Practice Recommendations: Activities of Daily Living

Recommendation	Level of Evidence
9.0 Nurses in all practice settings should assess stroke clients' ability to perform the activities of daily living (ADL). This assessment, using a validated tool (such as the Barthel Index or the Functional Independence Measure – appendix G of the Stroke Assessment Nursing BPG), may be conducted collaboratively with other therapists, or independently when therapists are not available. In situations where impairments are identified, clients should be referred to a trained healthcare professional for further assessment and management.	IV

Recommendation

Level of Evidence

9.0 Nurses in all practice settings should assess stroke clients' ability to perform the activities of daily living (ADL).

This assessment, using a validated tool (such as the Barthel Index or the Functional Independence Measure – appendix G of the Stroke Assessment Nursing BPG), may be conducted collaboratively with other therapists, or independently when therapists are not available.

In situations where impairments are identified, clients should be referred to a trained healthcare professional for further assessment and management.

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Two validated tools are commonly used to assess activities of daily living.

These include the Barthel Index of Activities of Daily Living (BI) which may be used in all settings across the continuum of care, and the Functional Independence Measure (FIM) which is used specifically in rehabilitation settings, where appropriate training and support can be provided. Activities of Daily Living include:

feeding
grooming
bathing
dressing
toileting
ambulation
transfers
stair climbing (AHCPR, 1995).

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