Activities of daily living
Activities of daily living (ADLs),are "the things we normally do in daily living including any daily activity we perform for self-care (such as feeding ourselves, bathing, dressing, grooming), work, homemaking, and leisure." [1]
Health professionals routinely refer to the ability or inability to perform ADLs as a measurement of the functional status of a person. [2] This measurement is useful for assessing the elderly, the mentally ill, those with chronic diseases, and others, in order to evaluate what type of health care services an individual may need. There are many tools to use for evaluation, such as the Katz ADL scale, and the Lawton IADL scale.
Most models of health care service use ADL evaluations in their practice, including the Medical(or Institutional) Models--including the Roper-Logan-Tierney model of nursing-- and Resident-Centered models--including the Program of All-Inclusive Care for the Elderly (PACE).
In the US, most medical insurance policies will not cover assistance with performing ADLs, whereas such assistance is often covered by policies specific to Long-term care.
Basic ADLs
The basic activities of daily living consist of these self-care tasks that are fundamental and crucial to self care.
The Katz scale defines these ADLs as: [3]
The ability to
- bathe
- dress (and undress)
- eat
- transfer from bed or chair, and back
- maintain continence and/or use the toilet
In the US, the Center for Medicare and Medicaid Services (CMS) also uses these five activities as the basis for their services. [4]
In the UK, Barthel's index [5] uses these ADLs for a basis of evaluation:
- Bowel Status
- Bladder Status
- Grooming
- Toilet Use
- Feeding
- Transfer
- Mobility
- Dressing
- Stairs
- Bathing
Instrumental ADLs
Instrumental Activities of Daily Living are not necessary for fundamental functioning, but enable the individual to live independently within a community. They are: light housework, preparing meals, taking medications, shopping for groceries or clothes, using the telephone, and managing money)[6]
Occupational therapists also look at IADLs when completing assessments. They include 11 areas of IADLs that are generally optional in nature, and can be delegated to others. These areas are:[7]
- Care of others (including selecting and supervising caregivers)
- Care of pets
- Child rearing
- Communication device use
- Community mobility
- Financial management
- Health management and maintenance
- Meal preparation and cleanup
- Safety procedures and emergency responses
- Shopping
References
- ↑ MedicineNet.com Medical Dictionary
- ↑ "Activities of Daily Living Evaluation." Encyclopedia of Nursing & Allied Health. Ed. Kristine Krapp. Gale Group, Inc., 2002. eNotes.com. 2006.Enotes Nursing EncyclopediaAccessed on: 11 Oct, 2007
- ↑ McDowell, I., and Newell, C. (1996). Measuring Health: A Guide to Rating Scales and Questionnaires, 2nd edition. New York: Oxford University Press
- ↑ CMS User's ManualAppendix A Last Accessed: October 12, 2007
- ↑ Barthel's Index of ADLsLast Accessed on Oct. 12, 2007
- ↑ Bookman, A., Harrington, M., Pass, L., & Reisner, E. (2007). Family Caregiver Handbook. Cambridge, MA: Massachusetts Institute of Technology.
- ↑ Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 56, 609-637