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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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