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Activities of Daily Living Checklist

Background led

This tool combines attributes from two well known tools (Katz Index and LAWTON - BRODY scale).   This tool evaluates all responses and provides a graphical output that points to either low functioning (dependent) or high functioning (independent).  For information on this topic, please review the following outstanding reference.

Key attributes (greater weight - 2 points each):

  1. Bathroom:  Able to bathe independently. May need assistance to clean hard to reach areas such as the back, otherwise no problems anticipated. Able to use the toilet without assistance.
    No   
    Yes
  2. Basic food preparation as well as the ability to eat from a plate. [Able to warm-up prepared food.  Adequate proficiency with eating utensils.]
    No   
    Yes
  3. Medications - able to maintain compliance with all prescribed medications without help from others.  [Medications may be delivered to the house e.g. it is not necessary for self pick-up from the local pharmacy.]
    No   
    Yes
  4. Getting dressed - no issues encountered. Able to manage all aspects including changing under garments, clothing, etc.
    No   
    Yes
  5. Finances -able to keep track of expenses and handle transactions from home including paying for outside services (shopping, lawn care, etc). This also includes the ability to
    use a telephone if necessary.
    No   
    Yes

Secondary functions - lower weighting (1 point each)

  1. Able to maintain the interior of the house (cleaning, laundry, etc).
    No   
    Yes
  2. Able to complete shopping tasks for basic necessities independently without assistance. May use a third-party for transportation.
    No   
    Yes
  3. Ability to travel - appointments, shopping, drug store, etc.  May use a third-party for transportation, however, does not require assistance entering or exiting vehicle.
    No   
    Yes


     

References

  1. Gallo, J.J., & Paveza, G.J. (2006). Activities of daily living and instrumental activities of daily living assessment. In J.J. Gallo, H.R. Bogner, T. Fulmer, & G.J. Paveza (Eds.), Handbook of Geriatric Assessment (4th ed., pp. 193-240). MA: Jones and Bartlett Publishers.
  2. Graf, C. (2006). Functional decline in hospitalized older adults. AJN, 106(1), 58-67.

  3. Katz, S., Down, T.D., Cash, H.R., & Grotz, R.C. (1970) Progress in the development of the index of ADL. The Gerontologist, 10(1), 20-30.

  4. Katz, S. (1983). Assessing self-maintenance: Activities of daily living, mobility and instrumental activities of daily living.

  5. Lawton, M.P., & Brody, E.M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist,9(3), 179-186.

Best practice information on care of older adults: www.ConsultGeriRN.org.


Activities of Daily Living Checklist

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