RoyÆs Nursing Model and Nursing Care of the AlzheimerÆs Patient
Sister Calista Roy described a model for nursing practice based on the concept of adaptation. The five major concepts of nursing elaborated in the model, according to Stein (2003), are: the person, the goal of nursing, nursing activities, health and the environment. Each concept is interrelated to the larger construct of adaptation, which views the persona as having available four specific adaptation modes: physiologic, self-concept, role function, and interdependence modes (Stein, 2003). This brief report will examine this nursing model and apply it to care of the patient with AlzheimerÆs Disease, a progressive, debilitating and chronic condition that imposes significant care burdens on family members and healthcare professionals while simultaneously limiting the capacity of the affected patient to cope with activities of daily living (ADL) (Newman, 1997).
The Roy model is, says Stein (2003), concerned with the internal and external environmental stimuli that affect the development and behavior of the person. The level of the individualÆs or personÆs adaptation is assessed clinically, and ways to remove the stimuli, to enhance, or to maintain adaptation are explored by the person and the nurse. The model positions the person as a bio-psycho-social being in constant interaction with a changing environment and possessed of the four adaptation modes listed above. As internal and external environment changes (i.e., stimuli) occur, the personÆs needs change, resulting in deficits and excesses. To protect physiologic, psychic and social integrity, the person adapts using coping mechanisms to restore need satisfaction (Stein, 2003).
Roy further described the person as having a zone surrounding his or her variable level of adaptation; stimuli falling within that zone result in a positive response or adaptation, while stimuli falling outside of this indiv...