Evaluating the functional autonomy of persons with Alzheimer's disease: A tool for observing four activities of daily living

Abstract

The goal of this study was to develop an instrument for evaluating the functional autonomy of demented persons in four ADLs: • Getting dressed; • Getting washed; • Eating; and • Eliminating. Thirteen persons with Alzheimer's disease who were living in care facilities were filmed three times while they were performing the first three ADLs, and observed during the last ADL. Based on these direct observations, the various sequences of tasks required to accomplish each of the ADLs were identified. Criteria for the successful accomplishment of each sequence were established and classifications of both autonomous behaviors and blocking conditions to autonomy were developed. The instrument includes three types of prompts to promote the emergence of potential abilities and provides two autonomy ratings - one of which distinguishes between actual and potential ability level. The prototype was submitted to different experts in the field and tried out on 26 other subjects suffering from Alzheimer's disease. Dividing tasks into sequences appears essential in identifying what subjects can accomplish without help and what they can do after a prompt.