Activities of Daily Living

Skills for the Job of Living

Basic ADL’s (BADL)

Self-CareMobilityCommunication

Self-Care Feeding Grooming Dressing Bathing Toileting

Mobility Bed Mobility Wheelchair Mobility Transfers Ambulation

Communication Writing Using a telephone Using communication devices

Instrumental ADL’s (I-ADL) Home Management Community Living Skills Health Management Safety Management

Self-Care Activities

Skills for Restoring: Function Independence Dignity

Feeding Set-up Handling utensils and cups Chewing and swallowing

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

Dressing Retrieving Clothing Dressing/Undressing Prosthesis or Orthosis

TLSO Abdominal binder TEDS

Bathing Washing & Drying Excludes neck, back Transfer not included Adding up the parts

Toileting Perineal hygiene Managing Clothing Transfer not included

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

Assessing Performance

Functional Independence Measure (FIM)

Universal Standard Multidisciplinary Severity of Disability Track Changes Analyze Outcomes

FIM Scores

7 Independent6 Modified Independent5 Supervision/Set-up4 Minimal Assistance3 Moderate Assistance2 Maximal Assistance1 Total Assistance

No Helper Required

Independent Normal method, performance

Modified Independent Equipment Extended time Saftey risk

Helper Required No physical contact required

SupervisionSet-upCuingOrthosis

Helper Required Physical Contact Required

Patient does:75-100% Minimal Assistance50-74% Moderate Assistance25-49% Maximal Assistance0-24% Total Assistance

FIM Scoring Example

Bathing

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

Equipment Needs Durable Medical Equipment Adaptive Equipment Orthotics

Durable Medical Equipment Tub Transfer Bench Shower Chair Bedside Commode

Adaptive Equipment Long-Handled Sponge Reacher Sock Aid Built-Up Handles Inspection Mirror

Orthotics Radial Nerve Palsy Splint Wrist-Hand Orthosis Universal Cuff

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

Role of OT Intervention

Hemi Dressing Techniques Patient/Family Training

Assistance Recommendations

Equipment24hr CareOutpatient

Occupational Therapy

Charity Hospital W504903-2388

Inpatient RehabOutpatient NeuroOutpatient Ortho