PROMOTING SELF-CARE THROUGH NURSING: APPLICATION OF DOROTHEA OREM'S SELF-CARE DEFICIT NURSING THEORY IN STROKE AND DEMENTIA

Abstract

Stroke and dementia frequently impair patients’ physical, cognitive, and functional abilities, resulting in substantial dependence on nurses and family caregivers for essential self-care activities. This study examines the application of Dorothea Orem’s Self-Care Deficit Nursing Theory (SCDNT) in promoting self-care and optimizing nursing care for an older patient experiencing acute ischemic stroke, right-sided hemiplegia, and dementia. The objective was to identify the patient’s therapeutic self-care demands, determine the extent of self-care deficit, and evaluate the appropriateness of Orem’s nursing systems in guiding individualized clinical interventions. A clinical case study approach was employed to assess the patient’s physiological condition, functional limitations, activities of daily living, nutritional and hydration needs, medication adherence, mobility, and oral health. Orem’s three interrelated theoretical components—Theory of Self-Care, Theory of Self-Care Deficit, and Theory of Nursing Systems—were used to analyze the patient’s care requirements and develop an appropriate nursing response. Findings indicated a substantial self-care deficit associated with hemiplegia, cognitive impairment, dysphagia, immobility, and oral thrush, increasing the risks of dehydration, malnutrition, infection, and pressure injuries. The Wholly Compensatory Nursing System was identified as the most appropriate approach because the patient required extensive assistance with feeding, hygiene, toileting, repositioning, medication administration, and oral care. The involvement and education of the patient’s daughter further supported continuity of care. The case demonstrates that Orem’s theory provides a structured framework for assessing self-care limitations, individualizing nursing interventions, preventing complications, and promoting improved patient outcomes.