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ALS& Aging: A Case Study in Autonomy and control
Author(s) -
Power Deborah J.,
Craven Ruth F.
Publication year - 1983
Publication title -
image: the journal of nursing scholarship
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.009
H-Index - 80
eISSN - 1547-5069
pISSN - 0743-5150
DOI - 10.1111/j.1547-5069.1983.tb01349.x
Subject(s) - autonomy , nursing , quality (philosophy) , staffing , control (management) , nursing care , health care , quality of life (healthcare) , ideal (ethics) , medicine , business , psychology , political science , computer science , law , philosophy , epistemology , artificial intelligence
Quality of life is often seen as an ideal that is impossible to achieve in long‐term care. This paper suggests that the maintenance of automony and control is basic to attaining the highest potential quality of life. Quality of care has become a particular concern in nursing. In the long‐term care setting, the quality of care has come to the attention of the public, resulting in a loud outcry against the nursing home industry as a whole. Even those facilities that already provide high‐quality nursing care must strive for even higher standards if they are to move health care delivery towards the ever elusive ideal–the greatest possible quality of life. Individualization of patient care has become a watchword in nursing. Yet it may be undermined by the health care system and by nursing staffing patterns in general and nursing philosophy and allocation of time in particular. Upon entering a long‐term care facility the geriatric patient loses much autonomy. Activities of daily living become regulated by the system and are determined by the time available for staff members to assist the patient. As the elderly become more physically disabled they become increasingly dependent on the staff, losing more and more control over their life‐style– when they rise, what they wear, even how they dress. Quality of life must be considered from a person's point of view and in relation to the capabilities of that person (Cassel, 1980). The maintenance of autonomy and control can be crucial in maintaining self‐esteem and achieving quality of life. Loss of control over the outcome of one's own behavior leads to helplessness. Helplessness is based on the perceptions and beliefs of the individual, whether they be founded on fact or fallacy (Seligman, 1975). The helpless individual too frequently lacks quality of life. This paper presents a plan for individualized care, which focuses on the issue of patient autonomy versus “adequate” nursing care. It was developed collaboratively between a patient and the authors–nurses who assume the role of consultant and patient advocate.