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) occupational therapy assessments to use in order 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 OT assessments will be best for your patients.
What Assessments are Used in Occupational Therapy?
There are hundreds of occupational therapy assessment tools OTPs can use in their practice to determine their patient’s baseline data. These vary depending on what information you are trying to attain. Some are disease specific, focusing on body function, occupational, ADL, IADL, leisure and everything in between!
Choosing the appropriate BADL geriatric assessment 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 and it helps you write more client centered and objective goals (check out the ebook: Occupational Therapy Goal Writing, Objective Measures + Goals Bank (for adults!) for more details on how to use occupational therapy assessments to write amazing goals! 
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So Which Geriatric Occupational Therapy Assessments Should You Choose When Determining Basic Activities of Daily Living?
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 therapy assessments for adults that focus on BADLS, so you can use in the adult and geriatric rehab settings focusing on:
- Bathing and showering
- Personal hygiene and grooming (including brushing/combing/styling hair)
- Dressing
- Toilet hygiene (getting to the toilet, cleaning oneself, and getting back up)
- Functional mobility, often referred to as “transferring”, as measured by the ability to walk, get in and out of bed, and get into and out of a chair; the broader definition (moving from one place to another while performing activities) is useful for people with different physical abilities who are still able to get around independently
- Self-feeding
1. The Barthel Index
The Barthel Index is one of the most common occupational therapy assessments 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. It measures feeding, bathing, grooming, dressing, bowel function, bladder function, toilet use, bed to chair transfers, functional mobility and stairs.
2. The Modified Barthel Index
This assessment measures the same domains as the Barthel Index, but with 0-20 as a score versus 0-100.
The Barthel/Modified Barthel Index are my personal assessments of choice in my part time position working with geriatrics in the ALF. It was probably the easiest BADL assessment for me to learn as a student as well.
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3. The Katz Index of Independence in Activities of Daily Living (aka Katz ADL)
The Katz ADL is another one of the most commonly used basic ADL occupational therapy assessments 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.
Here is a great demonstration of what this assessment looks like:
4. The Routine Task Inventory (RTI)
This is one of the common ADL assessments 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 Global Deterioration Index!
Occupational Therapy Assessments Honorable Mention
5. The Kohlman Evaluation of Living Skills (KELS)
I also really like the KELS assessment, 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 assessment 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.
And there you have the top BADL occupational therapy assessments for OT working in the adult and geriatric settings! I hope this post gave you a good idea of where to start when choosing one of the many BADL occupational therapy assessments. Each occupational therapy assessment tools listed here can be used at evaluation, during a visit, for a progress notes or at discharge to measure your patient’s improvements with self-care tasks.
Do you have any other favorite occupational therapy assessments for ADLs that 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 where she another great article on acute care assessment.
