Screening for mobility and self-care difficulties is often done in the context of screening for other issues such as falls or frailty. It is important that we identify our patients at risk of:

  • de-conditioning – a decline in strength, balance or endurance
  • falls
  • loss of independence.

Assessment

A Comprehensive Geriatric Assessment (CGA) (initial and ongoing) will assist in identifying factors contributing to functional decline. A CGA includes an assessment of ADLs and Instrumental ADLs as well as other factors such as cognition, continence, vision and hearing, psychological wellbeing and social supports1.

Physiotherapists undertake a full assessment of mobility and occupational therapists undertake assessments of ADLs. You can use assessment tools to identify underlying risk factors and prompt a more detailed assessment.

Tools to identify underlying risk factors to prompt a more detailed assessment

Tool

Mode

Components of tool

FIM ® (also known as the Functional Independence Measure)

Observation

18 items

Timed Up and Go test (a test of functional mobility):

Timed sit-to-stand, 3m walk out, turn around, 3m walk back, stand-to-sit

1 item test

Barthel Index (assessment ADL/functional mobility): N.B. there are a number of modified Barthel Index types in use

Best available evidence

10 items


1. Ellis, G., et al., Comprehensive geriatric assessment for older adults admitted to hospital: a meta-analysis of randomised controlled trials. BMJ, 2011. 343: p. d6553.