Katz ADL

Original Editor - Lucinda hampton Top Contributors - Lucinda hampton, Lauren Lopez and Kim Jackson

Top Contributors - Lucinda hampton, Lauren Lopez and Kim Jackson  

Objective

Elderly Woman.jpg

The purpose of the Index of ADL, or KATZ ADL, is to monitor the prognosis and treatment of older adults and chronically ill people[1]. In particular, the KATZ ADL measures a person's independence in common 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[2].

[3]

Intended Population

Older adults and individuals with chronic diseases.

Method of Use

The 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 five minutes to perform and requires training[4].

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: bathing, dressing, toileting, transferring, continence, and feeding. One point means the person is independent; zero points means the person requires supervision, direction, personal assistance or total care.

The following is referenced from McCabe[2].

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

Validity

Construct Validity

Scores on the Katz ADL Index are correlated with scores on the Barthel Index[2].

Predictive Validity

There is an indication the KATZ may have a predictive quality in regards to living situation and mortality[5], as well as stroke prognosis[6].

Turkish[7] and Spanish[8] versions have been translated and assessed for validity.

Responsiveness

The KATZ has a significant floor effect, i.e. it is unable to detect change at low levels of disability[9].

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.

References

  1. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of Illness in the Aged: The Index of ADL: A Standardized Measure of Biological and Psychosocial Function. JAMA. 1963;185(12):914–919. 
  2. 2.0 2.1 2.2 McCabe D. Katz Index of Independence in Activities of Daily Living (ADL). Best Practices in Nursing Care to Older Adults. 2019. 2. Accessed 24 June 2019.
  3. Describing occupation. Katz ADL. Available from: https://www.youtube.com/watch?v=ekwu49fH5QM (last accessed 5.5.2019)
  4. Katz P. Measures of Adult General Functional Status. Arthritis Care Res (Hoboken). 2003. 49; 5S: S15–S27. Accessed 24 June 2019.
  5. Brorsson B, Asberg KH.Katz index of independence in ADL. Reliability and validity in short-term care. Scand J Rehabil Med. 1984;16(3):125-32.
  6. Asberg KH, Nydevik I. Early prognosis of stroke outcome by means of Katz Index of activities of daily living. Scand J Rehabil Med. 1991;23(4):187-91.
  7. Arika G, Varana, HD, Yavuza BB, Karabulutb E, Karaa O, Kilica MK. Validation of Katz index of independence in activities of daily living in Turkish older adults. Arch Gerontol Geriatr. 2015. 61: 344–350. Accessed 24 June 2019.
  8. Cabañero-Martínez MJ, Cabrero-García J, Richart-Martínez M, Muñoz-Mendoza CL. The Spanish versions of the Barthel index (BI) and the Katz index (KI) of activities of daily living (ADL): a structured review. Arch Gerontol Geriatr. 2009 Jul-Aug;49(1):e77-84. doi: 10.1016/j.archger.2008.09.006. Epub 2008 Nov 5.
  9. McDowell I, Newell C. Measuring health: a guide to rating scales and questionnaires. 2nd Ed. New York: Oxford University Press; 1996. p. 63–7. Accessed 24 June 2019.