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Functional Assessment
- Plays a vital role in history taking- Central to assessment of
older persons and makes it different from assessment of younger
persons
- Measures the persons ability to perform self-care activities
and assume social roles inorder to determine the status of health
and well-being of the older person
- Involves the use of different tools such as: Gordons
Functional Health Pattern, BarthelIndex, Katz Index, Mini-Mental
State Examination, Geriatric Depression Scale
Four Dimensions of Functional Assessment
1. Physical health2. Functional status3. Psychological health4.
Social health
I. Physical Assessment- Numerous findings of physical
examination may be indicative of the health status- The examiner
must pay particular attention to the patient's general
appearance,
anthropometrics (height and weight), oral cavity, vision and
hearing, and upper extremity
mobility
- Cephalocaudal Assessment can be done- Common handicaps and
disabilities that must be reported during physical assessment:
a. Hearing impairmentb. Vision impairmentc. Limited ROMd. Speech
Difficultye. Memory Lossf. Acute Confusion
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II. Functional Status- Assess the ability to perform Activities
of Daily Living (ADLs)- Three levels of Activities of Daily
Living:
a. Physical ADL (basic)b. Instrumental ADL (intermediate)c.
Advance ADL
- Assessment Tool:a. Barthel Index- TheBarthel Index consists of
10 items that measure a person's daily
functioning specifically the activities of daily living and
mobility. The items include
feeding, moving from wheelchair to bed and return, grooming,
transferring to and
from a toilet, bathing, walking on level surface, going up and
down stairs, dressing,
continence of bowels and bladder.
b. Katz Index of ADL- a tool for assessing a patient's ability
to perform activities ofdaily living in the areas of bathing,
dressing, toileting, transferring, continence, and
feeding. In each category, a score of one indicates complete
independence in
performing the activity and zero indicates that assistance is
required, so that the total
score ranges from zero to six.
III.Psychological Function-
Assess the cognitive and affective status of the older adult-
Two most common Psychological Impairment:
a. Dementia- defined as significant decline in two or more areas
of cognitivefunctioning and is the most common cause of mental
decline among the elderly
b. Depression- one of the most common psychiatric problems;
often accompaniesAlzheimers Disease as well major illnesses such as
a recent stroke, CABG or
myocardial infarct
- Assessment tool:a. Folstein Mini-Mental State Examination
(MMSE)- a brief psychologic test designed
to differentiate among dementia, psychosis, and affective
disorders. It may include
ability to count backward by 7s from 100, to identify common
objects such as a
pencil and a watch, to write a sentence, to spell simple words
backward, and to
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demonstrate orientation by identifying the day, month, and year,
as well as town and
country.
b. Geriatric Depression Scale (GDS)- a brief depression
screening inventory composedof 30 items that require yes or no
answers. A score of 11 or above indicates depressed
individuals. There is a 15-item short version. Scores of 5 or
more may indicate
depression
IV.Social Function- Assess the older adults social network-
Social Networkthe web of relationship that the person has around
him or her, including
family, relatives and friends who give support in various
moments.
- Social Supportemotional, instrumental. or financial aid
obtained from the socialnetwork
