Tuesday, April 20, 2010

When it comes to scoring the Activities-of-Daily-Living (ADL) measurement tool used in Nursing Homes and Assisted Living Facilities,

When it comes to scoring the Activities-of-Daily-Living (ADL) measurement tool used in Nursing Homes and Assisted Living Facilities, those who perform them without human assistance are known as Independent.

They (Nurses, Doctors, Administrators, Coordinators who assess), score the test based on the daily experience and not the ability to do it one time. This is also turned into documentation-evidence that is used in future decision-making meetings used to discuss the progress of the Elderly resident and if they need more or less care which means more or less dollars coming out-of-pocket.

The decision-making and ADL meeting can be a difficult one to discuss without getting defensive, but if we can remember to focus on the client/family member, it may help a little. A person who refuses to perform a function is still considered independent-based on the daily experience of the Elderly person.

These ratings are narrowed down to just 6 letters. Which letter are we?

A. Independent to feeding, bathroom control, transferring (getting up-and-down) and independent to dressing and bathing.

B. Independent in all categories but one.

C. Independent in all but bathing and one.

D. Independent in all but bathing, dressing and one.

E. Independent in all but bathing, dressing, going to bathroom and one

F. Independent in all but bathing, dressing, going to bathroom, transferring and one

G. Dependent in all functions.

Friday, April 09, 2010

how to pass the activities of daily living pt 1

The absence of a clear measurement tool between general health and type of long-term care required, specialist have focused their efforts on developing such tools. The most approached method is measuring the Activities of Daily Living or ADL’s.
The Katz ADL method is the one nursing homes and assisted living facilities use to determine how much assistance is needed for your senior-loved one. The better the Elderly person does in using this method, the LESS expensive the cost. The assessment instrument and classification method is the best-known and studied.

A Katz evaluation form will look like a checklist that covers 6 catergories.

Bathing-Sponge Bath, Tub Bath or Shower (pick one)

-receives no assistance in getting in and out

-receives assistance in bathing only one part of body (like a back or leg)

-receives assistance in bathing more than one part or not bathed

Dressing, getting clothes from closet and drawers, putting on undergarments, outer garments and using fasteners AND body braces if used (pick one)

-gets clothes and gets completely dressed with no assistance

-gets clothes and gets dressed without assistance except for assistance in tying shoes

-receives assistance in getting clothes or in getting dressed or stays partly or completely undressed

Toileting, going to the bathroom (pick one)

-goes to the bathroom, cleans self and arranges clothes without assistance but may support (cane, walker, wheelchair, can empty commode in morning)

-receives assistance in going to the bathroom, or in cleansing self or arranging


-doesn’t go to the bathroom for the elimination process

Transferring (pick one)

-moves in and out of bed and chair without assistance (may use support like a cane, walker, wheelchair)

-moves in and out of chair, bed with assistance

-doesn’t get out of bed

Continence Level (pick one)

-Controls urination and bowel movement completely by self

-has occasional accident

-supervision helps keep urine or bowel control, or a catheter is used or incontinent

Feeding (pick one)

-Feeds self without assistance

-feeds self except for assistance in cutting meat or buttering bread

-receives assistance in feeding or fed partly or using tubes

Tomorrow, how they score each of the six categories to determine assistance needed.

Friday, April 02, 2010

Ted Hose, what are they?

Ted Hose, What are they?
Compression socks, are also called Ted Hose. If your family member has ever had swollen feet, ankles or legs due to edema (when water swells), Ted Hose are the answer.
Ted Hose come in different compression settings and can come in High, Med or Low compression. High compression means the sock or tights will come very, very tight and are a bit more difficult to put on, than a low compression. A physician may also prescribe the compression setting depending on the swelling as well as other factors.
Putting on compression socks:

1. Do not tear the skin of the Elderly person you are putting the Ted Hose on.

2. If they are able to, have the person lay down on their back and put their feet on the bed. It’s easier to put the Ted Hose on before dressing.

3. When putting on the Ted Hose, make sure the skin is dry to avoid moisture against the skin.

4. Completely stick your thumbs into the sock and spread the sock as much as you can. As you get ready to place the Ted Hose on the foot, make sure you concentrate on getting the toes into the Ted Hose first and make sure you are pulling the sock up while you make sure the skin isn’t folded when pulling up the sock.

The sock is never loose but is very, very tight. Sometimes it helps to roll the sock over the foot and then roll the stocking up the leg as it hugs the foot or leg.