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BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Lawton And Brody Instrumental Activities Of Daily Living (IADL) Scale Year: 1969 Domain: Biological / Social Assessment Tool category: Physical Function/IADL Variations / Translations: English and Japanese Assessment Setting: Community, research and hospital settings Method of Delivery: The scale
can be administered with a written questionnaire or by Description of Test: The Instrumental Activities of Daily Living (IADL) Scale is used to assess independent living skills of an individual and measures functional ability as well as declines and improvements over time. The test measures eight realms of function through self report, which attempt to assess everyday functional competence in the elderly. This is done by evaluating a more complex set of behaviours like telephoning, shopping, food preparation, housekeeping, laundering, use of transportation, use of medicine, and financial behaviour. Each domain measured by the scale relies on either cognitive or physical function, though all require some degree of both. These skills are considered more complex than the basic activities of daily living as measured by the Katz Index of ADLs. There is a gender difference in how tests are administered. This test is not acceptable for use on institutionalized older adults. It has been shown an effective tool for measuring baseline function and can provide data for functional comparisons with later assessment. This assessment instrument is widely used both in research and in clinical practice Scoring / Interpretation: The Lawton IADL scale can be scored in several ways, the most common method is to rate each item either dichotomously (0 = less able, 1 = more able) or trichotomously (1 = unable, 2 = needs assistance, 3 = independent) and sum the eight responses. The higher the score, the greater the person's abilities. Women are scored on all 8 areas of function, but, for men, the areas of food preparation, housekeeping, laundering are excluded. Clients are scored according to their highest level of functioning in that category. A summary score ranges from 0 (low function, dependent) to 8 (high function, independent) for women, and 0 through 5 for men. Time to Administer: 10 to 15 minutes. Availability: Can be accessed online. Software: N/A Websites:
http://www.annalsoflongtermcare.com/article/7453
Quantitative/Qualitative: Quantitative Validity: The validity of the Lawton IADL was tested by determining its correlation with four scales that measured domains of functional status. All correlations were significant at the .01 or .05 level. Reliability: A Pearson correlation of 0.87 and 0.91 was obtained in two different studies. ICCs ranging from 0.90 to 0.94 for the IADL items were obtained. Very high six-month retest reliability of 0.88 (range, 0.80–0.99) has been reported for the IADL scale. The IADL also shows good interrater reliability between personnel from different disciplines. References: Graf, C. (2008). Lawton Instrumental Activities of Daily Living Scale. American Journal of Nursing 108(4), 52-62 Hokoishi K, Ikeda M, Maki N, et al.
(2001). Interrater reliability of the Physical Self- Lawton, M., and Brody, E. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179-186 Comments: The Lawton Instrumental Activities of Daily Living Scale (IADL) is an appropriate instrument to assess independent living skills in the elderly. Limitations of the instrument can include the self-report or surrogate report method of administration rather than a demonstration of the functional task. This may lead either to over-estimation or under-estimation of ability. In addition, the instrument may not be sensitive to small, incremental changes in function. There is a variation in testing strategy related to gender and the number of domains investigated for each. |