Jun 16, 2015 - 03:37 PM
You asked a really awesome question, thank you!
The ADL Scale is a blanket term for an assessment that measures the amount of assistance that someone requires to manage their "Activities of Daily Living" (hence the acronym). There are several versions which measure common activities. Some scales are simplified to "needs assistance" or "independent", while others qualify the amount of assistance required for each task. If you are doing some Google research, you will likely run across the Katz, Barthel or Waisman scales.
The common tasks include:
You may use this as a loose guideline for determining whether someone requires more assistance, but it is not an end-all solution. Most assisted living communities use an expanded version of the scale as an assessment tool to plan for a resident's care needs.
I prefer the Waisman scales (if I'm not using the in-house assessment we use at The Fremont) because it covers a more logical breakdown of the tasks that become more difficult as seniors age, even though it is proposed as a guide for youth. You can find it here: http://www.waisman.wisc.edu/family/WADL/W-ADL.pdf. I don't think they are too difficult to fill out accurately, so long as you take the appropriate amount of time to observe the senior.
Again, this is an early guide for clarifying the level of independence of any given person. In terms of engaging the services of an assisted living or home health agency, I would go case-by-case based on the senior's unique circumstances. When I am talking with a family, I always include transportation and medication management to the list of ADL questions.
Oct 13, 2015 - 08:14 AM
Katz Index of Independence in Activities of Daily Living
INDEPENDENCE - NO supervision, direction or personal assistance: (1 POINT)
· (1 POINT) Bathes self completely or needs help in bathing only a single part of the body such as the back, genital area or disabled extremity.
· (1 POINT) Gets clothes from closets and drawers and puts on clothes and outer garments complete with fasteners. May have help tying shoes.
· (1 POINT) Goes to toilet, gets on and off, arranges clothes, cleans genital area without help.
· (1 POINT) Moves in and out of bed or chair unassisted. Mechanical transferring aides are acceptable.
· (1 POINT) Exercises complete self-control over urination and defecation.
· (1 POINT) Gets food from plate into mouth without help. Preparation of food may be done by another person.
DEPENDENCE - WITH supervision, direction, personal assistance or total care: (0 POINTS)
· (0 POINTS) Needs help with bathing more than one part of the body, getting in or out of the tub or shower. Requires total bathing.
· (0 POINTS) Needs help with dressing self or needs to be completely dressed.
· (0 POINTS) Needs help transferring to the toilet, cleaning self or uses bedpan or commode.
· (0 POINTS) Is partially or totally incontinent of bowel or bladder.
· (0 POINTS) Needs partial or total help with feeding or requires parenteral feeding.
TOTAL POINTS = ______ 6 = High (patient independent) 0 = Low (patient very dependent)