How to Promote Independence Through ADLs?

The actions we perform regularly are known as activities of daily life (ADLs). Because ADL abilities deteriorate as dementia advances, caregivers’ engagement evolves with time. As a result, caretakers frequently provide more assistance than is required, and evidence shows that patients with dementia, especially those with late dementia, can perform more than caregivers allow them to. Therefore, caregivers must promote patients’ independence through ADLs.

Promoting independence necessitates clear communication, compassion, and the capacity to recognize and accept that dementia alters how a patient approaches a task. Unfortunately, many caregivers presume that a patient with dementia can no longer comprehend how to accomplish an activity and assume control of the situation. This not only deprives people of their freedom but also of their self-worth.

This essay will tell you about the various strategies, and methods caregivers can use to help patients become independent\ndent with their daily activities.

What are the Strategies for Promoting Independence through ADLs?

To promote independence through ADLs, you can use various methods and strategies as a caregiver. Here you can see six strategies for this purpose.

 

Good Communication

Patience and attentiveness are prerequisites for effective communication. Good communication fosters trust, promotes independence, and results in better outcomes. Caregivers must learn and feel that attempting to recognize the patient’s needs they are caring for continuously will make their work simpler. A person’s comprehension skills, sensory talents, and culture are all factors in effective communication.

Communication may be more straightforward at home since the atmosphere is familiar and there are fewer distractions, but caregivers are generally alone and cannot seek assistance from a coworker. A calm tone, short straight phrases, a moderate speaking tempo, and patience support independence in persons with dementia in any context.

 

ADL Skill Training

Regardless of being family members or professionals, all caregivers should get ADL “skills training.” The emphasis is on developing independence in all tasks while offering enough help when necessary. ADL skill training encourages self-care participation, decreases caregiver stress, and decreases the number of physical work a caregiver needs.

A good caregiver learns to constantly examine the patient they care for to find their skills, comprehension, and capacities. Depending on the work, the time of day, comorbidities, and the amount and kind of dementia, more or less support may be required. For instance, a patient who can otherwise do autonomous self-care duties but has poor balance may need assistance in establishing a secure spot to wash her teeth and perform other grooming tasks. If the individual is compelled to stand during these tasks, they will most likely require more assistance from the caregiver than if a comfortable sitting location is provided.

Caregivers receive knowledge, methods, and resources to create a tailored program that precisely delivers the appropriate amount of help. Gestures, verbal and visual signals, assistive technology, planning and problem solving, and physical aid may all be used.

 

Planning Activities

Planning activities for patients with dementia must consider their passions and abilities, which increases efficiency and leads to a broader selection of activities. A detailed assessment of a patient’s lifestyle, employment, hobbies, and preferences will automatically result in well-planned activities. For instance, a patient who used to like hiking but cannot walk long distances will still enjoy going by car or visiting a park with wheelchair-accessible routes. However, that same individual may not enjoy watching a game show on television.

 

Assistive Technologies

Assistive technologies, which allow individuals with disabilities to operate more independently, have been created to help patients with families and caregivers. The primary goals of assistive technologies are safety and social involvement. They differ from assistive devices, which allow for movement and daily physical activity.

Assistive technologies:

• Give the caregiver a mechanism to ensure the patient’s safety they are caring.
• Assist in memory and recall.
• Increase a patient’s self-esteem and independence.
• Maintain social connections for those with dementia.

Assistive technologies include the following:

• Face-to-face interaction with family and friends via tablets or laptops.
• Devices that track a person’s movements and allow them to wander autonomously within a safe area.
• Medication reminders and electronic prompts
• Telephone or video conferencing medical examinations.
• Lights that are automated.
• Sensors that prevent floods switch off gadgets that have been left on or turn lights on and off automatically.
• Communication devices such as modified telephones with pre-programmed numbers are available.
• Cameras are strategically placed throughout the house.

Assistive technology can help persons with dementia save money on care, minimize caregiver load, enhance independence, and improve their quality of life. They may also encourage aging in place, postpone transfer to a care home, and assist persons with dementia in maintaining their independence.

 

Adaptive Aids

Adaptive aids are gadgets and equipment that help people with daily tasks, including movement, transfers, wearing clothes and hygiene, bathing, and eating. They can assist people with impairments in compensating for lost functions, increasing their independence, and developing their full potential. The patient’s stage of dementia, daily habits, lifestyle, and physical ability all influence the choice of adaptive assistance or gadget.

Adaptive aids include:

• Grab bars, transfer poles, handrails, and non-skid mats are safety devices.
• Walkers, chair lifts, braces, pulleys, slings, wheelchairs, and ramps are all examples of assistive devices.
• The use of products that support eating and drinking, including non-tip cups, assistive tableware, spill-proof cups, adjustable-height tables, and easy-grip silverware.
• A commode, shower chair, transfer bench, and a roll-in or walk-in shower are some examples of devices used for bathing and washing.
• Several household appliances accomplish household tasks, such as adjustable-height cabinets, reachers, grip extensions for appliance controls, and pull-out or pull-down shelves.

