Unit 1: Collecting Information on ADLs and IADLs

Question 1

What are the 4 ways to collect information on a patient’s ADLs and IADLs?

Answer 1

1. Self-report
2. Performance - watch the person do the activity
3. Standardized tools facilitate the collection of reliable data (Katz and Barthels)
4. Assess for areas of difficulty and areas of independence (None, Partial, or total assistance)

Question 2

Use the ways to collect info on a patient’s ADLs and IADLs on a situation where your resident goes to the washroom (3)

Answer 2

1. Self-report - see if they can go to the bathroom
2. They can go but with the toilet raised - intervention
3. Difficulty sitting/standing

Question 3

The Katz and Barthel index measure ____ (ADLs/IADLs)

Answer 3

ADLs

Question 4

What is the katz index used for?

Answer 4

• measures the degree to which a person is independent, or requires assistance or is dependent in 6 self care activities
  table 13.2

Question 5

What is the Barthel Index used for? (3)

Answer 5

• more specific description of type of assistance required
• ex. can come to sitting position but needs help standing from siting position
• better tool for assessment in rehab (before vs after

Question 6

What is the functional independence Measure (FIM)? (4)

Answer 6

• measures mobility, cognition, social functioning and ADLs
• more comprehensive but requires training
• used for rehabilitation
• captures more areas of function, measures ADLs

Question 7

Where is minimum data set used, and when is it done?

Answer 7

• used in personal care homes and homecare in Manitoba
• completed 14 days after resident’s admission and quarterly and with changes in resident’s status

Question 8

When would you use the minimum data set? (2 examples, 2 points each)

Answer 8

transferring
- moving between surfaces
- ability to get up and down off the toilet

Dressing
- Extent of assistance required to dress and undress above the waist
- Extent of assistance required to dress and undress lower body

Question 9

How would you code the minimum data set? (3)

Answer 9

• independent
• set up assistance
• supervision
• limited assistance
• Extensive assistance(s), 1 person etc.
• total dependence, 1 person etc.

Question 10

Why do we really do the MDS? (2)

Answer 10

• info collected by government to make care plans
• figure out what people in PCH need

Question 11

What are some limitations to Standardized measures, like Katz and Barthel? (3)

Answer 11

1. how the info is collected
2. Does not always specify the specific limitation and therefore does not guide an appropriate intervention
3. Performance measure provide information on abilities to do ADLs and IADLs or address factors that need to be addressed

Question 12

Why is how information collected a limitation to using standardized measures? (2)

Answer 12

• is it from the patient, family, or through obeservation?
• observation is the best way to determine the actual ability (in acute or rehab this is a team approach, formalized by OT)

Question 13

What can cause changes in ADLs and IADLs? (3)

Answer 13

• can occur quickly and be related to a disease process (ie stroke)
• Can occur gradual related to chronic conditions (ie. osteoarthritis)
• Can be related to external situations that do not support optimal function (causing excess disability)

Question 14

What can cause changes in the ability to manage ADLs and IADLs?

Answer 14

• can be related to chronic conditions but vary depending on the extent of the disease and the opportunity to optimize function
  ex. parkinsons, strokes, arthritis, dementia, frailty

Question 15

What is frailty?

Answer 15

• a condition where the body has few reserves and any change can cause health problems

Question 16

How does one manage chronic conditions? (2)

Answer 16

• requires the person to learn to live with the condition
• episodes of illness or sudden signs and symptoms of disease can be exacerbated by a chronic condition or cause a new one

Question 17

Is having a chronic illness for older adults important?

Answer 17

• not as important as its effect on functioning

Question 18

What are 3 ways to distinguish changes in ADLs and IADLs? (5 points)

Answer 18

1. acute changes are a medical emergency
   - ie. not making it to bathroom, geriatric syndrome
2. Chronic changes occur in some disease processes
   - if there is progression, we can try to decrease rate of change
3. Changes also occur if there is less than optimal opportunity to optimize function