Assisting in ADLs encompasses support provided in accordance with medical treatment protocols (refer to the section “Assistance during examination and treatment: Nurse’s role”), as well as duties outlined for nurses and associate nurses as specified in Articles 5 and 6 of the Act on Public Health Nurses, Midwives, and Nurses. According to this legislation, a nurse is defined as follows: “An individual licensed by the Minister of Health, Labour and Welfare who engages in assisting individuals in their daily living activities or medical treatment, particularly for those who are injured, ill, or postpartum.”

Assistance in ADLs involves aiding patients undergoing treatment with routine tasks such as eating, toileting, dressing, maintaining personal hygiene, mobility, engaging in activities, rest, and environmental upkeep while monitoring their condition. Such assistance is administered based on the clinical judgment of the nurse and aims to promote patient independence amidst limitations or restrictions on daily activities. Unlike medical assistance, which necessitates directives from a physician, assistance in ADLs typically does not require such instructions under administrative interpretation. Nonetheless, adherence to the treatment plan is paramount, and the nurse may consult with a physician for decisions or modifications regarding dietary adjustments, bed rest, hygiene protocols, and other such matters. Nurses are entrusted with the responsibility of determining whether consultation with a physician is necessary to ensure the provision of the most suitable assistance in ADLs for the patient. This necessitates sound judgment and application of medical knowledge concerning pathological conditions and treatments.

• Act on Public Health Nurses, Midwives, and Nurses 60 Year History Compilation Committee (Ed.). (2009). Act on public health nurses, midwives, and nurses 60-year history: History of nursing administration and development of nursing. Japan Nursing Association Press.
• Tamura, Y. (2008). Act on public health nurses, midwives, and nurses. Japanese Nursing Association Publishing.