Functional Assessment and Sensory Loss

1
Functional Assessment and Sensory Loss

• William Godfrey, MD
• KUMC Department of Ophthalmology

2
Importance of Function

• Initial Assessment
• Function Starting Point
• Diagnosis
• Care Plan
• Episodic Assessment
• Change in Function
• Sign of Medical Problem
• Concept of Diminished Functional Reserve

3
Definition of Function

• Independence Disability
• Activities of Daily Living
• Basic ADLs
• Advanced ADLs (IADLs)
• DEATTH SHAFTTT

4
Basic ADLs

• D Dressing
• E Eating
• A Ambulation
• T Transfers
• T Toileting
• H Hygiene
• Grooming
• Bathing

5
Advanced ADLs (IADLs)

• S Shopping
• H Housekeeping
• Cleaning
• Laundry
• A Accounting
• F Food Preparation
• T Telephone
• T Transportation
• T Taking Medications

6
ADL/IADL Assessment
7
COMORBIDITY
FRAILTY
DISABILITY
MOBILITY IMPAIRMENT
COGNITIVE IMPAIRMENT
8
Mobility Impairment

• Medical
• Cardiovascular
• Pulmonary
• Musculoskeletal
• Neurologic
• Stroke
• Neurodegenerative
• Sensory

9
Cognitive Impairment

• Dementias
• Alzheimers disease
• Vascular dementia
• Other
• Mental illness
• Chronic
• Late-life

10
Assessment of Function

• Self-Report
• Surrogate Report
• Direct Observation
• Get up and go test
• Clinic
• Bedside
• Home Safety Assessment

11
Functional Goals

• Optimize Independence
• Treat Impairments
• Apply Adaptive Strategies
• Support ADL IADL Needs
• Least Restrictive Setting

12
Functional Status of US Elderly, 2002
13
Predictive Value of Function
14
Predictive Value of Function