat as a resultSocial & Cultural values -Dietry requirements in relation to culture/religion. Who does the shopping and prepares the mealsPoliticoeconomic – Diet limited by financial constraintsPlace in lifespan -Might affect choices on what is consumed and how Activity of daily livingassessment AspectsEliminatingMicturation pattern – day/night, continence, last urinated Defecation pattern – continence, aids required (medications), last defecatedExamples of aspects to consider: Current state and usual stateBiological – Decreased mobility in hospital & analgesia can cause constipation. Injury may affect the level of assistance requiredPsychological – Stress can cause diarrhoea. Patients may feel anxious about using bedpansSocial & Cultural values -Special requirements around eliminationPlace in lifespan -Might affect level of assistance required Activity of daily livingassessment AspectsPersonal Cleansing and DressingDaily hygiene routine – own teeth/dentures, level of independence Appearance of skin – skin integrity, nails, hairExamples of aspects to consider: Current state and usual stateBiological – Injury may affect the level of assistance requiredPsychological – Depression can result in poor self careSocial & Cultural values -Specific requirements around cleansing and groomingPlace in lifespan -Might affect level of assistance required Activity of daily livingassessment AspectsControlling Body TemperatureTemperature Signs of infectionExamples of aspects to consider: Current state and usual stateBiological – Injury may affect the level of assistance required, weight of the patientPsychological – Emotional statusSocial & Cultural values -May affect type of clothing worn, social drugsPoliticoeconomic – May affect ability to buy warm clothes or heat house. Overcrowding = increased potential for spread of infectionsPlace in lifespan – affects ability to control body temperature (thermoregulation in babies, menopause) Activity of daily livingassessment AspectsMobilisationIndependence / Dependence – aids utilized, distance able to mobilise Balance – sitting, standing Falls risk assessmentExamples of aspects to consider: Current state and usual stateBiological – Injury/Illness may affect balance / the level of assistance required / distance able to mobilise. Pain decreases desire to mobilizePsychological – Depression can decrease desire to mobilise, agitation increases desire to mobilisePoliticoeconomic -transportation may be affected by economic situationPlace in lifespan -might affect level of assistance required Activity of daily livingassessment AspectsWorking and PlayingOccupation / Study / unemployed / retired Support Systems – Family, friends, whanau, pets, community, cultural groups, religious groups Interests / Activities – Physical, social, intellectual – how often, transportation Religious/ Cultural practices / BeliefsExamples of aspects to consider: Current state and usual stateBiological – Injury / Illness may affect ability to return to job, or activitiesPsychological – Emotional state can impact on recovery time (increasing time needed of work)Social & Cultural values – Support systems can impact on recovery, special needs in relation to culture / religionEnvironmental – Options for playing may be limited by environmentPlace in lifespan – Affects choices related to work and play Activity of daily livingassessment AspectsExpressing SexualityConcept of self Daily grooming routineExamples of aspects to consider: Current state and usual stateBiological – Injury / Illness can impact on concept of self, and may also affect ability to complete grooming routinePsychological – Emotional sate can impact on concept of selfSocial & Cultural values -Cultural or religious requirements in relation to grooming, Culture and religion can impact on concept of selfEnvironmental – Being away from ones normal environment can impact on their ability to complete grooming requirementsPlace in lifespan -Impacts on perception of self, affects choices related to grooming Activity of daily livingassessment AspectsSleepingSleeping pattern – Hours of sleep, broken / unbroken, day / night, position for sleeping Aids used to sleep – Pillows, drinks, medicationsExamples of aspects to consider: Current state and usual stateBiological – Pain may affect ability to sleep. Injury may affect position that the person usually sleeps inPsychological – Emotional state can impact on ability to sleepSocial & Cultural values -Job may alter sleeping pattern (e.g. shift work)Environmental – Noise & routine in ward may affect normal sleeping patternsPlace in lifespan – may affect amount of sleep required Activity of daily livingassessment AspectsDyingPerception of illness Concerns expressed by family / patient Resuscitation statusExamples of aspects to consider:Biological – May affect treatment optionsPsychological – Emotional state may affect perception of illnessSocial & Cultural values -Culture or religion may affect perception of illness and dyingPlace in lifespan -Impacts on perception of illness, recovery and dying
