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
- The index should be used as a record of what a patient does, not as a record of what a patient could do.
- The main aim is to establish degree of independence from any help, physical or verbal, however minor and for whatever reason.
- The need for supervision renders the patient not independent.
- 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.
- Usually the patient's performance over the preceding 24-48 hours is important, but occasionally longer periods will be relevant.
- Middle categories imply that the patient supplies over 50 per cent of the effort.
- Use of aids to be independent is allowed.