For individuals who are not fully independent in performing Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs), determining the level of assistance required is crucial.
An ADL assessment is a tool used to evaluate a person’s cognitive and physical functioning in relation to their personal care and social activities. This assessment is typically conducted by an Occupational Therapist (OT) and can take place in the individual's home or a nursing home setting.
Common Areas Assessed
An ADL assessment generally covers:
- Personal care – hygiene and grooming
- Physical functions – feeding, dressing, toileting
- Functional mobility – access and transferring
- Community integration – participation in social and public activities
- Communication and social interaction – ability to engage with others
- Home establishment and maintenance – ability to manage daily household tasks
ADL Assessments
Some of the standardised tests used to assess ADLs include:
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Disability Assessment of Dementia (DAD) - Evaluates ADL performance in individuals with dementia.
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Barthel Index (BI) - Assesses 10 basic ADL activities to produce a score ranging from 0 (maximal disability) to 20 (maximal independence).
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Katz Index of Independence in ADLs - Assesses 8 ADL tasks, with each rated from 0 (unable) to 6 (maximal function).
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Functional Independence Measure (FIM) - Based on the Barthel Index, assessing 6 functional areas through 18 items: Motor-FIM (13 items) and Cognitive-FIM (5 items). Special training is required to administer the FIM properly.
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ADL Profile - Originally designed for traumatic brain injury patients, the ADL profile uses observation and interviews to assess function in personal, home, and community environments.
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Activities of Daily Living Questionnaire (ADLQ) - Designed for individuals with cognitive impairments. Assesses ADL function across 6 areas of life. Can be completed by the patient or their caregiver.
Conclusion
Assessing ADLs provides valuable insight into a person’s ability to manage daily life and helps in determining the appropriate level of care and support. By using standardised tools, healthcare professionals can develop personalised care plans to maintain independence and quality of life.