5 BADL assessments for #OTs. Number 2 is my personal favorite. PLUS free PDF to print them all of + use tomorrow | SeniorsFlourish.com #geriatricOT

5 Top BADL Geriatric Assessments for Occupational Therapists

Mandy Chamberlain MOTR/L Education & Tips for Independent Living 11 Comments

When you’re a student or new occupational therapist practicing on your own, it can be hard to decide which Basic Activities of Daily Living (BADL) geriatric assessment tool to use to track your patient’s self-care progress. There are so many to choose from, so it can be overwhelming trying to comb Google trying to figure out which assessments will be best for your patients.

Choosing the appropriate BADL geriatric evaluation is important to show that our treatments are objective and measurable (how many times have you heard that in school?). This shows the payers (like Medicare and other health insurance companies) that the individual is benefiting from your OT services as evidenced by their progress.

So which geriatric assessment tool should you choose?5 BADL assessments for #OTs. Number 2 is my personal favorite. PLUS free PDF to print them all of + use tomorrow | SeniorsFlourish.com #geriatricOT

There are quite a few and it can be a little overwhelming if you have to pick one yourself. In order to make your choices a little easier, this post will highlight the top occupational therapyBADL assessments you can use in the adult and geriatric rehab settings.

<< Click Here to Download All 5 BADL Assessments  >>

1. The FIM, formerly known as the Functional Independence Measure

The FIM is widely used in pretty much all acute inpatient rehab facilities and acute care units among all disciplines (OT, PT, SLP, and nursing) with different domains for each discipline. The objective of the Occupational Therapy portion of the FIM is to measure your patient’s burden of care with self care and functional mobility at evaluation, during weekly progress notes, and at discharge.

The OT portion of the FIM consists of grooming, feeding, upper body dressing, lower body dressing, bathing, toileting, toilet transfers and shower/tub transfers.

The FIM scores range from 1-7, from dependent (1) to independent (7). The in between ranges include maximal assist (2) , moderate assist (3), minimal assist/contact guard assist (which are the same number for some reason) (4), standby assist (5) and modified independent (6).

The scoring can get pretty detailed based on how much of each task the patient can complete. Because of this, many settings require training before you begin using it. If this is the case, training will be provided on the job if the FIM is required for each patient.

Once you get the hang of the FIM, you can use it in pretty much any rehab setting if your facility accepts it. It’s definitely a must to review before any hospital fieldwork in the adult setting and really is a great measurement due to the detail.

2. The Barthel Index/Modified Barthel Index

This is also a very commonly used self-care assessment in the adult and geriatric settings and is very easy to administer and score. It can be used in hospital settings as well as subacute settings. The Barthel Index measures feeding, bathing, grooming, dressing, bowel function, bladder function, toilet use, bed to chair transfers, functional mobility and stairs.

The Modified Barthel Index measures the same domains, but with 0-20 as a score versus 0-100.

The Barthel/Modified Barthel are my personal assessments of choice in my part time position working with geriatrics in the ALF setting since our system is not set up for using the FIM. It was probably the easiest BADL assessment for me to learn as a student as well.

5 BADL assessments for #OTs. Number 2 is my personal favorite. PLUS free PDF to print them all of + use tomorrow | SeniorsFlourish.com #geriatricOT3. The Katz Index of Independence in Activities of Daily Living (aka Katz ADL)

The Katz ADL is another commonly used basic ADL assessment designed for older adults. This assessment measures the individual’s ability performing feeding, bathing, dressing, toileting, transfers, and continence. It may be one of the easiest assessments to score, since the patient either gets a 1 for Independent or 0 for “Very Dependent.” The scores only will range from 0-6.

While it’s super easy to score, it may not be the most detailed assessment if you’re looking for levels of assist, since patients have more range than just independent or very dependent.

