Mrs. Jia Tien’s age and history of chronic illnesses: Diabetes, osteoporosis, dementia, Afib represent a heavy burden in her life. These conditions inevitably interfere with her ability to
function normally in regard to her recent falls and diagnosis of UTI. She probably experiences
other collateral effects such as fatigue, weakness, neuropathic pain. As a home care nurse,
assessing Mrs. Tien’s home and level of independence through the Katz index of independence
in ADL’s is a priority.
This tool is based on the concept of physical disability and measures physical function in
older adults and the chronically ill (Jarvis, 2020). It has been modified, simplified; and, different
approaches to scoring have been used since it has been developed (Wallace M., 2007). This final
version can be used for many purposes. According to Jarvis, it is a perfect instrument for home
care nurses as it “measures performance, evaluates treatment outcomes, and predicts the need for
continuing supervised care”. The Katz index of independence in ADL’s (Katz ADL) measures
six basic activities: bathing, dressing, toileting, transferring from bed to chair, continence and
feeding (Jarvis, 2020). Being fully independent is not limited to these activities but at least they
are essential. However, this instrument has some limits. Its application to the outpatient clinic or
hospital setting would not yield good results (Jarvis, 2020).
Assessing Mrs. Tien level of independence for her safety in the house is crucial and
comes first. Due to her comorbidities, this tool will help provide effective care and prevent
further falls. The Katz ADL will help identify areas of weakness and dependence, so the nursing
team can help complete these activities. In addition, Mrs. Tien is already taking six different
medications and probably more. A study from the Eurasian Journal of Medicine reveals that the
more comorbidies an older person has, the more medications she takes; and, the increase in the
number of medications is closely related to the insufficiency in ADL’s (Sahingoz Erdol et al,
2021). The Katz index can be used to evaluates treatment applied to get older adults back on
their feet; and thereby, has all its meaning in limiting polypharmacy.
References
Jarvis, C. (2020). Physical examination and health Assessment
Sahingoz Erdol, G.,Kocoglu, H., Karandere, F., Kasapoglu, P. Isiksacan, N., & Hursitoglu, M.
(2021). The Effect of Polypharmacy on the Charlson Comorbidity Index and Katz Index in
Aging People with and Without Diabetes Mellitus. Eurasian Journal of Medicine, 53(2),85-89.
https://doi-org.library.esc.edu/10.5152/eurasianjmed.2021.20070
Wallace, M., & Shelkey, M (2007). Katz Index of Independence in Activities of Daily Living
(ADL). Urologic Nursing, 27(1),93-94.