What Are Activities of Daily Living?

Activity of Daily Living (ADL) refers to the necessary activities performed by a person in order to meet the needs of daily life, including eating, dressing, washing, bathing, toileting, dressing, etc. Functional movement includes turning over, moving from Sitting on the bed, transferring, walking, driving a wheelchair, going up and down stairs, etc.

Assessment of daily living ability

Assessment of daily living ability

All patients requiring occupational therapy are eligible for daily activity assessment.

awareness

1. Equipment prepare Barthel index scale. The scale stipulates that ADL inspection items are designed and systematically classified. The completion of each activity is quantified and expressed as a score. The scale is tested for reliability, validity, and sensitivity. Its unified and standardized inspection and scoring methods allow the evaluation results to be compared between different patients, different therapies, and different medical institutions.

2. Explain the purpose and examination method to the patient before the examination, in order to fully obtain the cooperation of the patient.

1.Barthel index assessment

The Barthel index can not only be used to evaluate the functional status before and after treatment, but also to predict the treatment effect, length of stay and prognosis.

The Barthel index includes 10 items, which are divided into four functional levels of 0, 5, 10, and 15 based on whether they need help and the degree of help, with a total score of 100 points. The higher the score, the stronger the independence and the smaller the dependency.

If the patient fails to meet the criteria specified in the project, a score of 0 is given. A score of 60 or higher indicates that patients can basically take care of themselves. People with a score of 60 to 40 need help. People with a score of 40 to 20 need a lot of help. People with a score below 20 need help. Those with a Barthel index of 40 or above had the greatest benefit in rehabilitation.

2. Functional independence measurement

Functional Independence Measurement (FIM) is more detailed, accurate and sensitive than Barthel Index in the way to reflect the level of disability or the amount of help needed, and it is a powerful indicator for analyzing and judging the efficacy of rehabilitation. FIM assesses not only ADL dysfunction due to motor impairment, but also the impact of cognitive dysfunction on daily life.

FIM includes 6 aspects, a total of 18 items, including 13 sports ADL and 5 cognitive ADL.

The score is based on a 7-point scale, that is, the highest score for each item is 7 points, and the lowest score is 1 point. The highest total score is 126 points; the lowest is 18 points. The score is based on the degree of patient independence, the need for assistive devices or assistive devices, and the amount of help given by others.

1. When applying FIM for evaluation, the evaluator should first clarify the content of each activity and the action points of the evaluation. Only by following the unique content defined by each activity for evaluation can the results be objective and accurate. .

2. Pay attention to observing the actual operation ability of the patient during the assessment, and not rely on their dictation alone.

3. When evaluating ADL for people with a disability, do not assess what they should be able to do or what they might be able to do under certain conditions. What has been examined should be the current actual state.

4. When a patient can complete an activity with the help of the patient, the method and amount of help should be recorded in detail. The assessment should take place at the appropriate time and place. Occupational therapists should usually go to the ward in the morning to observe patients' various self-care activities such as dressing, washing, shaving, or makeup, in order to be realistic. If the occupational therapy department has an ADL assessment setting, it must be as close to the actual living environment as possible. To avoid misunderstanding due to fatigue, the assessment can be completed in several times if necessary, but should be performed at the same location.

5. The purpose of re-assessing ADL is to observe the efficacy, test the treatment method, provide the basis for timely adjustment of the treatment plan, and judge the prognosis. Therefore, reassessment should be scheduled at the end of a session and before discharge. New dysfunctions should be assessed at any time.

6. For items that cannot be completed independently, the therapist needs to further check the factors that affect the completion of these activities, such as joint mobility, muscle strength, balance, coordination, feeling, etc. ADL activity level is closely related to cognitive function. Therefore, for patients with ADL disorders, cognitive and perceptual functions should be further evaluated.

Because the application of FIM assessment methods requires special training, the content of FIM assessment is not specifically described.