Activities of Daily Living Flashcards
-ADL’s - scored by how much a patient can do at what level of assistance. Things we must do on daily basis
Katz ADL Scoring Scale
Six Criteria
No Help (1 point)
Unable to Perform or Needs Help (0 points)
Bathing with sponge, bath or shower
Eating
Dressing
Toilet Use
Transferring
Urine/Bowel Continence
Score = 6 - patient is independent and has full functional capabilities
Score = 4 - patient has moderate impairment and needs some assistance
Score = 2 - patient has severe impairment and requires much assistance
Instrumental Activities of daily Living
• Actions that are important to living independently but are not necessarily required activities on a daily basis
• Not as noticeable as ADL’s when it comes to loss of functioning, but functional ability for lADL’s is generally lost prior to ADL’s
• IADL’s include:
- Basic communication skills - such as using a phone, email, or the Internet
- Transportation - either by driving oneself, arranging rides, or the ability to use public transportation
- Meal preparation - meal planning, cooking, clean up, storage, and the ability to safely use kitchen equipment and utensils
- Shopping - the ability to make appropriate food and clothing purchase decisions
- Housework - doing laundry, washing dishes, dusting, vacuuming, and maintaining a hygienic place of residence
- Managing medications - taking accurate dosages at the appropriate times, managing re-fills, and avoiding conflicts
- Managing personal finances - operating within a budget, writing checks, paying bills, and avoiding scams
Tips for ADL
• Activities should be simplified
- planning work ahead
- alternate light and heavy work
- use good body mechanics and breath control
- Exhale on Exertion
- Perform activities slowly
- Spend 10 minutes/every hour just resting
- Minimize body movements
• Sitting down takes less energy than standing up
• Pulling takes less energy than lifting (cart)
• Have supplies within reach
Stair Climbing tips
• Stand at bottom of stairs and inhale a breath
• Exhale as going up the stairs
• Stop at end of each exhalation
• Take in another breath
• Exhale as going up more stairs
• Important to pace yourself
• May need to place a chair at the top of the stairs for rest
Smoking
• QUIT!!!
- Greatly reduces decline in respiratory function
• Many rehab programs will not accept smokers into the program unless they are actively participating in a smoking cessation program
• Don’t allow smokers to smoke in the house or car
Air Pollution
• Inside
- aerosol sprays (hair sprays, cleaners, bug sprays)
- toxic fumes (space heaters, wood/coal burners)
- chemical fumes (paint, cleaners)
• Outside
- heavy traffic (exhaust)
- smog
Climate
• Cold air - may induce bronchospasm, SOB, coughing-cover nose/mouth with scarf
• Decreased indoor humidity - nose and throat dryness
- 30-50% ideal humidity level
- small humidifiers need to be cleaned regularly to avoid growth of mold, fungus, bacteria
• Limit time outside when hot/humid
Travel and Vacation
.Consider:
- travel stress
- risk
- logistics of travel
- availability of needed equipment/supplies
- Keep medications with person
• Arrange for oxygen ahead of time:
- buses - most all are non-smoking now
- trains - no restrictions but may need advance notice
- planes - 24 hour notice for oxygen use
• some flights may be too long
• some patient who do not normally need oxygen may need on plane due to increased altitude
Infections
• Stay away from large gatherings or places where there are known sick people (especially during flu season)
• Get flu and pneumococcal immunizations
• Notify doctor if
- increase in amount, thickness, color of secretions
- presence of blood in sputum
- unusual increase in degree of dyspnea
- increase in ankle swelling
- increase malaise, fatigue, lack of energy
Sleep
• seven to eight hours per night
• frequent rest periods during the day
• tranquilizers or sleeping pills are not recommended - they may depress both respirations and cough
• may need to raise the head of the bed - especially if suffer from orthopnea
