ADLs and IADLs Ch. 46

ADLs

Activities oriented toward taking care of one’s own body and completed on a routine basis - AOTA

• Bathing and showering

• Dressing

• Eating and swallowing

• Feeding

• Functional mobility

• Personal hygiene and grooming

• Sexual activity

IADLs

Activities to support daily life within the home and community

• Care of others

• Care of pets and animals

• Child rearing

• Communication management

• Driving and community mobility

• Financial management

• Home establishment and management

• Meal prep and cleanup

• Religious and spiritual expression

• Safety and emergency maintance

• Shopping

Mental Illness + ADL/IADL performance

ADL and IADL performance is shaped by skills and knowledge, task demands, and environmental barriers and supports

• Dementia

• Depressions

• Schizophrenia

• OCD

• Eating disorders

ADL and IADL Assessments

Questionnaire/Self-Report Measures

• Independent Living Skills Survey

• Eating and Meal Preparation Skills Questionnaire

Performance Based Measures

• KELS

• Milwaukee Eval of Living Skills (MEDLS)

• UCSD Performance-Based Skills Assessment (UPSA)

• PASS

• Test of Grocery Shopping Skills (TOGSS)

• Kitchen Task Assessment

• Rabideau Kitchen Eval-Revises

Occupation Based Measure

• Katz Index of Independence of Activities of Daily Living Scale

• Barthel Index

• Functional Independence Measure ( and WeeFIM)

Intervention Approaches: Occupations and Activities

Occupation as means and ends

Promote general well-being

Activity based groups

Interpersonal and Social Rhythm Therapy

Intervention Approaches: Prep Methods and Tasks

Assistive Technology

Altering the Environment

Home Environmental Skill Building Program

Five 90-minute sessions with three strategies

1. Simplification of physical environment

2. Modification of caregiver approach

3. Involvement of caregiving

Intervention Approaches: Education and Training

Skills Training

Motivational Strategies

Application to real life

Feedback about Performance

Match environmental and individual needs

Evaluate skill aquisition

Developing Skills Training Modules

Problem Identification

Solution Identification

Module Development

Behavioral Modification Interventions

• Based on learning theories ex. classical conditioning, operant conditioning, social learning theory

• Use commands and rewards to encourage desired behaviors

• Generally time intensive for better results (up to 40 hrs/week)

1. Task analysis of positive behavior

2. Daily measurement before intervention

3. Development and implementation of approach to teaching

4. Graphing behavior/response to treatment

5. Controlled single subject approach to show that intervention was responsible for change

Intervention Approaches: Advocacy

Use ADL and IADL intervention to support role participation

Address social recovery and inclusion

Advocate with client to obtain opportunities, supports, and supplies needed

Use an empowerment approach