Activities of daily living
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Activities of daily living (ADLs), is a way to describe the functional status of a person. It is a tool in the biopsychosocial model of medicine, and is useful for assessing the elderly, the mentally ill, those with chronic diseases, and others.
This is seen to include a number of components, though these are not strict rules.
[edit] Basic ADL
Occupational therapists typically look at 11 categories of ADLs. These are the activities that are fundamental for self care. [1]
- Bathing/Showering
- Bowel and bladder management
- Dressing
- Eating
- Feeding
- Functional mobility
- Personal device care - Includes items like hearing aids, glasses, prosthetics, adaptive equipment, etc.
- Personal hygiene and grooming
- Sexual activity
- Sleep/Rest
- Toilet Hygiene
Many of the above are considered to be obvious. Physicians, nurses and occupational therapists are typically interested in the ability to: dress, eat, ambulate (walk), do toileting and take care of their own hygiene. These five tasks can be remembered with the mnemonic DEATH: dressing, eating, ambulating, toileting, hygiene.[2]
[edit] Ambulation
Refers to a person's ability to move around, including: walking (independently or with the assistance of another person or a piece of equipment, such as a cane, walker), wheeling a wheelchair, being able to get in and out of their bed, bathtub, vehicle, etc
[edit] Instrumental ADL
This includes activities not necessary for fundamental functioning, but still very useful in a community. Cooking, shopping, housework and transport are in this category.
Occupational therapists also look at IADLs when completing assessments. They include 11 areas of IADLs that are generally optional in nature, and can be delegated to others. These areas are:[1]
- Care of others (including selecting and supervising caregivers)
- Care of pets
- Child rearing
- Communication device use
- Community mobility
- Financial management
- Health management and maintenance
- Meal preparation and cleanup
- Safety procedures and emergency responses
- Shopping
There are systems (such as the Katz ADL scale) that seek to quantify these functions and obtain a numerical value. These systems are useful for the prioritising of care and resources.
Generally though, these should be seen as rough guidelines for the assessment of a patient's ability to care for themselves.
A simple assessment of the IADLs is frequently done by asking about the ability to do shopping, housekeeping, personal finances, food preparation, and get around (e.g. driving). These tasks can be remembered with the mnemonic SHAFT: shopping, housekeeping, accounting, food preparation, transportation.[2]
[edit] References
- ^ a b [No authors listed] Occupational Therapy Practice Framework: domain and process. Am J Occup Ther. 2002 Nov-Dec;56(6):609-39. PMID 12458855. Erratum in: Am J Occup Ther. 2003 Jan-Feb;57(1):115.
- ^ a b Onn ILY, Jin PCW. Assessment of the Elderly Patient. The Singapore Family Physician. 25(2). 1999. Available at: http://www.cfps.org.sg/sfp/25/252/articles/e252008.html. Accessed on: April 22, 2006.
