The Katz ADL scale is sensitive to changes in declining health status, but its limitations include the limited in its ability to measure small elements of change seen in the rehabilitation of older adults. The Katz scale assesses the basic activities of daily living but does not assess more advanced activities of daily living. The most frequently used checklists are the Katz Index of Independence in Activities of Daily Living and the Lawton Instrumental Activities of Daily Living (IADL) Scale. Although there is some consensus among what ADLs should be included, there exists significant variability on how these questionnaires ask about ADL functions. Several checklists have been developed by various entities. They found that many hospitalized older people are discharged with ADL function that is worse than their baseline function.ĭefining the extent of loss of ADL and IADL is important to help define and ensure appropriate care support. performed a prospective observational study that evaluated the changes in ADL function occurring before and after hospital admission. reported that loss of ADL functioning over 1 year is independently associated with acute hospital admission for acute illness and cognitive impairment among frail older adults.
Hospitalization and acute illnesses have also been associated with a decline in ADLs. Other factors such as side effects of medications, social isolation, or the patient's home environment can influence the ability to perform ADLs. Social isolation can lead to impairment in instrumental activities of daily living. Severe cognitive fluctuations in dementia patients have a significant association with impaired engagement in activities of daily living that negatively affect the quality of life. A cognitive or mental decline can also lead to impaired ADL's. Musculoskeletal, neurological, circulatory, or sensory conditions can lead to decreased physical function leading to impairment in ADLs. Aging is a natural process that may present a decline in the functional status of patients and is a common cause of subsequent loss of ADLs. ĭecline or impairment in physical function arises from many conditions. The IADL differs from ADL as people often begin asking for outside assistance when these tasks become difficult to manage independently. Managing medications: Ability to obtain medications and taking them as directed. In 2011, the United States National Health Interview Survey determined that 20.7% of adults aged 85 or older, 7% of those aged 75 to 84, and 3.4% of those aged 65 to 74 needed help with ADLs. Chronic illnesses progress over time, resulting in a physical decline that may lead to a loss of ability to perform ADLs. Hospitalization for an acute or chronic illness may influence a person’s ability to meet personal goals and sustain independent living. Nurses are often the first to note when patients' functionality declines during hospitalization therefore, routine screening of ADLs is imperative, and nursing assessment of ADLs is performed on all hospitalized patients. The outcome of a treatment program can also be assessed by reviewing a patient’s ADLs. Measurement of an individual’s ADL is important as these are predictors of admission to nursing homes, need for alternative living arrangements, hospitalization, and use of paid home care. The inability to accomplish essential activities of daily living may lead to unsafe conditions and poor quality of life. The inability to perform ADLs results in the dependence of other individuals and/or mechanical devices. ĪDL is used as an indicator of a person’s functional status. The term activities of daily living was first coined by Sidney Katz in 1950. The activities of daily living (ADLs) is a term used to collectively describe fundamental skills required to independently care for oneself, such as eating, bathing, and mobility.
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