| RPT |
.|.|Katz Index of Independence in Activities of Daily Living-18pt||Date Given: <.Date_Given.>|Clinician: <.Staff_Ordered_By.>|Location: <.Location.>||Veteran: <.Patient_Name_Last_First.>|SSN:
<.Patient_SSN.>|DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)|Gender: <.Patient_Gender.>|||Katz Index of Independence in ADL: <-Independence->||Index score possible range is 6 to 18. A high index indicates independence, a low index
means dependence on others to help with activities of daily living.||Questions and Answers||1.Bathing: either sponge bath, tub bath or shower.| <*Answer_5132*>|2.Dressing: gets clothes from
closets and drawers, including under-clothes, outer garments and using fasteners (including braces if worn).| <*Answer_5133*>|3.Toileting: going to the "toilet room" for bowel and urine
elimination; cleaning self after elimination and arranging clothes. (May use cane, walker, or wheelchair, and manage bedpan or commode, emptying same next morning). | <*Answer_5134*>|4.Transfer:|
<*Answer_5135*>|5.Continence:| <*Answer_5136*>|6.Feeding:| <*Answer_5137*>|||Sources:|Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist.
1970;10(1):20-30.|Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The Index of ADL: a standardized measure of biological and psychosocial function. JAMA.
1963;185(12):914-9. $~
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