Saint Louis University

School of Nursing
Level IV

“Katz Index of Independence in Activities of Daily

Living and Lawton - Brody
Instrumental Activities of Daily Living Scale”

Submitted by:
BALANAY, Sonia Marie L.
PALOD, Christine C.

Submitted to:
Sir Raymund Mamayson
Patient Name:
Patient ID #
M.M Date: 2/17/19
Katz Index of Independence in Activities of Daily Living
Activities Independence Dependence
Points (1 or 0) (1 Point) (0 Points)

NO supervision, direction or personal WITH supervision, direction,

assistance. personal assistance or total care.

BATHING (1 POINT) Bathes self completely or (0 POINTS) Need help with

Points: 1 needs help in bathing only a single part

of the body such as the back, genital
area or disabled extremity.
bathing more than one part of the
body, getting in or out of the tub or
shower. Requires total bathing

DRESSING (1 POINT) Get clothes from closets (0 POINTS) Needs help with
and drawers and puts on clothes and dressing self or needs to be

Points: 1 outer garments complete with fasteners.

May have help tying shoes.
completely dressed.

TOILETING (1 POINT) Goes to toilet, gets on and (0 POINTS) Needs help

Points: 1 off, arranges clothes, cleans genital area

without help.
transferring to the toilet, cleaning
self or uses bedpan or commode.

TRANSFERRING (1 POINT) Moves in and out of bed or (0 POINTS) Needs help in moving

Points: 1 chair unassisted. Mechanical transfer

aids are acceptable
from bed to chair or requires a
complete transfer.

CONTINENCE (1 POINT) Exercises complete self (0 POINTS) Is partially or totally

control over urination and defecation. incontinent of bowel or bladder
Points: 1
FEEDING (1 POINT) Gets food from plate into (0 POINTS) Needs partial or total

Points: 1 mouth without help. Preparation of food

may be done by another person.
help with feeding or requires
parenteral feeding.

TOTAL POINTS: 6/6 SCORING: 6 = High (patient independent) 0 = Low (patient very dependent

Source:
try this: Best Practices in Nursing Care to Older Adults, The Hartford Institute for Geriatric Nursing, New York University, College of
Nursing, www.hartfordign.org.
Patient Name:
Patient ID #
M.M Date: 2/17/19
LAWTON - BRODY
INSTRUMENTAL ACTIVITIES OF DAILY LIVING SCALE (I.A.D.L.)

Scoring: For each category, circle the item description that most closely resembles the client’s highest functional
level (either 0 or 1).

A. Ability to Use Telephone E. Laundry

1. Operates telephone on own initiative-looks 1 1. Does personal laundry completely 1
up and dials numbers, etc. 2. Launders small items-rinses stockings, etc. 1
2. Dials a few well-known numbers 1 3. All laundry must be done by others 0
3. Answers telephone but does not dial 1
4. Does not use telephone at all 0
B. Shopping F. Mode of Transportation
1. Takes care of all shopping needs 1 1. Travels independently on public transportation or 1
independently drives own car
2. Shops independently for small purchases 0 2. Arranges own travel via taxi, but does not 1
3. Needs to be accompanied on any shopping 0 otherwise use public transportation
trip 3. Travels on public transportation when 1
4. Completely unable to shop 0 accompanied by another
4. Travel limited to taxi or automobile with 0
assistance of another
5. Does not travel at all 0
C. Food Preparation G. Responsibility for Own Medications
1. Plans, prepares and serves adequate meals 1 1. Is responsible for taking medication in correct 1
independently dosages at correct time
2. Prepares adequate meals if supplied with 0 2. Takes responsibility if medication is prepared in 0
ingredients advance in separate dosage
3. Heats, serves and prepares meals, or 0 3. Is not capable of dispensing own medication 0
prepares meals, or prepares meals but does
not maintain adequate diet
4. Needs to have meals prepared and served 0
D. Housekeeping H. Ability to Handle Finances
1. Maintains house alone or with occasional 1 1. Manages financial matters independently 1
assistance (e.g. "heavy work domestic help") (budgets, writes checks, pays rent, bills, goes to
2. Performs light daily tasks such as dish 1 bank), collects and keeps track of income
washing, bed making 2. Manages day-to-day purchases, but needs help 1
3.Performs light daily tasks but cannot 1 with banking, major purchases, etc.
maintain acceptable level of cleanliness 3. Incapable of handling money 0
4. Needs help with all home maintenance 1
tasks
5. Does not participate in any housekeeping 0
tasks

Score 4 Score 4
Total score_8/8
A summary score ranges from 0 (low function, dependent) to 8 (high function, independent) for women
and 0 through 5 for men to avoid potential gender bias.
Source: try this: Best Practices in Nursing Care to Older Adults, The Hartford Institute for Geriatric Nursing,
New York University, College of Nursing, www.hartfordign.org.
REFLECTION:

Within the community of Pito, Bokod, we found a client within the range from 65 years
old and older that would suffice the age range necessary to conduct a gerontology assessment
involving Kutz and Lawton’s scale of performing activities of daily living. In this case, my partner
and I decided to assess one of our family designated to us in the community M.M. in accordance
to Data Privacy Act of 2012, RA 10173. She is an independent 70 year-old female diagnosed with
hypertension since 2006. Despite her condition of being hypertensive in which she complies
regularly with her daily maintenance medications, she is able to perform daily activities
independent without assistance such as basic self-care involving bathing, toileting, dressing, urine
and bowel continence, transferring, and feeding. Also, furthermore with advanced doings such as
marketing, housekeeping, cooking, cleaning, financial handling, and the ability to walk to go to
the small convenience store in the area for condiments and other foods. Nevertheless, she is able
to do productive activities such as joining social groups including Bible study and church-affiliated
events.
In accordance to assessing the ability to perform activities of daily living, my partner and
I utilized two geriatric assessment tools including Lawton-Brody Instrumental Activities of Daily
Living Scale and Katz Index of Independence in Activities of Daily Living. The informant my
partner and I interviewed in terms of accomplishing the assessments was the client herself. She
was conversant and cognitively fit for the interview as evidenced by her responses being aligned
and appropriate to queries provided. In addition, observation, history taking, and physical
assessment were done to verify the concerns of the client as well as the appropriateness of
response.

