Assessment of ADL in home-care for the elderly. Change in ADL and use of short-term hospital care.

In order to study the value of Katz' Index of ADL (Activities of Daily Living) for monitoring ADL-status among elderly persons receiving home-care, and to study their use of short-term hospital care, 40 consecutive recipients of a home-care subsidy in a health service district were followed during a period of six months. A licensed practical nurse visited them monthly, assessed their ADL-performance, and recorded their use of short-term hospital care. Twenty-seven persons changed in ADL-grade: 8 improved, 13 deteriorated, and 6 changed temporarily between the first and the final observation. Twenty-one persons were admitted to short-term hospital care; 19 of these changed in ADL-grade. The medical conditions that motivated hospital admission were serious and required hospital resources. The Index of ADL was found to monitor changes in ADL-status and is used today as a common language of disability between caretakers in the home and in hospital care.