This tool consists of 18 items that evaluate 6 functional areas of the individual. This tool is useful for stroke patients in all age groups, and the use of this tool requires training and specialty courses under the supervision of trained people The Persian version of this instrument has been validated by Naghdi et al.
The internal consistency of the items was good to excellent 0. The 17 items of this tool are based on performance-based evaluation direct observation of the evaluated function , and 3 items are based on semi-structured interviews with the person or other people individual's caregivers and completed by a questionnaire.
The Scoring of this tool varies from 0 full independency to 3 full dependency. It measures individual autonomy in ADL based on four executive performance skills including formulating the goal, planning, carrying out the task, and verifying the initial goal This tool is available in both Canadian and French versions 29 , The validity and reliability of this tool have not been studied in Iran.
This tool assesses the ADL performance of individuals with Alzheimer's in six areas of self-care, household care, employment and recreation, shopping and money, travel and communication. Each of the areas of this tool includes a set of activities that individuals or caregivers should answer to them. For scoring each item a 4-point scale from 0 no problem to 3 need help for completion and long-term is used.
Also, there is a score of 9 in each question, which indicates that there is a lack of ability to do activity or not knowing the activity by the individuals. If the person is not familiar with the activity and has not done it in the past, the score of 9 is given to that task.
The scoring and calculations of the questionnaire are available in the questionnaire. This tool is available in both Australian and Swedish versions It evaluates the ADL performance of individuals with visual impairment. This tool is designed as a desk based clinical assessment and includes two areas: the first contains 18 observational items in the field of ADL functions, and the second includes 9 items for self-care activities.
Scoring for each item is based on independence, speed, and accuracy of performance on a five descriptive Likert scale 4 -0 This scale includes 24 items that assess the ADL performance of individuals with Parkinson's.
The scoring scale for this tool is 5 points for each activity and varies from 5 ability to do work alone and without difficulty to 1 unable to do activity This is available in two British and Serbian versions 38 , The Persian version of this scale is not available. It evaluates the IADL of stroke patients. The score for each item is varied from 1 lowest level of activity to 4 highest level of activity so that the sum of the minimum points is equal to 15 and the sum of the maximum points is equal to 60 This tool also has two modifications of 13 and 18 items, respectively, by the modified version of 13 items in by Tooth et al.
However, the original version of the questionnaire 15 items is still used. This tool has been translated and verified in Canadian, Dutch, and Chinese versions 43 - The Persian version of this tool is not available.
This tool is actually an upgraded version of the ADL Profile, developed to evaluate the IADL performance of individuals that are closely related to the environmental performance. This tool includes 29 items in 8 areas: putting on outdoor clothes, going to the grocery store, shopping for groceries, preparing a hot meal for guests, having a meal with guests, cleaning up after a meal, getting information and making a budget.
This tool is an ecological measure in relation to the degree of individual autonomy in doing activities in the community and at home. The Canadian version of this tool is available and for use requires the presence of workshops held by the developer This tool includes 8 activities: the ability to use a phone, shopping, meal preparation, housekeeping, laundry, the model of transportation, the responsibility for owns medication, and the ability to handle finance.
The scoring scale is zero and one, and the sum of the scores is varied from 0 low function, dependence to 8 high function, independence Given the items in this tool, women can answer up to 8 questions, but men do not need to answer 3 items related to: meal preparation, housekeeping, and laundry.
However, recent studies suggest that it is better for men to respond to these items and questions, as these items together provide a good predictor of the independence and dependence of the older adult on IADL performance This scale has been translated and validated in Australian, Spanish, Malay and Korean versions 49 - This scale was also translated into Persian by Hassani Mehraban et al.
Performance Assessment of Self-care Skills PASS : This tool is a criterion reference, client reference, performance-based and observational that was developed in by Rogers and Holm. This tool consists of 26 tasks and sub-tasks.
This tool assesses the IADL performance of individuals in four functional areas: functional mobility including 5 items , Basic ADL including 3 items , ADL function with an emphasis on physical performance 4 items , ADL function with an emphasis on cognitive function 14 items This tool has been translated into Persian by Taghizadeh et al.
This scale is a performance-based scale that contains 24 items in 4 areas of: time, money, calculation, and communication. Only the American version of this tool is available Applying the right and proper assessment tools can help therapists achieve a suitable intervention plan. The purpose of this study is to identify the outcome measures specific to the ADL and IADL for older adults and to investigate the psychometric properties of these measures.
