LEARNING OBJECTIVES
1.Define ADLs as it pertains to the occupational
therapy practice framework.
2. Comprehend safety rules as related to ADLs.
3. Delineate between the role of occupational
therapist and occupational therapist assistant.
4. Identify specific ADL compensation/
adaptation strategies.
5. Identify general ADL maintenance strategies.
INTRODUCTION
ADLs are defined by American occupational
therapy association (AOTA) as “Activities which
are oriented toward caring for one’s own body.
These are also called basic activities of daily
living or personal activities of daily living.
 Various categories of ADLs are self care (bathing,
hygiene, dressing, feeding and toileting skills),
functional mobility and eating.
COMPONENTS OF ADLS
ADL – self care, functional mobility, eating and sexual
activity.
1. Performance skills.
2. Performance patterns, context and activity demands.
3. Client factors.
1. Performance skills.
o Motor skills.
o Process skills.
 Motor skills. 1. Posture , mobility , coordination strength
and efforts.
 Process skills. 1. Energy , knowledge , organization and
adaptation.
COMPONENTS OF ADLS
2. Performance patterns , context and activity demands.
3. Client factors :
 Body functions.
 Mental : Global & specific Sensory & pain movement
systems.
 Body structures.
SAFETY DURING ADL INTERVENTIONS
 One of the primary concern during any typy of ADL is
safety of our client.
 Therapists should monitor these hazards and provide
client and care giver education.
ROLE OF OCCUPATIONAL THERAPIST &
OCCUPATIONAL THERAPY ASSISTANT
 Intervention for ADLs can be completed by OT or OT
assistant.
 Both have adequate training and knowledge regarding
most ADL tasks.
 The information provided regarding ADLs is primarily
entry level information for both OTs and OTAs.
 If further training is required beyond entry level skills ,
this will be indicated as dysphagia.
SELF CARE
The definitions of self care activities according to the
AOTA are as follows.
 Bathing : obtaining and using supplies, soaping,
rinsing and drying body parts, maintaining bathing
position and transferring to and from bathing
positions.
SELF CARE
 Personal hygiene and grooming : Obtaining and using
supplies, removing body hair, applying and removing
cosmetics, washing , drying, combing, styling,
brushing and trimming hair, caring for nails, caring for
skin, ears, eyes, nose, applying deodorant, cleaning
mouth, brushing or removing cleaning and reinserting
dental orthotics and prosthetics.
SELF CARE
 Dressing : Selecting clothing and accessories
appropriate to time of day, weather and occasion,
obtaining clothing from storage area, dressing and
undressing in a sequential fashion, fastening and
adjust clothing and shoes and applying and removing
personal devices, prosthesis and orthosis.
SELF CARE
 Feeding : the process of bringing food from the plate
or cup to the mouth.
 Toilet hygiene : Obtaining and using supplies, clothing
management, maintaining toilet position transferring
to and from toileting position, cleaning body .
DEFINITIONS
According to AOTA,
 Bowel and bladder management - It includes
complete intentional control of bowel movements and
urinary .
 Personal device care – Using cleaning and
maintaining personal care items such as hearing aids
contact lenses, glasses, orthotics , prosthetics, and
adaptive equipment.
 Sleep - A period of inactivity in which one may or may
not suspend consciousness.
EVALUATION OF ADLS
 The first step of any evaluation is the completion of an
interview or an occupational profile with the client.
This allows the therapist to gather information
regarding the client’s motivating factors, goals,
discharge needs.
EVALUATION OF ADLS
Few examples of formal evaluations include
 the performance Assessment of self Care skills(PASS)
,
 the assessment of motor and process skills (AMPS)
and
 functional independence measure(FIM).
These evaluations have been chosen because they all
begin with function.
THE PERFORMANCE ASSESSMENT OF SELF
CARE SKILLS(PASS)
 PASS developed by Rogers and Holm includes 26
activities that can be evaluated as a whole or
individually. Eight of the 26 items are related to ADLs
as defined by AOTA, and the client is scored based on
independence in completing the task, safety during
the task as well as completion and outcome of task.
 This evaluation has two versions - clinic and home, it
can be used in multiple settings.
THE ASSESSMENT OF MOTOR AND PROCESS
SKILLS (AMPS)
The AMPS , developed by Fisher evaluates both motor and process skills through the
use of ADLs.
The client are scored based on their effort , safety , efficiency and independence.
This tool has excellent validity and reliability as well as cultural sensitivity.
FUNCTIONAL INDEPENDENCE MEASURE(FIM).
 FIM is the most limited of the evaluation tools listed. It
is frequently used by rehabilitation facilities.
 It is most effective and quickly as compared to other
tools.
 FIM is often used in an interdisciplinary format with
speech , occupational therapy & physical therapy .
 The FIM evaluates self care , continence ,
mobility/locomotion , communication.
REMEDIATION OF SELF CARE
 Remediation of self care skills include completion of
an ADL session.
 By completing the session therapist can incorporate
performance skill issues such as decreased fine
motor skills or decreased cognitive skills.
 One technique of remediation is called backward
chaining. This technique allows the client to finish the
task rather than start it and stop once he or she has
failed.
 As therapist decreases the assistance given , the
client continues to gain skill and confidence,
becoming independent.