4. The Routine Task Inventory (RTI)

This is an ADL assessment used based on Allen’s model of cognitive disabilities. It’s designed for adults and older adults with cognitive impairments. Along with BADLs (grooming, dressing, walking, feeding, and toileting), the RTI also has separate measurements for instrumental ADLs, communication, and work readiness if you choose to assess these components as well.

To score the assessment, you as the OT can either observe the patient’s performance, or use self-report of the patient or caregiver. Scores given range from 1-6 and the assessment states the scores can model the FIM numbers, 6 equally 6-7 on the FIM (yet another reason to learn the FIM!)

Honorable Mention

5. The Kohlman Evaluation of Living Skills (KELS)

I also really like the KELS, but did not add it to the actual list as you do have to purchase it versus locating it freely online. If your facility will reimburse you for purchasing it, I do recommend adding it to your assessment repertoire. It can be purchased through Amazon here.

The KELS was updated in 2016, and updated the bill paying segment (optional online banking) and the safety photos. It covers 17 basic living skills, which not only covers your standard self care BADLs, but also IADLs like money management, home safety, transportation and work/leisure activities.

It was designed for pretty much every adult setting, from skilled nursing facilities to acute care hospitals. If your facility already owns a copy, it will be great to try out as an additional assessment.

<< Click Here to Download All 5 BADL Assessments  >>

And there you have the top BADL assessments for occupational therapists working in the adult and geriatric settings! I hope this post gave you a good idea of where to start when choosing a BADL assessment. Each assessment listed here can be used at evaluation, progress notes, and at discharge to measure your patient’s improvements with self-care tasks.

Do you have any other favorite BADL assessments you incorporate into your practice or fieldwork?

Guest post written by Sarah Stromsdorfer, OTR/L. She is an occupational therapist working in the adult inpatient rehab and geriatric settings. She is also the creator of the occupational therapy website, MyOTSpot.com.

 

 

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Comments 11

  1. Hi Mandy,

    Do you know where I can find a free PDF of the self care assessment tool, the “AM-PAC: Daily Activity “? Thank you! Ann

  2. The 6 Click ADL short form. Used here in our hospital and we use it in skilled rehab also. Not only gives you and easy scoring form but them tells you a % Of functional impairment that the score corresponds to. You can then redo at discharge to show improvement or use it in overall goal setting.

    1. I have heard the 6 Click ADL short form is good! I do know that the facilities have to purchase the test, but gives some really valuable and helpful information. Thanks for the insight Sharon!

  3. Hi Mandy
    Is using the Modified Barthel Index in any setting considered ‘commercial use’ ?
    In that case is permission required to use it with my patients?
    Thanks

    1. Copyright for the Barthel (modified) is: The Maryland State Medical Society holds the copyright for the Barthel Index. It may be used freely for noncommercial purposes with the following citation:
      Mahoney FI, Barthel D. “Functional evaluation: the Barthel Index.”
      Maryland State Med Journal 1965;14:56-61. Used with permission.
      Permission is required to modify the Barthel Index or to use it for commercial purposes

      As far as I know, you are not using for commercial purposes and as long as it is cited correctly on the form, you can use it, BUT I am also not a lawyer. might have to dig around a bit on this

  4. Another assessment is called the AM-PAC (activity measure post acute care). The shortest form for self-care can be a nice option because it is brief but actually gives you more options than barthel. It gives “dependent” , “a lot”, “a little” or “none”.

    1. Great addition to the list Ashley! I have used this one as well, I guess the only disadvantage is the facility has to pay for it’s use. It is quick and easy with lots of good info.

  5. The KELS was recently updated and is available from AOTA for $99 for members:
    Kohlman Evaluation of Living Skills (KELS), 4th Edition

    By Linda Kohlman Thomson, MOT, OTR, OT(C), CAPS, FAOTA, and Regi Robnett, PhD, OTR/L

    This new edition of the classic assessment determines the ability to function in basic living skills. Easily administered and appropriate for use with many populations and in many settings, this versatile assessment assists in identifying areas in which a person can perform and where he or she needs assistance.

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