Katz Index Of Independence In Activities Of Daily Living (Page 3 of 4) in pdf

general assessment series

Best Practices in Nursing

Care to Older Adults

From The Hartford Institute for Geriatric Nursing, New York University, College of Nursing

Issue Number 2, Revised 2007

Series Editor: Marie Boltz, PhD, GNP-BC

Series Co-Editor: Sherry A. Greenberg, MSN, GNP-BC

New York University College of Nursing

Katz Index of Independence in Activities of Daily Living (ADL)

By: Meredith Wallace, PhD, APRN, BC, Fairfield University School of Nursing, and Mary Shelkey, PhD,

ARNP, Virginia Mason Medical Center

WHY: Normal aging changes and health problems frequently show themselves as declines in the functional status of older adults. Decline

may place the older adult on a spiral of iatrogenesis leading to further health problems. One of the best ways to evaluate the health status

of older adults is through functional assessment which provides objective data that may indicate future decline or improvement in health

status, allowing the nurse to intervene appropriately.

BEST TOOL: The Katz Index of Independence in Activities of Daily Living, commonly referred to as the Katz ADL, is the most appropriate

instrument to assess functional status as a measurement of the client’s ability to perform activities of daily living independently. Clinicians

typically use the tool to detect problems in performing activities of daily living and to plan care accordingly. The Index ranks adequacy

of performance in the six functions of bathing, dressing, toileting, transferring, continence, and feeding. Clients are scored yes/no for

independence in each of the six functions. A score of 6 indicates full function, 4 indicates moderate impairment, and 2 or less indicates

severe functional impairment.

TARGET POPULATION: The instrument is most effectively used among older adults in a variety of care settings, when baseline

measurements, taken when the client is well, are compared to periodic or subsequent measures.

VALIDITY AND RELIABILITY: In the thirty-five years since the instrument has been developed, it has been modified and simplified and

different approaches to scoring have been used. However, it has consistently demonstrated its utility in evaluating functional status in the

elderly population. Although no formal reliability and validity reports could be found in the literature, the tool is used extensively as a flag

signaling functional capabilities of older adults in clinical and home environments.

STRENGTHS AND LIMITATIONS: The Katz ADL Index assesses basic activities of daily living. It does not assess more advanced activities

of daily living. Katz developed another scale for instrumental activities of daily living such as heavy housework, shopping, managing finances

and telephoning. Although the Katz ADL Index is sensitive to changes in declining health status, it is limited in its ability to measure small

increments of change seen in the rehabilitation of older adults. A full comprehensive geriatric assessment should follow when appropriate.

The Katz ADL Index is very useful in creating a common language about patient function for all practitioners involved in overall care

planning and discharge planning.

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