NURSING JOURNAL

Student’s Name: Carissa Mae T. Estrada Date: July 31, 2022

Year/Block/Group: 3BSN-13
Clinical Instructor: Maria Cecilita C. Lusung, R.N. and
Amelita Delos Santos Dumaguin, R.N.
OLD AGE

The health of the elderly will be an important issue defining the health status of a population. With the
rise in aged population, there is a greater need to look into their physical disability aspects, which is
otherwise neglected. 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. Aging reduces
older adults’ physical and cognitive capacities and further affects their basic activities of daily living
(ADL). Long-term clinical surveillance of older adults’ functional independence in ADL has become
necessary in community-based elderly care. Several reliable assessment scales have been developed for
monitoring functional changes over time.

The Barthel Index of Independence in Activities of Daily Living 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 instrument is most effectively used among older adults in a variety of
care settings, when baseline measurements, taken when the client is well, are compared to periodic or
subsequent measures.

References: Katz index of independence in activities of daily living. (n.d.). Retrieved July 31, 2022, from
https://www.alz.org/careplanning/downloads/katz-adl.pdf

REFLECTION:

The Barthel Index is of the most widely used measurements that provide useful information regarding a
patient’s functional ability. Scales are simple to use, comprehensive, require little resources and can be
scored by nurses. Choosing a scale for assessing ADL is difficult, nonetheless users must decide exactly
what is the purpose of the measurement taking into consideration the individual, the process to be
assessed, the interval between assessments, their medical condition and the clinician who applies the
instrument. The user must decide, in short, on the appropriate balance between the detail and accuracy
required in applying the measurement and the method of collecting and interpreting the scale. It is
essential to administer the index objectively so that referrals to therapists can be generated and/ or that
clinically relevant improvements are detected. Accurately scoring the indices allows nurses to estimate
specific functional problems enabling appropriate planning of health needs and correct resource
allocation. Nurses should be familiar with the strengths, weaknesses and precision of assessment scales
to understand how best to use the scale as adjunct to clinical practice. Further challenges lie in
improving the quality of both the measurement instruments and performance of actual measurements,
especially in relation to formal research.