A8 · Loss of independence
Actual Older adult
Definition
The person can no longer do tasks they once managed alone and feels reduced control.- Illness
- weakness
- fear
- cognitive decline
- Frustration
- withdrawal
- refuses help
- dependence
📋 Scenario
A former driver cannot go out alone after a stroke.
Subjective (S): "I used to drive myself everywhere."
Objective (O): After stroke; cannot go out alone; frustrated; refuses help.
Assessment tools for this scenario: CP-OLDER Older Adult Check
Validated scales to consider: 4AT / CAM, Mini-Cog
**CarePath diagnosis:** Loss of independence related to illness, as evidenced by frustration and withdrawal.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Respect choices. | Respecting his choices keeps his dignity and sense of control, which reduces frustration and the urge to refuse help. |
| Encourage independence. | Letting him do what he can safely helps rebuild skills and confidence and prevents avoidable dependence. |
| Use adaptive aids. | Aids such as walking supports, adapted tools or transport options let him do more for himself and go out more. |
| Set goals. | Goals that he helps set give direction and show progress, which supports motivation after a stroke. |
**Expected outcomes**
- Uses adaptive aids.
- Takes part in decisions.
- Sets achievable independence goals.
**Linking the data to the diagnosis**
The patient says, 'I used to drive myself everywhere.' Since his stroke he cannot go out alone, and he is frustrated and refuses help. The loss has already happened, so this is an actual problem, and it rests on illness with frustration and withdrawal. It fits better than a mobility statement because the main issue is his loss of control and independence. The plan aims for him to use adaptive aids, take part in decisions and set achievable independence goals.
CarePath diagnosis
Loss of independence related to illness, as evidenced by frustration and withdrawal.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Respect choices. | Respecting his choices keeps his dignity and sense of control, which reduces frustration and the urge to refuse help. |
| 2. Encourage independence. | Letting him do what he can safely helps rebuild skills and confidence and prevents avoidable dependence. |
| 3. Use adaptive aids. | Aids such as walking supports, adapted tools or transport options let him do more for himself and go out more. |
| 4. Set goals. | Goals that he helps set give direction and show progress, which supports motivation after a stroke. |
Expected outcomes
- Uses adaptive aids.
- Takes part in decisions.
- Sets achievable independence goals.
Linking the data to the diagnosis
The patient says, 'I used to drive myself everywhere.' Since his stroke he cannot go out alone, and he is frustrated and refuses help. The loss has already happened, so this is an actual problem, and it rests on illness with frustration and withdrawal. It fits better than a mobility statement because the main issue is his loss of control and independence. The plan aims for him to use adaptive aids, take part in decisions and set achievable independence goals.