A Comparison of Self-Report versus Observation of Performance Using the Assessment of Living Skills and Resources (ALSAR) with an Older Population

Abstract

This study assessed the capacity of 15 older people to report their instrumental activities of daily living (IADL) function accurately. The Assessment of Living Skills and Resources (ALSAR) (Williams et al 1991) was used to measure IADL function in the clinical and home environments. The subject's self-reported function was also compared with performance-based measurement of three IADL tasks from the ALSAR (use of the telephone, meal preparation and medication management) in the subject's home environment. The sensitivity of the ALSAR 3-point scale was examined through comparison with the Medical Rehabilitation Follow Along scale (Granger et al 1995). The findings highlighted problems associated with the use of self-reporting for the assessment of IADL in the older population. The ALSAR 3-point scale was shown to be sufficiently sensitive to detect IADL function when used with performance observation; however, further research is required to ascertain sensitivity when it is used as a self-report tool. The findings suggest that occupational therapists attain more accurate results when carrying out IADL assessment procedures by using performance-based measures.