Each of the above tools has some advantages and limitations that therapists and researchers must take into account to choose the right and proper assessment tools based on its clinical utility or research purpose. Researchers report that the Katz questionnaire, given the shortness number of items and the general questions specific to the elderly living in the care centers, can be more effective for therapists than the other two scales Barthel, FIM in the elderly care centers 19 , On the other hand, translated versions of the two Barthel and FIM scales are more relevant to the Katz questionnaire, which indicates more use of this tool in assessing the ADL performance of older 17 , Laura Duffy in a study showed that the participants reported that Barthel's questionnaire was much easier to complete than the FIM questionnaire Another point to consider is that, given the fact that FIM has used the 7-point Likert scale in scoring, it can report the difference between maximum independence and maximum dependence of individuals with more caution and accuracy The ADL profile and AusTOMs are performance-based tools, although these tools provide much more accurate information than other tools in relation to ADL performance of individuals, but the time duration for completing this assessment takes hours so it is perhaps more difficult for older adults and make them exhausted 28 , 36 , besides the AusTOMs tool is a tool developed for the Australian context 36 , and it's better to be used in its context and culture.
The ADLQ tool is a comprehensive tool for assessing the ADL performance of individuals with cognitive impairment, in particular Alzheimer's patients, and because it is available in Canadian 31 , Chinese 32 , Spanish 33 , Brazilian 35 and Chilean 35 versions it indicate the high utilization of this tool in assessing the ADL performance of older adults with Alzheimer's.
According to that, the psychometric properties of this tool in Iran have not been studied yet. It is suggested that the psychometric properties of this tool be studied in Iran to be used as a useful tool for assessing the ADL performance of older adults by therapists and researchers.
Among the ADL assessment tools in older adults the MLVAI tool is specially developed for individuals with visual impairment, and since vision loss is one of the first symptoms in the aging process, this tool can be used to evaluate the ADL performance of older adults with visual impairment.
However, given the fact that this tool is also a performance-based tool and requires training, it seems less satisfying than other assessment tools The especial tool for assessing the ADL performance of older adults with Parkinson's disease, is the SPDDS tool, which is specific to the Parkinson's disease and is free and does not require any training The psychometric properties of this scale have not been studied in Iran so it is recommended that the Persian version and the psychometric properties of this tool be studied in Iran.
The FAI tool is developed specifically for patients with stroke and is usable to examine the progress of the IADL function of patients by 3 to 6 months after the stroke period; so it used in these patients frequently As the Persian version of this tool is not available in Iran, it is suggested that the psychometric properties of this tool in Iran be studied.
But the limiting factor for using this tool is the need for training courses that requires a fee Among these tools, perhaps the most widely used available tool in the Persian version is the Lawton questionnaire, which evaluates 8 IADL performance in older adults 47 , An implausible point in using this tool in the context of Iran is the existence of a culture of domestic and out-of-home duties based on gender in Iran.
Since some items in the Lawton questionnaire, such as meal preparation and laundry, are the tasks and responsibilities that are most often done by women, the lack of responsiveness to these questions by men leads to a reduction in their rating in the field of IADL performance and this is due to the fact that this reduction is due to cultural differences, not because of the inability to do those tasks.
Therefore, it is advisable to be careful about the use of this tool in Iran. While the PASS tool is performance-based and has accurate information about the ability of the older adults to do IADL functions, use of this tool is time-consuming and somewhat boring for older adults. One of the best ways that occupational therapists can play a role in health management of elderlies is to find a common language between rehabilitation specialists and other disciplines such as physicians.
Comprehensive assessment of the needs of elderlies especially the needs related to ADL and IADL using approved assessment tools is important. This study tried to introduce the ADL and IADL assessment tools of elderlies for the use of occupational therapists and encourage them to use these assessment tools and do there interventions based on the comprehensive evaluation. Assessment tools that can report ADL and IADL performance of individuals, especially in older adults, is partly dependent on the culture that dominates the community.
Because performance-based tools are tools that give information that is more accurate to therapists and researchers, the use of these tools is better than subjective tools, but most performance-based tools have been developed in other communities and cultures.
In addition, they are culture-based tools and need cultural adaptation and also require the cost of training courses for use. Therefore, it is recommended that aging and rehabilitation specialists, especially occupational therapists, try to develop performance-based tools and client-centered tools for assessing the ADL and IADL performance of older adults living in Iran.
Hereby, we appreciate the authorities of the School of Rehabilitation Sciences in Iran University of Medical and the authors announce their gratitude to all those who helped us with this research.
This research did not receive any grant from funding agencies in the public, commercial, or not-forprofit sectors. Cite this article as: Pashmdarfard M, Azad A. Med J Islam Repub Iran. National Center for Biotechnology Information , U. Published online Apr Author information Article notes Copyright and License information Disclaimer. Corresponding author: Dr Akram Azad, ri. Received Aug This article has been cited by other articles in PMC.
Abstract Background: Given the increasing population of older adults in different societies, it is important to take into account the needs of them. Keywords: Elderly, Evaluative, Everyday life, Review.
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