How important is it for staff of Elderly Care Homes to be aware and trained on person-centered care including respecting resident’s privacy and dignity at the same time be able to assist them with Activities of Daily Living?
I guess India has a long way to get professionally trained cadre of frontline workers who are trained to improve the Quality of Life (QoL) of elders in Senior Citizens Care Homes.
Activities of Daily Living are functional activities which all of us do on a daily basis, the capacity to undertake these activities defines our level of independence or our dependence.
Individual independence to conduct activities such as brushing, bathing, eating etc are essential for maintaining an Independent Living and this is where assessment of Activities of Daily Living comes into picture.
Typically the activities which we call Activities of Daily Living (ADL) are classified under two broad categories:
1) Basic Activities of Daily Living
Basic Activities of Daily Living are related to a person’s ability to walk independently or with assistance, eating by themselves or being fed, being able to dress independently or with someone’s help, bathing, ability to use the toilet, grooming, brushing (oral care), shaving, wearing shoes, basic communication etc.
2) Instrumental Activities of Daily Living (IADL)
IADL activities are more complex than ADLs and are activities which requires mental and physical capabilities to conduct the same independently. Activities like ability to use the telephone, do the laundry, being able to go shopping, travelling, ability to cook, home management and maintenance, handle own finances, self-medication etc.
The larger point of debate is, almost 70%-80% Care Homes in India are run by charitable organisations and do not have full resources and/or qualified manpower, in these cases do the training modules remain simple paperwork or have real impact on the ground level? I guess we will only know if we have National Standards on Aged Care.
Another important point is, should evaluation of a person’s ability to conduct Activities of Daily Living be the sole responsibility of Care Homes or should the family members be aware of such activities?
There are numerous assessment tools and measurement scales like Barthel Index (BI), Katz Index of Independence in Activities of Daily Living, Functional Independence Measures (FIM), Lawton Instrumental Activities of Daily Living Scale etc which are measurement scales to evaluate the ability of a person’s capacity level to conduct ADLs / IADLs.
4) The attached assessment tool on Instrumental Activities of Daily Living (IADL) by M.P. Lawton & E.M. Brody is a simple assessment tool for Instrumental Activities of Daily Living which can be used by Care Homes and family members.
The document can be downloaded here (Instrumental Activities of Daily Living) or can be viewed below