.|.|Katz Index of Independence in Activities of Daily Living||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.>||<.DLL_String.>||Questions and Answers||1. Bathing:| <*Answer_5421*>|2. Dressing:| <*Answer_5422*>|3.
Toileting:| <*Answer_5423*>|4. Transferring:| <*Answer_5424*>|5. Continence:| <*Answer_5425*>|6. Feeding:| <*Answer_5426*>|||Information contained in this note is based on a self-report
assessment and is not sufficient to use alone for diagnostic purposes. Assessment results should be verified for accuracy and used in conjunction with other diagnostic activities and
procedures.||Copyright (c) The Gerontological Society of America.| $~
|
