The valuation of ADL (Activities Daily Living) is based only on the analysis provided by the patient or on the actual evaluation of the activities performed during the day by the elderly?
Thanks for your answer and explanation about the evaluation of ADL in elderly.
Caro Michele,
la valutazione delle ADL storicamente si basa su quanto dichiarato dal paziente e/o dal caregiver/familiare.
Nello storico lavoro di Katz, il NON VOLER fare una determinata attività equivaleva ad IMPOSSIBILITA a farla......
Una visita appena attenta consente al medico di valutare se ciò che il paziente dice e vero o no . Sai - poi - bene che esistono alcune scale valutative per "smascherare" il paziente che per vari motivi (risarcito in primis....) volesse dichiarare il ....falso. Non occorre osservare il paziente durante la sua intera giornata.....
Le ADL nascono in ambito riabilitativo . In ámbito medico-legale la loro "passiva" applicazione genera mostri.....
Un caro saluto.
C.M.
Hi Michele,
I am a Geriatric Nurse Specialist that works in the community providing comprehensive nursing assessments.
My main role is to assess a patients ability to perform ADL's in a safe manner. Shower assessments, tea and toast tests etc. OT will be internally referred to if there is a specific cognitive/equipment/aide requirement that goes beyond the scope of my role.
There is a bit of a grey line between a community nurse and an OT in ADL assessments.
From our assessments, referrals are made to community health service providers and the Aged Care Assessment teams for provision of services to assist with the specific tasks of need.
Not sure if that was the answer that you were after but I hope it helps
hi dear Michele Sammicheli
I think that barthel index is a good test for you but I believe it is better we see person's in their context and check their daily activities.
I am completely agree with Sajjad.
All the articles are good, all the evaluation scales are useful.....but elderly patient must be visited.
From my point of view, this prospective is not always present in the forensic evaluation (often based on the lecture of scripts of other collegues such as neurologists or geriatricians....).
Article Il riconoscimento dell’indennità di accompagnamento al pazie...
The medicolegal evaluation is inextricably linked to a accurate medical examination. This happens both in the evaluation of the "invalidità civile" and also in the disability evaluation according to the law 222/1984 ("invalidità previdenziale").
Neurological, physiatric or psychiatric specialistic medical reports are only used to support the medicolegal evaluation made in the course of medical examination.
In the case of the evaluation of blindness, professional medical reports and instrumental medical reports became fundamentals for the final medicolegal evaluation.
The medical examination is important especially in establish the so called "indennità di accompagnamento", i.e. the inability of the patient to walk without unaided or to carry out daiily Activities of live (ADL).
The Katz Index can be used as a Measure of Activities of Daily Living (ADL). The index has been described as a valid and reliable measure to determine independency level in performing activities of daily living [1]. The assessment is based on the ability to perform an activity without assistance from another person. The Katz Index of ADL includes six basic activities of daily living (BADL): bathing, dressing, toileting, transferring, continence, and feeding. The ability in performing each activity is assessed using a two-point categorical scale: 1= independence and 0 = dependence. The total score ranged from 0 (low function, dependent) to 6 (high function, independent).
1. Brorsson B, Asberg KH. Katz index of independence in ADL. Reliability and validity in short-term care. Scand J Rehabil Med. 1984;16(3):125-32.
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