ADL General Collection Information

General Considerations

• ADL - assess functional status during the first 24 hours after the patient has been "accepted" to medicine service by a medicine service attending physician.
• If dependancy of an ADL is induced solely by medical intervention, estimate the ADL without intervention.
• ADL assesses a patient "capability" to perform a certain activity if allowed. Patients who are ordered not to do a certain activity should not be assessed as requiring assistance. If patient would be able to perform the activity if allowed then they are to be assessed as "unassisted"
• If the patient is surgical take the ADL prior to surgery. This information is from Fran Lindell who gets the renal transplants.

Discussion

where to get the data

This information can be obtained from a variety of sources in the first 24 hours depending on the timing and details documented.For example:

• OT/PT intial assessment
• nursing activity flow sheets if used
• Nursing data base or Primary patient care record
• Integrated progress notes
• risk assessment for falls form if used

which of several values to use

• We have addressed that status during first 24 hrs is what should be collected. Should it really be worst status during the first 24 hrs?Template:Discussion
  • most likely accurate in other location

Reference

• Studies of Illness in the Aged: The Index of ADL; a standardized measure of ...ological and Psychological functioning. by Katz S, et al.. Copyright 1963 by the American Medical Association. Reprinted with permission of AMA via the Copyright Clearance Center.

• S Katz, TD Downs, HR Cash, RC Grotz, (1970). Index of Activities of Daily Living, The Gerontologist, 1:20-301.

Discussion

ADL Unassisted Minor Major ADL Bathing Receives no assistance Needs assistance with only one part of body (such as back or leg). Needs assistance with more than one part of the body. ADL Continence Controls urination and BM’s completely by self. If has foley used solely for fluid output issues. Home foley: manages on his own. Has occasional incontinence Needs supervision to maintain urine or bowel control or is incontinent. Foley if used for incontinence. ADL Feeding Feeds self without assistance. Feeds self except for assistance with ie cutting meat, buttering bread. Pt requires feeding partly or completely. Also for tube feeds, TPN and dysphagic pts. ADL Toileting Independent in going to toilet room. Able to clean self, etc. May need aids like cane or wheelchair. Needs some assistance like help with cleaning self or with arranging clothing after elimination, but can go to the toilet room Does not go to the washroom for elimination. Needs commode or bed pan. ADL Transferring Can move in and out of bed and in and out of chair without assistance. May use cane or walker. Needs some assistance to get in and out of bed and in and out of chair. Does not get out of bed.