basic activities of daily living

basic activities of daily living (bADL, Katz)

Basic daily activities such as eating, grooming, toileting, bathing, ambulating & dressing. The ADL score [3,4] is an index of independence based on: 1) bathing 2) dressing 3) toileting 4) transfers 5) continence 6) feeding 1 point for each; maximum of 6 points. Functions assessed: basic self care Range or sensitivity: 1) limited to basic activities 2) not sensitive to small changes Administration: 1) by patient or interviewer 2) based on judgements Advantages: 1) simple assessment of basic skills 2) useful for rehabilitation setting Disadvantages: 1) limited range of activities assessed 2) ratings subjective Procedure: (evaluation) 1) bathing - 1: receives no assistance* or receives assistance in bathing only 1 part of the body - 0: needs assistance bathing 2) dressing - 1: gets clothes & fasteners & gets completely dressed without assistance (exception is for assistance tying shoes) - 0: needs assistance dressing 3) toileting - 1: uses toilet, cleans self, arranges clothes without assistance (may use object for support such as cane, walker, wheel chair & may manage night time commode or bedpan, emptying same morning) - 0: needs assistance toileting, cleansing, arranging clothes or managing night time commode or bedpan 4) transfers - 1: moves in & out of bed & chair without assistance (may use object for support, i.e. cane or walker) - 0: needs assistance moving in &/or out of bed or chair 5) continence - 1: controls urine & bowel movement - 0: incontinence (bowel or bladder, occasional or frequent) has urinary catheter, or requires supervision to control bowel or bladder incontinence 6) feeding - 1: feeds self without assistance (exception is cutting meat or buttering bread) - 0: needs/receives assistance eating * assistance means supervision, direction or direct assistance Management: (tools for activities of daily living) 1) bathing a) handheld shower hoses b) bath seats & benches c) long-handed scrubbers d) grab bars 2) dressing a) button hooks b) velcro closures c) sock donners d) clothes e) hooks 3) toileting a) raised toilet seats b) arm attachments c) grab bars 4) transfers a) side rails b) sliding boards c) trapeze bars 5) continence 6) feeding a) large handle utensils b) rocker knives c) plate guards d) plate holders e) hand braces 7) ambulation a) cane b) walker c) special shoes d) wheel chair Allowing demented patients to participate in their ADL, accompanied by functionally-based exercises, performed during ADL, diminishes rate in decline of ADL [5]

General

activities of daily living (ADL)

References

nlmpubs.nlm.nih.gov/hstat/ahcpr/
Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 390, 408
Sepulveda VA GRECC assessment guidelines
Katz et al, The Gerontologist, 10:20-30, Spring 1970, part I
Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
Brummel-Smith K In Cassel C 2003

Contents

Search