INTRODUCTION TO SELF CARE ACTIVITIES Activities of Daily

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

Activities of Daily living(ADL) n 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 n Basic ADL (BADL): It is typically restricted to activities involving functional mobility and personal care. n 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) n n n Self-Care Mobility Communication Management of Environmental Hardware and devices [Operating bolts of doors/windows, electrical switches etc. ] Sexual expression

Self-Care Feeding n Grooming n Dressing n Bathing n Toileting n

Mobility: moving from one place to another e. g. , inside the house(indoor mobility) and movement in community(outdoor mobility) Bed Mobility n Wheelchair Mobility n Transfers (movement from one surface to n another like bed to wheel chair or wheel chair to commode) n Ambulation (passive transfer from one surface or one place to another)

Communication Writing n Using a telephone n Using communication devices n

Instrumental ADL’s (I-ADL) n Home Management [cooking, cleaning up] n Community Living Skills [money management, shopping, using public transport] n Health Management [ Handling medications, knowing health risks, making appointments] n Safety Management [Calling at emergency nos. , identifying dangerous situations]

Feeding Set-up n Handling utensils and cups n Chewing and swallowing n

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

Dressing Retrieving Clothing n Dressing/Undressing n Donning/Duffing [ Shoes/Socks] n Prosthesis or Orthosis[ prosthesis is the n mechanical replacement of lost body part and orthosis is the mechanical device to support weak body parts or to enhance function]

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

Toileting Perineal hygiene n Managing Clothing n Transfer not included n

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 n Equipment Needs n Intervention n Patient and Family Training n Recommendations n

Assessing Performance Functional Independence Measure (FIM) n Universal Standard n Multidisciplinary n Severity of Disability n Track Changes n Analyze Outcomes

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

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

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

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

Items of assessment FIM consists of 18 items organized under six categories: n Self Care n 1. Eating n 2. Grooming n 3. Bathing n 4. Dressing upper body n 5. Dressing lower body n 6. Toileting Sphincter Control 1. Bladder management 2. Bowel management n

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

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

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

Self- care activities n Skills for restoring Function Independence Dignity