Impaired ADL/IADL
Carole K. H. Bartoo
Changes in a patient’s daily self-care or independent living activities are important indicators of functional decline. Well-tested screening tools have been in use for 50 years:
1.Activities of daily living (ADLs): The Katz Index of Independence in ADLs ranks adequacy of performance in six functions:
a.Bathing.
b.Dressing.
c.Toileting.
d.Transferring.
e.Continence.
f.Feeding.
A score of 6 indicates full function, 4 indicates moderate impairment, and 2 or less indicates severe functional impairment. Typically, the early loss of function is in the areas involved with hygiene, the mid-loss functions are toilet use and locomotion, and the late loss function is eating. See an example of the Katz ADL here (http://consultgeri.org/try-this/general-assessment/issue-2).
2.Instrumental activities of daily living (IADLs) are not necessary for fundamental functioning, but they let an individual live independently in a community; they include cleaning and maintaining the house, managing money, moving within the community, and preparing meals:
a.Lawton IADL Scale (http://consultgeri.org/try-this/general-assessment/issue-23).