Functional ability

  • Functional Health 

  • Helps identify how health impacts self care ability and helps identify areas that need improvement

  • Factors

    • Psychological

    • Social

    • Cultural

    • Economical

    • Physical

  • Nursing assessment

    • Ask questions

      • relationships/support and potential domestic violence

      • values/beliefs/spirituality

      • Self esteem and coping abilities

      • Impairments

      • Personal habits (substance abuse)

      • Environmental and occupational hazards

      • Mental health

    • Vision

    • Hearing

    • Mobility

    • Fall history

    • Continence

    • Nutrition

    • Cognition

    • Affect

    • Home environment

    • Social participation

    • ADLs

  • Functional ability

    • Cognitive, social, physical, and emotional ability to carry out the normal activities of life needed to meet basic needs

    • Fulfill roles in family workplace and community

    • Maintain health and well being

    • Major contributing factor to quality of life

  • Optimal Functional Ability

    • Cognitive abilities

      • Memory, attention, problem solving etc

    • Physical ability

      • Strength, endurance, mobility, etc

    • Emotional ability

      • Self regulation, coping mechanisms, resilience

    • Social ability

      • Communication, interpersonal skills, role fulfillment

    • Environmental factors

      • Accessibility, resource availability, support systems

    • Absence of impairments or disabilities that could limit functional capacity

    • Maintaining these attributes through healthy lifestyle practices, rehabilitation, assistive devices when needed and supportive environments can help individuals achieve their highest level of functional independence across the lifespan.

  • Theory: Roper-Logan-Tierney model of nursing

    • Focus on health rather than illness and promotes care directed toward health promotion and wellness

    • 12 ADLs essential to life

      • Maintaining safe environment

      • Communication 

      • Breathing 

      • Eating and drinking

      • Elimination

      • Washing and dressing

      • Controlling temperature

      • Mobilization

      • Working and playing

      • Sexuality

      • Sleeping

      • death

    • Asses upon admittance and then throughout stay for dependent and independent status

      • Changes in this status can show whether the patient is improving or not

  • Notice factors that impact functional ability

    • Developmental and biological factors

    • Current state of health

    • Psychological

    • Social cultural

    • environmental factors

    • Socioeconomic

  • Situations that increase risk for functional impairment 

    • Developmental abnormalities

    • Trauma (physical or psychological)

    • Disease (acute or chronic)

    • Social and cultural factors

    • Advanced age

    • Cognitive function

    • Mental health issues (depression)

    • Comorbidities and socioeconomic factors

  • Recognize when functional impairment exists

    • Difficulties with ADLs

    • Cognitive issues

    • Sensory deficits

    • Need for assistance/ assistive technology

    • Behavior or mood changes

  • Basic activities of Daily Living (BADLs)

    • Personal care and mobility

  • Instrumental activities of daily living (IADLs)

    • More complex skills essential to living in a community

  • Be familiar with the following functional assessment tools

    • 24hFAQ (24 hour Functional Activities Questionnaire)

      • Outpatient Post-op patients

      • Assesses functional ability

    • MMSE (Folstein Mini-Mental Status Examination)

      • Older adults assessment

      • Assess for cognitive function

    • FAQ (Functional Activities Questionnaire) 

      • Older adult assessment

      • Assess for IADLs

    • FSS (Functional Status Scale)

      • Hospitalized children

    • MDS(Long Term Care Minimum Data Set)

      • Nursing home residents

    •  EFAT (The vEdmonton Functional Assessment Tool)

      • Cancer patients

      • Functional performance




  • Assess a client’s risk for falls (BMAT / MORSE fall risk assessment)

    • Risk factors

      • Previous falls

      • Gait or balance issues

      • Cognitive impairment

      • Vision problems

      • Medication side effects

      • Age related conditions and changes

      • Environmental hazards

    • Patients should be evaluated frequently for fall risks

    • Fall risk assessments

      • MORSE Fall Scale 

        • Evaluates history of falls, secondary diagnosis, ambulatory aids, IV lines, gait, and mental status.

      • Hendrich II Fall Risk Model 

        • Assesses risk factors like confusion, dizziness, male gender, and certain medications.

      • STRATIFY Scale 

        • Considers risk factors like transfer and mobility issues, vision impairment, and high-risk medications.

      • Berg Balance Scale 

        • Measures balance abilities through functional tasks in older adults.

  •  Interventions to optimize functional abilities

    • Physical therapy

    • Occupational therapy

    • Cognitive rehabilitation

    • Assistive technology

    • Environmental modifications

      • Changes to home to make more accessible

    • Caregiver training

    • Lifestyle changes

      • Diet

      • Exercise

      • Stress management

    • Medication management

    • Social support

  • Considerations for Care

    • For patient education make sure to cater to the patient's functional ability