INTRODUCTION TO SELF CARE ACTIVITIES

Activities of Daily Living

[ Lecture No. 08]

Activities of Daily living(ADL)

Introduction Activities of Daily Living (ADL) is

used in rehabilitation as an umbrella term relating to self care, comprising those activities or tasks that people undertake routinely in their every day life.

Categorization of ADL

Basic ADL (BADL): It is typically restricted to activities involving functional mobility and personal care.

Instrumental ADL (IADL): instrumental activities of daily living functions are concerned with a person's ability to cope with her/his environment.[domestic and community activities]

Basic ADL’s (BADL) Self-Care Mobility Communication Management of Environmental

Hardware and devices [Operating bolts of doors/windows, electrical switches etc.]

Sexual expression

Self-Care Feeding Grooming Dressing Bathing Toileting

Mobility: moving from one place to another e.g., inside the house(indoor mobility) and movement in community(outdoor mobility)

Bed Mobility Wheelchair Mobility Transfers (movement from one surface to

another like bed to wheel chair or wheel chair to commode)

Ambulation (passive transfer from one surface or one place to another)

Communication Writing Using a telephone Using communication devices

Instrumental ADL’s (I-ADL) Home Management [cooking, cleaning up]

Community Living Skills [money management, shopping, using public transport]

Health Management [ Handling medications, knowing health risks, making appointments]

Safety Management [Calling at emergency nos., identifying dangerous situations]

Feeding Set-up Handling utensils and cups Chewing and swallowing

Grooming & Hygiene Oral Care Brushing the hair Washing the face Washing the hands (Shaving, makeup)

Dressing Retrieving Clothing Dressing/Undressing Donning/Duffing [ Shoes/Socks] Prosthesis or Orthosis[ prosthesis is the

mechanical replacement of lost body part and orthosis is the mechanical device to support

weak body parts or to enhance function]

Bathing Washing & Drying Excludes neck, back Managing Clothes Transfer not included

Toileting Perineal hygiene Managing Clothing Transfer not included

Occupational Therapy and Activities of Daily Living

Occupational therapists work with persons, groups and organizations that are experiencing difficulties in performing the occupations of life (i.e. self-care, work voluntary activities, play, and leisure). Therefore a large component of occupational therapy practice is to provide interventions to overcome ADL and IADL deficits.

Role of Occupational Therapy Assess Performance Equipment Needs Intervention Patient and Family Training Recommendations

Assessing Performance

Functional Independence Measure (FIM)

Universal Standard Multidisciplinary Severity of Disability Track Changes Analyze Outcomes

FIM Scores

7 Independent6 Modified Independent5 Supervision/Set-up4 Minimal Assistance3 Moderate Assistance2 Maximal Assistance1 Total Assistance

No Helper Required

Independent Normal method, performance

Modified Independent Equipment Extended time Saftey risk

Helper Required No physical contact required

SupervisionSet-upCuingOrthosis

Helper Required Physical Contact Required

Patient does:75-100% Minimal Assistance50-74% Moderate Assistance25-49% Maximal Assistance0-24% Total Assistance

Items of assessment

FIM consists of 18 items organized under six categories: Self Care 1. Eating 2. Grooming 3. Bathing 4. Dressing upper body 5. Dressing lower body 6. Toileting

Sphincter Control1. Bladder management2. Bowel management

Mobility1. Transfers: bed/chair/wheelchair2. Transfers: toilet3. Transfers: bathtub/shower

Locomotion1. Locomotion: walking/wheelchair2. Locomotion: stairs

Communication1. Expression2. Comprehension

Social Cognition1. Social Interaction2. Problem Solving3. Memory

Other Assessment Tools

Barthel Index

Katz Index

Canadian Occupational Performance Measure & Many more……..

Self- care activities

Skills for restoring Function Independence Dignity