Daily Living Activities for Nursing Homes

The activities of daily living are a set of basic functions that people who are able to function independently perform on a day-to-day basis. Individuals who cannot perform enough of these daily activities may need to be placed in a nursing home to receive residential care. Nursing home employees and administrators closely monitor these activities to follow the progress of their patients and determine improvement or need for more intensive assistance. While activities of daily living are not restricted to the elderly--they apply in cases involving persons with varying levels of physical and mental disabilities--they are often used to assess deterioration of individual activity and self-sufficiency common with advanced aging.

Katz Activities of Daily Living Scale

• The Katz Activities of Daily Living Scale is the tool most often used to measure functional ability. The scale measures an individual's ability to perform or handle six basic tasks with little to no assistance: bathing (sponge bath, tub or shower), dressing, toileting, transferring (moving in and out of a chair or bed), feeding and continence. When being evaluated, individuals receive a one for every activity that they can carry out on their own. A score of six indicates full function, four is moderate impairment and two or less denotes severe impairment.

Instrumental Activities of Daily Living

• Because there is much more involved in living independently than those six Katz categories would suggest, Lawton and Brody's scale of Instrumental Activities of Daily Living (IADL) should also be used in determining the level of care for an individual. IADLs include more cognitively complex activities such as communicating by telephone, writing, or computer; doing laundry and other chores; managing self-care and daily drug regimens; managing finances; and driving. Assessing these tasks can be especially useful for families and caregivers in determining where an individual's overall level of functional ability.

Nursing Home Implications

• Using both the Katz Activities of Daily Living Scale and the scale of Instrumental Activities of Daily Living can help caregivers or family members determine the level of care that someone may need. Depending on how many basic and more complex activities a person can perform independently in their home, that individual may only need occasional family assistance or in-home nursing attention. However, if the person has difficulty performing a moderate amount of the more complex tasks outlined in the scale of Instrumental Activities of Daily Living, an assisted living or nursing home situation may be more appropriate.

  Even in a nursing home, there are variables to determine how much assistance a patient requires. For example, a patient may struggle with writing or using a telephone, but he may be perfectly capable in all areas of the Katz Activities of Daily Living and in handling daily drug routines. Once patients enter a nursing home, they should be evaluated for baseline functionality and then periodically monitored for changes to determine whether or not they are receiving the appropriate level of care.