Medication / Allergy / Significant Operative & Invasive Procedure Record

Barthel Index

ACTIVITY

FEEDING

ACTIVITY SCORE
0 Unable
5 Needs help cutting, spreading butter, etc., or requires modified diet
10 independent

BATHING

ACTIVITY SCORE
0 Dependent
5 Independent (or in shower)

GROOMING

ACTIVITY SCORE
0 Needs to help with personal care
5 Independent face / hair/ teeth / shaving (implements provided)

DRESSING

ACTIVITY SCORE
0 Dependent
5 Needs help but can do about half unaided
10 Independent (including buttons, zips, laces, etc.)

BOWELS

ACTIVITY SCORE
0 Incontinent (or needs to be given enemas)
5 Occasional accident
10 Continent

BLADDER

ACTIVITY SCORE
0 Incontinent, or catheterized and unable to manage alone
5 Occasional accident
10 Continent

TOILET USE

ACTIVITY SCORE
0 Dependent
5 Needs some help, but can do something alone
10 Independent (on and off, dressing, wiping)

TRANSFERS (BED TO CHAIR AND BACK)

ACTIVITY SCORE
0 Unable, no sitting balance
5 Major help (one or two people, physical), can sit
10 Minor help (verbal or physical)
15 Independent

MOBILITY (ON LEVEL SURFACES)

ACTIVITY SCORE
0 Immobile or < 50 yards
5 Wheelchair independent, including corners, > 50 yards
10 Walks with help of one person (verbal or physical) > 50 yards
15 Independent (but may use any aid; for example, stick) > 50 yards

STAIRS

ACTIVITY SCORE
0 Unable
5 Needs help (verbal, physical, carrying aid)
10 Independent

The Barthel ADL Index: Guidelines

  1. The index should be used as a record of what a patient does, not as a record of what a patient could do.
  2. The main aim is to establish degree of independence from any help, physical or verbal, however minor and for whatever reason.
  3. The need for supervision renders the patient not independent.
  4. A patient's performance should be established using the best available evidence. Asking the patient, friends/relatives and nurses are the usual sources, but direct observation and common sense are also important. However direct testing is not needed.
  5. Usually the patient's performance over the preceding 24-48 hours is important, but occasionally longer periods will be relevant.
  6. Middle categories imply that the patient supplies over 50 per cent of the effort.
  7. Use of aids to be independent is allowed.
Log Out ?

Are you sure you want to log out?

Press No if youwant to continue work. Press Yes to logout current user.