Functional Functional Assessment Assessment of Older of Older AdultsAdults

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ObjectivesDefine functional assessment and the

terminology related to functional assessment.

Describe some characteristics of functional decline in older persons.

Define functional assessment and the terminology related to functional assessment.

Describe some characteristics of functional decline in older persons.

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Objectives Identify comorbid conditions that might

impact negatively on the functional status of an older adult.

Assess function using validated tools.

Plan strategies to promote / maintain optimal function in older adults.

Identify comorbid conditions that might impact negatively on the functional status of an older adult.

Assess function using validated tools.

Plan strategies to promote / maintain optimal function in older adults.

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Terminology Functional Assessment

Activities of Daily Living (ADLs)

Instrumental Activities of Daily Living (IADLs)

Psychological function

Social functioning

Functional Assessment

Activities of Daily Living (ADLs)

Instrumental Activities of Daily Living (IADLs)

Psychological function

Social functioning

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Characteristics of functional declineChronic conditions increase with age –

arthritis, HTN, heart disease, hearing impairment, cataract

Older persons use 1/3 of physician resources, 1/4 of total medications prescribed, and 2/5 of hospital admissions

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Functional decline35.6 million over 65 (2002)

Who are limited by chronic condition? (from 2000 data)

26.1% of those 65 – 74 (young-old)45.1% of those 75+ (old old)73.6% of those 80+ (oldest old)

35.6 million over 65 (2002)

Who are limited by chronic condition? (from 2000 data)

26.1% of those 65 – 74 (young-old)45.1% of those 75+ (old old)73.6% of those 80+ (oldest old)

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Comorbid conditions Acute illness Alteration in nutrition and / or hydration Chronic illness Delirium Dementia Economics Environment Medications Psychiatric comorbidities – depression Psychological / social stressors

Acute illness Alteration in nutrition and / or hydration Chronic illness Delirium Dementia Economics Environment Medications Psychiatric comorbidities – depression Psychological / social stressors

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Functional assessment toolsKatz Activities of Daily Living (ADL)

Older American Resources and Services Assessment (OARS)

Bathing Dressing Toileting Transferring Continence Feeding

Katz Activities of Daily Living (ADL)Older American Resources and Services

Assessment (OARS) Bathing Dressing Toileting Transferring Continence Feeding

KATZ ADL Try This Assessment Series available on Hartford Institute website at www.hartfordign.org

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Functional assessment tools

Ability to TelephoneAbility to Telephone

ShoppingShopping

Food PreparationFood Preparation

HousekeepingHousekeeping

LaundryLaundry

Ability to TelephoneAbility to Telephone

ShoppingShopping

Food PreparationFood Preparation

HousekeepingHousekeeping

LaundryLaundry

Lawton Instrumental Activities Lawton Instrumental Activities of Daily Living (IADL)of Daily Living (IADL)

Mode of TransportationMode of Transportation

Responsibility for Own MedicationResponsibility for Own Medication

Ability to Handle FinancesAbility to Handle Finances

Mode of TransportationMode of Transportation

Responsibility for Own MedicationResponsibility for Own Medication

Ability to Handle FinancesAbility to Handle Finances

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Functional assessment toolsPULSES Profile

Physical ConditionUpper Limb FunctionLower Limb FunctionSensory ComponentsExcretory FunctionsSupport Factors

PULSES Profile

Physical ConditionUpper Limb FunctionLower Limb FunctionSensory ComponentsExcretory FunctionsSupport Factors

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Functional assessment toolsSPICES

Sleep DisordersProblems IncontinenceConfusionEvidence of FallsSkin Breakdown

SPICES

Sleep DisordersProblems IncontinenceConfusionEvidence of FallsSkin Breakdown

SPICES Try This Assessment Series available on Hartford Institute website at www.hartfordign.org

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Functional assessment tools

Timed “Get-up and Go” Test – Ambulation

Timed “Get-up and Go” Test – Ambulation

Rise from a chair

Stand still momentarily

Walk toward the wall

Turn around

Walk back to chair

Turn around

Sit down

Rise from a chair

Stand still momentarily

Walk toward the wall

Turn around

Walk back to chair

Turn around

Sit down

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Strategies for optimal functioning

Exercise and physical activity

Design environments with handrails, wide doorways, raised toilet seats, etc.

Judicious use of medications

Regular exam for cancer prevention and other diseases

Alternatives to restraints

Exercise and physical activity

Design environments with handrails, wide doorways, raised toilet seats, etc.

Judicious use of medications

Regular exam for cancer prevention and other diseases

Alternatives to restraints

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Strategies for optimal functioning

Minimize bed rest

Optimize nutritional patterns

Maintain vaccination status

Provide information to caregivers on causes of functional decline related to acute and chronic conditions.

Minimize bed rest

Optimize nutritional patterns

Maintain vaccination status

Provide information to caregivers on causes of functional decline related to acute and chronic conditions.

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Summary

Defined functional assessment

Described functional decline

Comorbid conditions

Reviewed assessment tools

Strategies for optimal functioning

Defined functional assessment

Described functional decline

Comorbid conditions

Reviewed assessment tools

Strategies for optimal functioning

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QUESTIONS?QUESTIONS?