Assessing Activities of Daily Living- Mobility

Today we are going to again cover activities of daily living. Why? Because I have been blogging about a geriatric assessment and we are now covering a functional assessment. This is the second part of a geriatric assessment, with the first part a psychosocial assessment, which you can review in former blogs.

The term Activities of Daily Living was coined in 1949 by Edith Buchwald in Physical Therapy Review

In 1950 Katz and colleagues came up with scale in Cleveland at Benjamin Rose Hospital and designed Katz scale

Designed 6 indexes

v Feeding- late loss

v Continence- late loss

v Transferring- late loss

v Toileting early loss

v Dressing –early loss

v Bathing – early loss

Today we are covering mobility

q As a geriatric care manager, you are looking for

q Gait

q Balance

q Ability to transfer

q Joint function

Early detection of mobility problems and assistive devices, rehab prevent falls

Tips for GCM Administering test

Ø Observation- watch him/her walk, get up out of chair, listen to talking for clarity cognitive problem (not making sense)

Ø Ask caregiver or family member to confirm if cognitively impaired

Ø Reframe question say “ Did you drive here” instead of “ Are you still driving?”

Ø 30% of older adults living at home fall each year- makes them at risk for nursing home placement

Ø Ask them to get you a drink of water (you can watch them get out of chair and walk)

Ø Balance

Ø Observe the older person sitting balance, transfer from supine to sitting, and sit to chair sit to stand

Ø Pivoting

Ø If in bed watch transfer from one surface to another

Ø If they fall they can’t be safe at home without care or assistive device (cane)

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Ø Shoulder Function

Ø Ask client if they have shoulder pain

Ø Ask them to lift and rotate each arm

Ø If can’t lift can’t put on clothes etc

Ø Hand function

Ø As the client to two of the GCM’s fingers – measure grasp

Ø Ask client to pick up small object like toothbrush, penny, and spoon- measuring dexterity

Ø If can’ pick up toothbrush or spoon can’t eat or do personal care

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Ø 1-5 older adults have a gait disorder, which is an excellent reason to administer the activities of daily living test.

Ø More on this tomorrow