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
Health professionals, and especially occupational therapists[1] look at many Activities of Daily Living. These are the activities that are fundamental for self care. They are:
- Mobility
- Communication
- Breathing
- Bowel and bladder management
- Eating and drinking
- Personal cleansing and grooming
- Personal device care - Includes items like hearing aids, glasses, prosthetics, adaptive equipment, etc.
- Controlling body temperature
- Work and play
- Sexuality
- Sleeping
In certain circumstances (such as care of the elderly) Physicians, nurses, physical therapists, and occupational therapists are generally 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] 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
- Roper N., Logan W.W. & Tierney A.J. (1980). The Elements of Nursing. Churchill Livingstone. ISBN 0-443-01577-5.
- ^ a b [No authors listed] (Nov-Dec 2002) "Occupational Therapy Practice Framework: domain and process", Am J Occup Ther 56(6):609-39. PMID 12458855. Erratum in: (Jan-Feb 2003) Am J Occup Ther. 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.
