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.
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 allowing the nurse to intervene appropriately.
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