1. INTRODUCTION TO SELF CARE ACTIVITIES
Activities of Daily Living
[ Lecture No. 08]

2. 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.

3. 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]

4. Basic ADL’s (BADL) Self-Care Mobility Communication
Management of Environmental Hardware and devices [Operating bolts of doors/windows, electrical switches etc.]
Sexual expression

5. Self-Care
Feeding
Grooming
Dressing
Bathing
Toileting

6. Mobility: moving from one place to another e. g
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)

7. Communication
Writing
Using a telephone
Using communication devices

8. 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]
Home Mgmt – Cooking and cleaning
Cmty Living Skills – Money Mgmt, shopping, using public transportation
Health Mgmt – Handling medications, knowing health risks, making appts
Safety Mgmt – Calling 911, identifying dangerous situations

9. Feeding Set-up Handling utensils and cups Chewing and swallowing
Do they have any problems with chewing and swallowing?
And if so, do they need supervision to make sure they do it as safely as possible?

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

11. 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]

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

13. Toileting
Perineal hygiene
Managing Clothing
Transfer not included

14. 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.

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

16. Assessing Performance
Functional Independence Measure (FIM)
Universal Standard
Multidisciplinary
Severity of Disability
Track Changes
Analyze Outcomes
Universal tool used across disciplines, across a wide range of facilities and tx programs

17. FIM Scores 7 Independent 6 Modified Independent 5 Supervision/Set-up
4 Minimal Assistance
3 Moderate Assistance
2 Maximal Assistance
1 Total Assistance

18. No Helper Required Independent Normal method, performance
Modified Independent
Equipment
Extended time
Saftey risk

19. Helper Required No physical contact required Supervision Set-up Cuing
Orthosis

20. Helper Required Physical Contact Required Patient does:
75-100% Minimal Assistance
50-74% Moderate Assistance
25-49% Maximal Assistance
0-24% Total Assistance

21. 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 Control
1. Bladder management
2. Bowel management

22. Mobility
1. Transfers: bed/chair/wheelchair
2. Transfers: toilet
3. Transfers: bathtub/shower
Locomotion
1. Locomotion: walking/wheelchair
2. Locomotion: stairs

23. Communication
1. Expression
2. Comprehension
Social Cognition
1. Social Interaction
2. Problem Solving
3. Memory

24. Other Assessment Tools
Barthel Index
Katz Index
Canadian Occupational Performance Measure & Many more……..

25. Self- care activities Skills for restoring Function Independence
Dignity