Performing Activities of Daily Living

As COPD progresses, dyspnea at rest develops and the ability to perform activities of daily living declines. 

Intermittent claudication decreases exercise capacity and overall functional capacity, Impaired walking ability is coupled with the inability to perform activities of daily living and results in a decrease in overall quality of life (60). Pharmacologic and nonpharmacologic measures aimed in improving mobility and consequently the quality of life is important treatment goals for patients with PAD,... 

Alzheimer s disease (AD) is the most common neurodegenerative disease in the elderly. Prevalence increases with age and by the year 2050 it has been estimated that world-wide 1 out of 85 persons will suffer from AD (Brookmeyer et ah, 2007). AD is clinically characterized by progressive memory deficits, speech problems, and visuospatial orientation. As the disease advances, the patient my develop apraxia (loss of the ability to execute or cany out learned purposeful movements), and requires help in performing activities of daily living. In moderate and severe stages of the disease, AD patients may show signs of neuropsychiatric syndromes like labile affect, aggression, hallucinations, sleep disturbances, and apathy. 

A family physician/psychiatrist concludes that Sara has a history of hypoxic brain injury with consequent significant cognitive impairment, inability to perform activities of daily living, and impulse control problems (disinhibition because of her frontal lobe injury) in her role as a parent. Sara is given trazodone for her impulse-control problems. The therapist continues to work with Maria, Hector, and Sara to develop coping strategies for the family of this brain-injured woman. 

Disagreement exists about the utility of cholinesterase inhibitors in advanced stages of AD. Some clinicians feel that patients should be taken off cholinesterase inhibitors once they have reached severe stages of AD, while others believe that these medications may continue to be helpful with managing psychiatric symptoms and maintaining function. Most clinicians probably discontinue cholinesterase inhibitors once the AD patient is bedridden and unable to perform activities of daily living. 

While the true impact of rhythm control on mortality remains to be determined, current data suggest that the restoration and maintenance of sinus rhythm in patients with AF may impart other important clinical benefits, such as improvements in symptoms, exercise tolerance, ability to perform activities of daily living and quality of life (41). In the Rate Control versus Electrical Cardioversion (RACE) study, patients with AF who converted to sinus rhythm had a significant reduction in atrial size and improvement in left ventricular function (36). Despite efforts to enroll patients who would tolerate rate-controlled AF, the AFFIRM Functional Status Substudy showed that AF was associated with poorer New York Heart Association (NYHA) functional capacity and rhythm control was associated with a modest improvement in six-minute walk distance compared to rate control (42). 

Is the client able to breathe easier How many pillows does the client have to sleep on when lying down Is the client able to perform activities of daily living (ADL) without shormess of breath What do the lung fields sound like ... 

Cramped showers, bathrooms, or other facilities in combination with poor work practices may cause providers to assume awkward positions or postures or use forceful exertions when performing activities of daily living ... 

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