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Self-care in elders with dementia: a concept analysis.

PURPOSE
The purpose of this study was to analyze the concept of self-care in elders with dementia through a review of nursing literature and to provide more understanding of the definition and perspectives of the concept of self-care notion in elders with dementia.


METHODS
The technique developed by Walker and Avant was used as a guide in analyzing the concept of self-care.


RESULTS
Attributes of self-care in dementia may include a single or group of actions needed for sustaining life, a personal effort to maintain functional independence while minimizing other's assistance, an outcome behavior from the person's interaction with inter-personal and/or contextual environment, and a functional ability that may decline in parallel to cognitive impairment. Antecedents of self-care in dementia may include at least presence of a certain degree of cognitive appraisal for the self-care needs, self-willingness for the self-care action, spatial and visual orientation, cultural pre-conception of the self-care behavior, presence of environmental context/equipment available for self-care, and sufficient time available. The consequences may include sustaining of life, feel of satisfaction, achieving independence, extended life expectancy, increased self-confidence, decreased caregiver distress and/or burden, savings in health care costs.


DISCUSSION
Defining attributes and antecedents and consequences of self-care in dementia identified in this study provided empirical ground of a middle-range theory of self-care for a clinical population with dementia and generated possible hypotheses to be tested in future studies.