Scaling functional status within the interRAI suite of assessment instruments

BMC Geriatrics

Research Article

Elizabeth P Howard¹  Knight Steel²  John N Morris³  Brant E Fries⁴  Katherine Berg⁵ 

[1] Bouvé College of Health Sciences, School of Nursing, Northeastern University, 360 Huntington Avenue, 02115, Boston, MA, USA;Hackensack University Medical Center, 30 Prospect Avenue, 07601, Hackensack, NJ, USA;Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, 02131, Boston, MA, USA;School of Public Health, Geriatric Research, Education and Clinical Center, Ann Arbor VA Healthcare Center, University of Michigan, 300 NIB, 933 NW48109, Ann Arbor, MI, USA;University of Toronto, 160-500 University Avenue, M5G 1 V7, Toronto, ON, Canada;

关键词: Home Care;    Informal Care;    Personal Hygiene;    Formal Care;    Support Count;   

DOI  :  10.1186/1471-2318-13-128

 received in 2013-04-23, accepted in 2013-10-10,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundAs one ages, physical, cognitive, and clinical problems accumulate and the pattern of loss follows a distinct progression. The first areas requiring outside support are the Instrumental Activities of Daily Living and over time there is a need for support in performing the Activities of Daily Living. Two new functional hierarchies are presented, an IADL hierarchical capacity scale and a combination scale integrating both IADL and ADL hierarchies.MethodsA secondary analyses of data from a cross-national sample of community residing persons was conducted using 762,023 interRAI assessments. The development of the new IADL Hierarchy and a new IADL-ADL combined scale proceeded through a series of interrelated steps first examining individual IADL and ADL item scores among persons receiving home care and those living independently without services. A factor analysis demonstrated the overall continuity across the IADL-ADL continuum. Evidence of the validity of the scales was explored with associative analyses of factors such as a cross-country distributional analysis for persons in home care programs, a count of functional problems across the categories of the hierarchy, an assessment of the hours of informal and formal care received each week by persons in the different categories of the hierarchy, and finally, evaluation of the relationship between cognitive status and the hierarchical IADL-ADL assignments.ResultsUsing items from interRAI’s suite of assessment instruments, two new functional scales were developed, the interRAI IADL Hierarchy Scale and the interRAI IADL-ADL Functional Hierarchy Scale. The IADL Hierarchy Scale consisted of 5 items, meal preparation, housework, shopping, finances and medications. The interRAI IADL-ADL Functional Hierarchy Scale was created through an amalgamation of the ADL Hierarchy (developed previously) and IADL Hierarchy Scales. These scales cover the spectrum of IADL and ADL challenges faced by persons in the community.ConclusionsAn integrated IADL and ADL functional assessment tool is valuable. The loss in these areas follows a general hierarchical pattern and with the interRAI IADL-ADL Functional Hierarchy Scale, this progression can be reliably and validly assessed. Used across settings within the health continuum, it allows for monitoring of individuals from relative independence through episodes of care.

【 授权许可】

CC BY   
© Morris et al.; licensee BioMed Central Ltd. 2013