ADL General Collection Information

The Activities of Daily Living (ADL) assesses a patient's capability to perform six daily self-care activities.

Collection Instructions

• The ADL assessment should reflect the amount of assistance a patient requires to perform the six activities. It takes into consideration acute medical issues that resulted in admission to the hospital.
• Using your best judgment based on age, diagnosis, pre hospital admission ADL, and #Where to get data below, select the option that best reflects their ADL status
• For ostomy care see ADL Toiletting and ADL Continence
• For use of mechanical aids see ADL Transfering

Timeframe

The ADL assessment (done by allied health or nurses) we utilize is the patient's state of activity on first Service tmp entry. When possible, use an ADL assessment done within 24 hours after the admission to the ward

Low functioning ADL due to condition that is expected to be temporary

If a patient is admitted with a diagnosis that is expected to improve to the point of higher functioning ADLs (and they possibly have improved already by the time collection happens), code the ADLs that are expected to be the long-term state.

Example:

A patient is admitted with Diabetic ketoacidosis (DKA) and is expected to improve with treatment to the point where they can manage their activities of daily living (ADLs) independently. Code the ADLs based on their anticipated long-term state of independent functioning, even if they are still experiencing limitations at the time of data collection.

Directed Restrictions

Directed restrictions on a patient's activities should not be assessed as requiring assistance. Code these based on what the patient would actually be capable of doing if they were permitted.

Example:

A patient comes in with a stroke. They can mobilize independently and go to the washroom. The patient is then ordered to be on bedrest after a procedure. If the patient would be able to perform the activity if allowed then they are to be assessed accordingly. So in this case they would would be coded as unassisted.

Where to get data

Data to evaluate ADL can be obtained from the following sources:

• OT/PT initial assessment
• Nursing activity flow sheets (if used)
• Nursing database or primary care patient record
• Integrated progress notes
• Risk assessment for falls form (if used)

Data Entry Instructions

For every Medicine profile, enter the status into the ADL dropdown boxes in the Patient Viewer Tab ADL in CCMDB.accdb.

Specific Activities collected

See the following for specific coding instructions for the different activities.

• ADL Bathing
• ADL Dressing
• ADL Toiletting
• ADL Transfering
• ADL Continence
• ADL Feeding

Data Use

• ADL Score
• ALERT Scale

References/Background

The evaluation tool used for all Medicine patients is the Katz ADL.

• S Katz et al. Studies of illness in the aged: the index of ADL. American Medical Association, 1963.
• S Katz, SD Downs, HR Cash, RC Grotz. Index of daily living. The Gerontologist 1:20-301.