Utilizing the Lawton-Brody Instrumental Activities of Daily Living Scale, there were eight
categories that were assessed in resemblance to the client’s highest functional level that includes
the ability to use telephone, shopping, food preparation, housekeeping, laundry, mode of
transportation, responsibility of own medications, and ability to handle finance. Within the
category of ability to use a telephone, the client is able to dial a few well-known numbers, which
is scored as 1. In comparison to current state and previous state, the client still has an intact
cognitive function in terms of ability to use a telephone and dial with a normal rate, well-
coordinated, and steady finger dexterity. As for shopping, the client is able to take care of shopping
needs independently, which is scored as 1. In comparison to previous state and current state, the
client still has a well-balanced coordination and cognitive functioning to remember the items she
have to purchase with the use of a shopping list as a reminder as well as the ability to carry the
groceries independently unless the items are heavy that she requires company nowadays. As for
food preparation, the client is able to plan, prepare, and serve adequate meals independently, which
is scored as 1. In comparison to previous and current state, the client still has an intact memory
with no obvious deterioration of ability to perform tasks such as cooking since she usually cooks
for the family in a daily basis. As for housekeeping, the client maintains house alone such as
dishwashing, bed making, cleaning, and sweeping, or with occasional assistance in rigorous, heavy
loads such as washing clothes and carrying a bucket of water or other heavy items. As for laundry,
the client does personal laundry independently, which is scored as 1. In comparison to previous
state from current state, the client complains of being easily fatigued and sometimes with back
pain from squatting for too long unlike previous years. As for mode of transportation, the client is
able to travel through vehicles and other transportations with the company of another family
member, which is scored as 1. In comparison to previous state from current state, the client
verbalizes that she does not usually travel through transportations such as buses or taxis as much
as she used to since the travel to the highway may trigger other physical problems that she fear of
in relation to her age and her hypertensive condition. As for responsibility for own medications,
the client is responsible of preparing and taking daily medications in correct dosages and correct
time, which is scored as 1. In comparison to previous state from current state, the client is still
cognitively capable of preparing and taking own medications without any assistance same as
before. Lastly, as for the ability to handle finances, the client is capable of managing financial
matters independently such as taxes, bills, budgets, and bank accounts with minimal assistance or
guidance from her husband, which is scored as 1. In comparison to previous state from current
state, the client is still cognitively capable of computing expenses and paying bills on time monthly
same as before.
To conclude, the client has a high functional level with a summary score of 8/8, which
classifies her as independent despite her hypertensive condition that minimally affects her capacity
of performing activities of daily living. With this data, the perspective of older adults having
physical and cognitive deterioration that may leads to self-care deficits is not implicated by the
client since the client proves that despite age with is categorizes as middle old age as well as
condition of hypertension, there is no decrease in productiveness and is able to perform all
activities of daily living independently. There may be minimal physical changes such as easily
fatigability, muscle cramps and joint pain due to decrease muscle strength, decrease production of
hormones, and other biologic changes that may lead to deterioration, which is indeed inevitable.
However, with proper diet, exercises, and compliance to therapeutic regimens such as maintaining
daily medications, the deterioration can be delayed since lifestyle is a factor that can prevent
deficits and further worsening of conditions.

Utilizing the Katz Index Independence in Activities of Daily Living, there were six
categories that were assessed that includes bathing, dressing toileting transferring, continence, and
feeding which are all basic activates that determines sensitive changes in declining health status
but is indeed limited in its ability to measure small increments of change seen in possible hospital
rehabilitation of the client. As for bathing, the client is able to bathe herself completely with no
assistance, which is scaled as 1. In comparison to previous state from current state, the client
complains that she is easily fatigued and cannot stand too long. As for dressing, the client is able
to dress herself independently, which is scaled as 1. As for toileting, the client is able to defecate
and urinate independently in the bathroom, which is scaled as 1. As for transferring, the client is
able to ambulate and move in and out of bed independently, which is scored as 1. As for
continence, the client is able to exercise complete self-control over urination and defecation, which
is scaled as 1. However, in comparison to current state from previous state, the client has a more
difficult time holding her urination for a period of time. As for feeding, the client is able to prepare
own food and eat food with the use of proper utensils, which is scored as 1.
To conclude, the client overall has a score of 6/6 which is classified as independent. This
implicates that the client despite her ill condition of hypertension that lead to her easy fatigability
and slow yet inevitable progressive deterioration of muscle strength and muscle cramps which are
normal physical changes depicted in the aging process, the client can still perform activities of
daily living by herself. Despite the programmed cells that are genetically coded for the aging
process, lifestyle such as diet and compliance to therapeutic regimen and attitude towards life such
as joining social groups can play a major role in sustaining a well-balanced method of delaying
progression of deterioration that may lead to deficits.