Katz ADL

Original Editor - Lucinda hampton Top Contributors - Lucinda hampton and Kim Jackson

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Top Contributors - Lucinda hampton and Kim Jackson  

Objective

Elderly Woman.jpg

Purpose. Measure independence in activities of daily living (ADL).

Age-related changes and health problems frequently show themselves as declines in the functional status of older adults. This decline often places the older adult on a downwards health spiral. An effective way to evaluate the health status of older adults is through their functional ability. An objective assessment which provides objective data helps indicate decline or improvement in health status, allowing the physiotherapist to plan and intervene appropriately[1]

[2]

Intended Population

Older adults and individuals with chronic diseases.

Method of Use

The Katz Index of Independence in Activities of Daily Living (Katz ADL), is an appropriate tool to assess functional status when measuring the client’s ability to perform activities of daily living independently. It takes less than 5 minutes to perform and requires no training.

Physiotherapists use the tool when assessing function and detect problems in performing ADL and formulate a plan care. The Index ranks adequacy of performance in six functions of bathing, dressing, toileting, transferring, continence, and feeding. 1 point is independent, 0 points is with supervision, direction, personal assistance or total care

BATHING

Points: __________

(1 POINT) Bathes self completely or

needs help in bathing only a single part

of the body such as the back, genital

area or disabled extremity.

(0 POINTS) Need help with

bathing more than one part of the

body, getting in or out of the tub or

shower. Requires total bathing

DRESSING

Points: __________

(1 POINT) Get clothes from closets

and drawers and puts on clothes and

outer garments complete with fasteners.

May have help tying shoes.

(0 POINTS) Needs help with

dressing self or needs to be

completely dressed.

TOILETING

Points: __________

(1 POINT) Goes to toilet, gets on and

off, arranges clothes, cleans genital area

without help.

(0 POINTS) Needs help

transferring to the toilet, cleaning

self or uses bedpan or commode.

TRANSFERRING

Points: __________

(1 POINT) Moves in and out of bed or

chair unassisted. Mechanical transfer

aids are acceptable

(0 POINTS) Needs help in moving

from bed to chair or requires a

complete transfer.

CONTINENCE

Points: __________

(1 POINT) Exercises complete self

control over urination and defecation.

(0 POINTS) Is partially or totally

incontinent of bowel or bladder

FEEDING

Points: __________

(1 POINT) Gets food from plate into

mouth without help. Preparation of food

may be done by another person.

(0 POINTS) Needs partial or total

help with feeding or requires

parenteral feeding.

TOTAL POINTS: ________ SCORING: 6 = High (patient independent) 0 = Low (patient very dependent)

Evidence

Reliability

The interrater reliability is 0.95 or better after training (1,4). The coefficient of reproducibility, (a measure of the internal consistency of an ordered measure), is 0.96 – 0.99

Validity

The Katz tool was originally developed in the late 1950s and has consistently demonstrated its utility in evaluating functional status in the elderly population.It is used extensively as a flag signalling functional capabilities of older adults in clinical and home environments.[1]

Construct validity. Scores on the Katz ADL Index are correlated with scores on the Barthel index (r  0.78, kappa  0.77).

Predictive validity. Correlation with mobility dysfunction (0.50) and house confinement (0.39) among older adult patients 2 years later.

[3]

Responsiveness

Sensitivity/responsiveness to change. This scale has a significant floor effect, in that it is relatively insensitive to variations at low levels of disability[3]

This occurs as it does not assess more advanced activities of daily living and it is limited in its ability to measure small increments of change seen in the rehabilitation of older adults. A comprehensive geriatric assessment should follow when appropriate. The Katz ADL Index is very useful in that is in a simple form all involved in a care plan can interpret.[1]

References

  1. 1.0 1.1 1.2 Donna McCabe, DNP, APRN-BC, GNP. Katz Index of Independence in Activities of Daily Living (ADL). Best Practices in Nursing Care to Older Adults. Issue Number 2, Revised 2019. Available from: https://consultgeri.org/try-this/general-assessment/issue-2.pdf (last accessed 5.5.2019)
  2. Describing occupation. Katz ADL. Available from: https://www.youtube.com/watch?v=ekwu49fH5QM (last accessed 5.5.2019)
  3. 3.0 3.1 Arthritis & Rheumatism (Arthritis Care & Research) Vol. 49, No. 5S, October 15, 2003, pp S15–S27 DOI 10.1002/art.11415 © 2003, American College of Rheumatology Measures of Adult general function. Available from: https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.11415 (last accessed 5.5.2019)