B.

Functional Assessment

1. Activities of Daily Living

- used as a measurement of a person’s functional status

- First proposed in 1950 by Sidney Katz, who developed the first evaluation tool called the Katz
ADL scale

- ADLs consist of Basic ADLs and Instrumental ADLs

- Basics ADLs are more essential for survival than IADLs

- Instrumental ADLs (IADLs) are not necessary for fundamental functioning, but they let an
individual live independently in a community

Basic Activities of Daily Living

- Activities of daily living (ADLs) are basic tasks that must be accomplished every day for an
individual to thrive. Generally, ADLs can be broken down into the following categories:

 Personal hygiene
Bathing, grooming, oral, nail and hair care
 Continence management
A person’s mental and physical ability to properly use the bathroom
 Dressing
A person’s ability to select and wear the proper clothes for different occasions
 Feeding
Whether a person can feed themselves or needs assistance
 Ambulating
The extent of a person’s ability to change from one position to the other and to walk
independently

Instrumental Activities of Daily living (IADLs)

Instrumental activities of daily living (IADLs) are somewhat more complex but nevertheless also reflect
on a person’s ability to live independently and thrive. IADLs thus include securing assistance for:

 Companionship and mental support

This is a fundamental and much needed IADL for daily living. It reflects on the help that may be
needed to keep a person in a positive frame of mind
 Transportation and shopping
How much a person can go around or procure their grocery and pharmacy needs without help
 Preparing meals
Planning and preparing the various aspects of meals, including shopping and storing groceries
 Managing a person’s household
Cleaning, tidying up, removing trash and clutter, and doing laundry and folding clothes
  Managing medications
How much help may be needed in getting prescriptions filled, keeping medications up to date and
taking meds on time and in the right dosages
 Communicating with others
Managing the household’s phones and mail and generally making the home hospitable and
welcoming for visitors
 Managing finances
How much assistance a person may need in managing bank balances and checkbooks and paying
bills on time

Katz Index of Independence in Activities of Daily Living (ADL)

WHY: Normal aging changes and health problems frequently show themselves as declines in the
functional status of older adults. Decline may place the older adult on a spiral of iatrogenesis leading to
further health problems. One of the best ways to evaluate the health status of older adults is through
functional assessment which provides objective data that may indicate future decline or improvement in
health status, allowing the nurse to intervene appropriately.

BEST TOOL: The Katz Index of Independence in Activities of Daily Living, commonly referred to as the
Katz ADL, is the most appropriate instrument to assess functional status as a measurement of the
client’s ability to perform activities of daily living independently. Clinicians typically use the tool to
detect problems in performing activities of daily living and to plan care accordingly. The Index ranks
adequacy of performance in the six functions of bathing, dressing, toileting, transferring, continence,
and feeding. Clients are scored yes/no for independence in each of the six functions. A score of 6
indicates full function, 4 indicates moderate impairment, and 2 or less indicates severe functional
impairment.

Bartel

Gordon