Resources on Aging

The Katz Index of Independence in Activities of Daily Living, commonly referred to as the Katz ADL, is the most appropriate instrument to assess functional status as a measurement of the client’s ability to perform activities of daily living  independently. 

The Index ranks adequacy of performance in the six functions of bathing, dressing, toileting, transferring, continence, and feeding. Clients are scored yes/no for independence in each of the six functions. A score of 6 indicates full function, 4 indicates moderate impairment, and 2 or less indicates severe functional impairment.  

Activities of Daily Living (ADLs) are the basic self-care tasks that we initially learn as young children. They are sometimes referred to as “Basic Activities of Daily Living” (BADLs). 

They Include:  Walking, or otherwise getting around the home or outside. The technical term for this is “ambulating.” Feeding, as in being able to get food from a plate into one’s mouth. Dressing and grooming, as in selecting clothes, putting them on, and adequately managing one’s personal appearance. Toileting, which means getting to and from the toilet, using it appropriately, and cleaning oneself. Bathing, which means washing one’s face and body in the bath or shower. Transferring, which means being able to move from one body position to another. This includes being able to move from a bed to a chair, or into a wheelchair. This can also include the ability to stand up from a bed or chair in order to grasp a walker or other assistive device.  

If a person is not fully independent with ADLs, then we usually include some information about the amount of assistance they require. For each ADL, people can vary from needing just a little help (such as a reminder or “stand-by assist”) to full dependency, which requires others to do the task for them (ADLs were originally defined in the 1950s by a geriatrician named Sidney Katz, who was trying to define what it might look like for a person to recover to independence after a disabling event such as a stroke or hip fracture).  

America’s senior population is larger than ever. There were 57.8 million people age 65 or older in the U.S. in 2022 – about 17.3% of the population, or roughly one in every six Americans. This share is up from 13% in 2010 and is on a steep rise as the Baby Boom generation ages.

The 65+ age group is growing much faster than the rest of the population. Between 2012 and 2022, the number of Americans age 65+ increased by 34%, whereas the under-65 population grew by only 2%. In other words, the senior population grew about 17 times faster than the non-senior population over the past decade.

Every day, thousands more Americans become seniors. In 2022 alone, about 4 million people celebrated their 65th birthday – averaging roughly 11,000 new seniors per day joining the 65+ ranks. This influx contributed to an annual net increase of approximately 1.6 million older adults in the population (https://acl.gov).

In the 1980’s a shift in healthcare from institutional based care to community-based transitional based care began to occur because of increasing growth trends in our older population, advanced medical treatments and public awareness that institutional programs did not meet the needs of older persons and their families.

Transitional Care – defined by the American Geriatrics Society  as “a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care within the same location” – is designed to prevent unnecessary rehospitalizations and improve outcomes for older people. 

Many nurses, social workers, case managers and other allied health professionals began leaving their traditional provider roles and began working in specialized provides roles that pioneered a new model that promoted an integrated and collaborative “care management” model. 

The profession of Geriatric Care Management was born. 

(American Geriatrics Society Health Care Systems Committee, 2007).

Advance care planning involves discussing and preparing for future decisions about your medical care if you become seriously ill or unable to communicate your wishes. Having meaningful conversations with your loved ones is the most important part of advance care planning. Many people also choose to put their preferences in writing by completing legal documents called advance directives

https://www.nia.nih.gov/health/advance-care-planning/advance-care-planning-advance-directives-health-care 

Autonomy can be expressed, and to some extent be exercised, by the elder through the use of Advance Directives created and signed by the elder under the provisions of the Texas Advance Directives Act of 1999 including a medical power of attorney, advance directive to physicians and family or surrogates and a do-not-resuscitate order. By doing so, the elder can express his intentions and have an assurance that decisions made in his autonomy while having capacity will be maintained and respected when he does not have capacity or when he cannot express his decisions. 

http://www.ensignlaw.com/Ethical%20Issues%20and%20Elderly.html

Research shows that you are more likely to get the care you want if you have conversations about your future medical treatment and put a plan in place. It may also help your loved ones grieve more easily and feel less burden, guilt, and depression. During an emergency or at the end of life, you or your loved one may face questions about their medical treatment and not be able answer them. You may assume your loved ones know what you would want, but that’s not always true. In one study, people guessed nearly one out of three end-of-life decisions for their loved one incorrectly.