Preventing Loss of Independence through Exercise

Walking, resistance training and sitting activities that focus on developing cardiovascular endurance, power, balance, and flexibility have been indicated to improve physical function in patients with dementia. In addition, exercise enhances the capacity to conduct fundamental daily tasks, including eating, dressing, washing, toileting, and shifting from bed to chair.

Dementia-friendly and comfortable and safe surroundings increase confidence and physical activity. This can involve creating safe places to walk around and traverse, as well as regulations that prevent unnecessary transfers from one facility or region to another.

 

What are Care Techniques to Promote Independence through ADLs?

Care methods are the abilities required by the caregiver to observe, help, and provide comprehensive care in clothing, grooming, eating, cleaning, toileting, and incontinence.

 

Dressing and Grooming

People with dementia, like everyone else, require time to dress and groom themselves. The caregiver must examine the patient they are responsible for to decide the amount of assistance needed, be patient, and refrain from intervening if no assistance is required. Caregivers must teach themselves to support as much independence as possible, based on the intensity of dementia and comorbidities, including visual and perceptual problems, balance and strength, and even the time of day.

Consider a patient with significant macular degeneration and moderate dementia who is incredibly flexible and powerful. This patient may easily lift their knee to their chest while sitting in a chair with sufficient back support. Nevertheless, when attempting to put on their pants, this patient cannot see where to position their leg. It’s easy to do everything for them, but this adds to the caregiver’s workload and does little to enhance the patient’s independence. The caregiver has to be tolerant in this scenario, assisting the patient in laying out their clothes and providing verbal and appropriate tactile cues to steer the task.

The same may be said about grooming. Step by step, provide a secure and pleasant environment for grooming when doing oral care and other grooming duties. Encourage males to use an electric razor and both men and women to visit a beauty salon or a barber shop regularly.

 

Eating and Hydration

Interventions to help older adults eat and drink differently include:

• Changing the color of a plate
• Boosting activity
• Changing the surroundings
• Improving knowledge or attitudes

Some therapies directly affect food and consumption through oral nutrition supplements, food customization, dysphagia treatment, eating assistance, or promoting the social aspect of eating and drinking. Other therapies, including changing the eating sets, offering information and training to individuals with dementia and their caregivers, behavior modification, and fitness programs, indirectly affect food and drink consumption or experience.

For many years, assistive or adaptable dinnerware has been a standard in nursing homes and assisted living institutions. Unfortunately, most assistive dinnerware is unsightly. Because people’s needs and skills vary, and accessible tableware differs from regular products, users of assistive table settings may feel ostracized.

As dementia progresses and feeding issues arise, it is standard practice to simplify meals by providing only a plate and spoon with pureed or diced food that may be consumed without the person having to chop it up. The dish should have a high lip to assist press the food onto the spoon when it is scooped up

Assistive, well-designed dinnerware may be utilized by persons of various abilities and should look like conventional home tableware. Color contrasts should be prominent. For instance, royal blue dishes contrast with a white tablecloth and food on a plate. A similar strategy may be applied to cups. For example, royal blue and white can be utilized to assist patients with limited visual acuity or agnosia in locating the handle and rim. The cup’s sides should be sloped to lessen the need to tip it, a broad handle will provide a secure grip, and the top should be wide enough to fit a patient’s nose within the cup when listed.

In addition to eating meals with caregivers, cooking family-style meals, playing soothing music at mealtimes, providing snack time constantly, facilitating breakfast clubs, and providing Montessori activities, several interventions have shown promise. However, researchers need to spend more time researching how to help adults with dementia eat and drink well and maintain an active engagement with food and drink.

 

Bathing

Bathing has always been a private, autonomous, and intimate activity. Bathing with the assistance of another person may be difficult and even dangerous for someone who has dementia. The capacity of a caregiver to assist the patient they are caring for feel in control and independence is critical to success. This is achieved through including the individual in the bathing choice, increasing independence, maintaining the individual’s privacy and dignity, and exercising flexibility.

Make sure the atmosphere is relaxed and secured before bathing. Bathing materials should be easily accessible, and the water should be preheated to the appropriate degree. Non-skid matting and grab bars should be supplied.

Techniques for comforting and reassuring a dementia patient while showering include:

• Set a regular bathing time.
• Scrubbing should be avoided on delicate skin.
• Make bathing easier by using assistive gadgets.
• If necessary, coach or prompt the patient through each stage.
• For your convenience and safety, provide a bench or shower chair.
• Clean difficult-to-reach regions
• Use a sponge bath between those baths or instead of bathing.

 

Toileting and Incontinence

The unintentional spilling of urine, feces, or both is known as incontinence. Incontinence can be humiliating and stigmatizing for patients with cognitive impairment who live at home. In addition, incontinence increases caregiver stress and sadness and plays a role in the choice to commit a family member to a care facility.

