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Chapter 6 Phase Two
We all felt that Hodges model recognises that the resident already has a
biography that has been influenced by their physical and psychological make-up,
the kinds of families and social networks they have experienced and the culture
or geographical location in which they live. Hodges model recognises that the
nurse is also influenced by his or her own personal factors such as their
individual physical or psychological origin and factors relating to their social
world and the policies that govern their daily life. Hodges model directs the nurse
(assessor) to take cognizance of the attributes the person (resident) brings with
them in their current presentation and how this affects their future choices both in
terms of ability to make them and the range of choices available. All of these
components were mirrored in the attributes of autonomy and therefore we felt
that this model would work best with helping to enhance the residents autonomy.
Furthermore, choosing Hodges model was in support of the literature which
encouraged new and imaginative designs (Cheevakasemsook et al, 2006; Mason,
1999). Having agreed on the theoretical model which would underpin the new
care plan we then further reviewed the literature in order to identify a guideline
which could inform the design of the care plan template. It was agreed that the
“New Zealand Guidelines for Assessment for Older People” (2003) (Table x)
was the most suitable. The New Zealand guidelines for assessment for older
people suggest that there are five domains of most importance to older people.
These domains are: Personal care, Social participation, Daily life – promotion of
choice, Safety and Food. Traditional care plans using the Roper Logan and
Tierney Model have 12 domains or activities of living: Maintaining a safe
environment, Communicating, Breathing, Eating and drinking, Eliminating,
Personal cleansing and dressing, Controlling body temperature, Working and
playing, Mobilising, Sleeping, Expressing sexuality and Dying. We felt that the
New Zealand domains of care were more aligned to older people and therefore
potentially more facilitating of resident autonomy. For example the domain of
care “daily life – promotion of choice” would facilitate the attribute of autonomy
“resident involved in decision making” (Table 6.2).