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Posted: August 19th, 2022
Affected person Initials:
Date:
Katz Index of Independence in Actions of Each day Residing
Actions
Factors (1 or zero) Independence
(1 Level)
NO supervision, course or private help. Dependence
(zero Factors)
WITH supervision, course, private help or complete care.
BATHING
Factors: (1 POINT) Bathes self fully or wants Help in bathing solely a single a part of the physique such because the again, genital space or disabled extremity. (zero POINTS) Need Helpance with bathing a couple of a part of the physique, getting in or out of the bathtub or bathe. Requires complete bathing
DRESSING
Factors: (1 POINT) Get garments from closets and drawers and places on garments and outer clothes full with fasteners. Might have Help tying sneakers. (zero POINTS) Wants Help with dressing self or must be fully dressed.
TOILETING
Factors: (1 POINT) Goes to rest room, will get on and off, arranges garments, cleans genital space with out Help. (zero POINTS) Wants Help transferring to the bathroom, cleansing self or makes use of bedpan or commode.
TRANSFERRING
Factors: (1 POINT) Strikes out and in of mattress or chair unHelped. Mechanical switch aids are acceptable (zero POINTS) Wants Help in transferring from mattress to chair or requires an entire switch.
CONTINENCE
Factors: (1 POINT) Workout routines full self management over urination and defecation. (zero POINTS) Is partially or completely incontinent of bowel or bladder
FEEDING
Factors: (1 POINT) Will get meals from plate into mouth with out Help. Preparation of meals could also be accomplished by one other individual. (zero POINTS) Wants partial or complete Help with feeding or requires parenteral feeding.
TOTAL POINTS: SCORING: 6 = Excessive (affected person unbiased) zero = Low (affected person very dependent
• Affected person is:
Geriatric Despair Scale (Quick Type):
1. Are you principally happy along with your life?
2. Have you ever dropped a lot of your actions and pursuits?
three. Do you’re feeling that your life is empty?
four. Do you usually get bored?
5. Are you in good spirits more often than not?
6. Are you afraid that one thing unhealthy goes to occur to you?
7. Do you’re feeling joyful more often than not?
eight. Do you usually really feel helpless?
9. Do you like to remain at dwelling quite than exit and do new issues?
10. Do you’re feeling you could have extra issues with reminiscence than most?
11. Do you assume it’s great to be alive now?
12. Do you’re feeling fairly nugatory the way in which you are actually?
13. Do you’re feeling filled with vitality?
14. Do you’re feeling that your state of affairs is hopeless?
15. Do you assume that most individuals are higher off than you’re?
SCORE: __/15. Assessment: _______________
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