Toileting and incontinence are two challenges that patients with dementia face. Some are caused by cognitive and memory loss, others by behavioral and psychiatric problems, and others by the interaction of these with additional comorbidities. In addition, over-medicating with laxatives (often without the caregiver’s awareness) can be a concern. Issues with toileting and incontinence might include:

• Inability to respond to the feeling of the desire to urinate on time.
• Inability to find, recognize, and use toilets and unlock toilet doors while inside.
• Inability to manage tasks such as unraveling and changing clothing, directing the penis for men, and performing washing and personal hygiene.
• Soiled clothing, urine, and feces that are not adequately managed, hiding soiled underwear, otherwise contaminating surfaces with feces or wiping feces off the caregiver’s hands to contaminate clothing.
• Voiding without attempting to remove clothing or move to a toilet.
• Choosing not to defecate in the wrong places, including the garden or near the bed at night, or in inappropriate containers, such as rubbish bins.
• Rejection of others assisting with toileting.

Caregivers’ techniques and tactics for managing toileting and incontinence in a dementia patient often begin with cues to go to the restroom regularly. However, other approaches, including adult diapers, bedside commodes, and direct caregiver assistance, are required as dementia develops.

To find things more straightforward for a dementia patient to find and use the restroom:

• Move furniture to make a route to the bathroom.
• Leave the toilet door open so that you can see the toilet.
• Put colorful rugs on the floor or a toilet image on the door.
• Keep the toilet secure and straightforward to use. Lift the toilet seat, add handrails on either side and put lights in the bedroom and bathroom.
• Get a portable commode or urinal in the bedroom for night use.
• Plants, waste bins, and other anything that may be confused for a toilet should be removed.
• Remove any throw rugs that might cause someone to trip and fall.
• Make a direct line or route to the toilet with glow-in-the-dark tape.

Remember that incontinence might be caused by a medical condition, including a urinary tract infection, constipation, or prostate issues. Incontinence is also linked to diabetes, stroke, Parkinson’s, and physical impairments that make it difficult to use the restroom on time. Medications and diuretics can also cause incontinence. This includes sleeping medicines, anti-anxiety medications that may loosen bladder muscles, and beverages including cola, coffee, and tea.

 

What is the Importance of Independence?

Maintaining independence benefits older adults in a variety of ways. It may enhance their physical and mental health, as well as their confidence and self-esteem, as well as their feeling of purpose and quality of life. In addition, it can make them feel helpful, which is especially crucial if they have the fear of becoming a burden to their family members or loved ones.

 

Giving someone the freedom to do one thing might enhance their confidence and spread to other aspects of their life. Instilling confidence in them to go to the hairdresser alone, for example, may make children more conscious of their own talents and indicate that they wish to start doing other things alone as well.

 

When is a Good Time to Intervene to Help Seniors with their Independence?

Promoting a person’s independence requires a delicate balance of understanding when they genuinely require assistance and when they must accomplish things on their own. But, of course, there will be instances when you must intervene.

In these circumstances, it’s best to assist without making a big fuss about it or attracting attention to what the individual is no longer able to accomplish. One of the most crucial components of taking care of a loved one is humor and enjoyment – be self-effacing, admit you’re bad at certain things, and accept aid from others.

You must also distinguish between someone wishing to do things independently and someone insisting on doing things alone because they feel obligated, guilty, or bothersome. You must thus be aware of the cues indicating how easy it is for the individual to complete the activities they desire and their personality. For example, is it in their nature to deny aid when they are in need?

If all of the indicators lead to them desiring more support than they admit, you may assess which parts of their life they may want more assistance in while ensuring their freedom in others. For instance, if they are no longer physically capable of getting dressed independently but still have the full ability, you might guarantee they have complete control over decisions and finances while proposing they obtain help getting dressed.

Perhaps fear or uncertainty is preventing the person from reaching their full potential if you know they are capable of more than they seem. Ask for more help each time, and gently encourage them as you make progress.

Maintaining independence necessitates a person’s confidence, health, and happiness. This is why keeping them physically active and socially engaged is critical by including them in activities. This might be as easy as proposing a daily stroll around the neighborhood or assisting in the organization of fitness sessions.

 

Conclusion

People who have Alzheimer’s disease eventually require assistance with daily chores (ADLs). A person with Alzheimer’s disease may need help with personal care tasks such as eating, bathing, grooming, and using the bathroom, depending on their level of independence. Caregivers require knowledge, expertise, and patience to help with these duties.

This article gave caregivers some tips about promoting independence through performing ADLs and how to care for patients with dementia.

If you reside in Las Vegas and require help with Daily Activities and ADLs for a family member, the Health and Care Professional Network can help you and your loved ones. The company has been providing home care services to the Las Vegas area since 2006. For further information or to get benefits, please contact us at (702) 871-9917.

You can learn more about other Home Assist services.