Medical care of older persons in residential aged care facilities

The Silver Book

Barthel Index

☰ Table of contents

The Barthel Index is a simple to administer tool for assessing self care and mobility activities of daily living. It is widely used in geriatric assessment settings. Reliability, validity and overall utility are rated as good to excellent. Information is gained from observation, self report or informant report. It takes approximately 5/10 minutes to complete if the observational method is used.262

Guidelines for scoring:

  • The index should be used as a record of what a patient does, not as a record of what a patient could do
  • The main aim is to establish degree of independence from any help, physical or verbal, however minor and for whatever reason
  • The need for supervision renders the patient not independent
  • Usually the patient's performance over the preceding 24/48 hours is important, but occasionally longer periods will be relevant
  • Middle categories imply that the patient supplies over 50% of the effort
  • Use of aids to be independent is allowed.

Maximum score is 100. Low scores on individual items highlight areas of need.

The Barthel Index

Patient name

Rater name

Date


ACTIVITY


SCORE
 

Feeding

0 = unable

5 = needs cutting, spreading butter, etc, or requires modifies diet

10 = independent

____________

 

Bathing

0 = dependent

5 = independent (or in shower)

____________

 

Grooming

0 = needs help with personal care

5 = independent face/hair/teeth/shaving (implements provided)

____________

 

Dressing

0 = dependent

5 = needs help but can do about half unaided

10 = independent (including buttons, zips, laces, etc)

____________

 

Bowels

0 = incontinent (or needs to be given enemas)

5 = occasional accident

10 = continent

____________

 

Bladder

0 = incontinent, or catheterised and unable to manage alone

5 = occasional accident

10 = continent

____________

 

Toilet use

0 = dependent

5 = needs some help, but can do something alone

10 = independent (on and off, dressing, wiping)

____________

 

Transfer (bad to chair and back)

0 = unable, no sitting balance

5 = major help (one or two people, physical), can sit

10 = minor help (verbal or physical)

15 = independent

____________

 

Mobility (on level surfaces)

0 = immobile or <50 yards

5 = wheelchair independent, including corners, >50 yards

10 = walks with help of one person (verbal or physical) >50 yards

15 = independent (but may use any aid, eg. stick) > 50 yards

____________

 

Stairs

0 = unable

5 = needs help (verbal, physical, carrying aid)

10 = independent

____________

 

 

Total (0 - 100)
 
 
 
 
 


Reprinted with permission. Mahoney FI, Barthel D. Functional evaluation: the Barthel Index. Maryland State Med J 1965;14:56–61

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