basic activities of daily living (bADL, Katz)

Introduction

Basic daily activities such as eating, grooming, toileting, bathing, ambulating & dressing.

The ADL score is an index of independence based on:

• bathing
• dressing
• toileting
• transfers
• continence
• feeding

1 point for each; maximum of 6 points.

Functions assessed: basic self care

Range or sensitivity:

• limited to basic activities
• not sensitive to small changes

Administration:

• by patient or interviewer
• based on judgements

Advantages

• simple assessment of basic skills
• useful for rehabilitation setting

Disadvantages

• limited range of activities assessed
• ratings subjective

Procedure

(evaluation)

• bathing
  • 1: receives no assistance* or receives assistance in bathing only 1 part of the body
  • 0: needs assistance bathing
• dressing
  • 1: gets clothes & fasteners & gets completely dressed without assistance (exception is for assistance tying shoes)
  • 0: needs assistance dressing
• 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
• 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
• 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
• 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)

• bathing
  • handheld shower hoses
  • bath seats & benches
  • long-handed scrubbers
  • grab bars
• dressing
  • button hooks
  • velcro closures
  • sock donners
  • clothes
  • hooks
• toileting
  • raised toilet seats
  • arm attachments
  • grab bars
• transfers
  • side rails
  • sliding boards
  • trapeze bars
• continence
• feeding
  • large handle utensils
  • rocker knives
  • plate guards
  • plate holders
  • hand braces
• ambulation
  • cane
  • walker
  • special shoes
  • wheel chair

Allowing demented patients to participate in their ADL, accompanied by functionally-based exercises, performed during ADL, diminishes rate in decline of ADL

More general terms

• activities of daily living (ADL)

Additional terms

• instrumental (intermediate) activities of daily living (iADL, Katz)