Lesson 8: Functional Assessment

Question 1

An evaluation of the person’s ability to carry
out the basic self-care activities of daily living
(ADLs), such as bathing, eating, grooming, and
toileting

Answer 1

Functional Assessment

Question 2

1. To identify and describe the client’s
   ability to perform ADLs
2. To indicate presence and severity of
   disease
3. To measure a person’s need for care

Answer 2

Purpose of FA

Question 3

1. Katz Index of Independence in ADL
2. Lawton Scale for Instrumental ADL
3. Barthel Index of Activities of Daily Living

Answer 3

Functional Assessment of an Adul

Question 4

A term used to collectively describe
fundamental skills that are required to
independently care for oneself such as
eating, bathing, and mobility.

Answer 4

Activities of Daily Living (ADL)

Question 5

skills required to manage
one’s basic physical needs including
personal hygiene or grooming, dressing,
toileting, transferring or ambulating, and
eating.

Answer 5

Basic ADL

Question 6

include more
complex activities that are related to the
ability to live independently in the
community.

e.g., managing finances and
medications, food preparation,
housekeeping, laundry.

Answer 6

Instrumental ADL

Question 7

Causes for Limitations in ADLs

Answer 7

1. Decline in physical function
2. Cognitive or mental decline
3. Social isolation
4. Side effects of medication
5. Social isolation
6. Patient’s home environment
7. Hospitalization
8. Acute illnesses

Question 8

thought to be the most appropriate
instrument to assess functional status as
a measurement of the client’s ability to
perform activities of daily living
independently.
● Nurses typically use this tool to detect
problems in performing ADL and to plan
care accordingly.
● The Index ranks adequacy of
performance in the six functions of
bathing, dressing, toileting, transferring,
continence, and feeding.
● Clients are scored yes/no for
independence in each of the six
functions. A score of 6 indicates full
function, 4 indicates moderate
impairment, and 2 or less indicates
severe functional impairment.

Answer 8

Katz Index of Independence in ADL

Question 9

It is a functional assessment tool that
focuses primarily on household chores,
mobility-related activities and cognitive
abilities, a person’s ability to perform
tasks such as using a telephone, doing
laundry, and handling finances.
● It can be administered in 10 to 15
minutes.
● The scale may provide an early warning
of functional decline or signal the need
for further assessment

Answer 9

Lawton Scale for Instrumental ADL

Question 10

A performance-based tool based on
assessing performance of ten ADLs.
● Assesses activities in two major
categories: Personal care and mobility.
○ The personal care items include
tasks such as drinking from a
cup, dressing, grooming, bathing,
and bowel and bladder
continence.
○ The mobility items include
wheelchair maneuvering, walking,
stairs, and transfers.
● Regarded by many as a precise and
reliable instrument to check whether the
patient is able to take care of their basic
needs or he needs help.
● Can be administered via
○ interview
○ observation of the patient’s
performance in a specific setting

Oftentimes used to evaluate clients with
the following conditions
○ Neurological disorders: stroke
○ Musculoskeletal disorders.
○ Neuromuscular disorders.
○ Oncology
○ Elderly individuals
● Scoring of the Barthel is done through
assignment of different values to
different activities.
○ Individuals are scored on 10/15
activities which are summed to
give a score of 0 (totally
dependent) to 100 (fully
independent).
○ The scores are designed to reflect
the amount of time and
assistance a patient requires.
○ However, the scoring method is
inconsistent in that changes by a
given number of points do not
reflect equivalent changes in
disability across different
activities.
● Several authors have proposed
guidelines for interpreting Barthel
scores.
○ Suggestion be Shah et al.
▪ 0-20 indicate “total”
dependency
▪ 21-60 indicate “severe”
dependency
▪ 61-90 indicate “moderate”
dependency
▪ 91-99 indicates “slight”
dependency
● The Barthel index score interpretation
helps to determine the patient’s degree
of independence and establish what
kind of help the examined patient
requires.
● An overall score is formed by adding
scores on each rating. Scores range
from 0 to 100, in steps of 5, with higher
scores indicating greater independence.
Items are weighted and include
instructions for assessing the time it
takes a subject to perform a task as a
dimension of ability.

Answer 10

Barthel Index of Activities of Daily Living