Standardized Patient Actor Training
Section 2 - Assessment of Activities of Daily Living
ASSESSING FUNCTIONAL STATUS
Observing the Patient
In evaluating a patient's function, doctors should consider the circumstances of the patient's visit. For example, does the patient complain about problems with any activities? Does the patient appear well dressed and groomed, or does the patient's appearance raise questions about the ability to do these activities? Does someone accompany the patient, possibly because of concern about the patient's ability to get to or participate in the clinic visit alone? Often, the doctor may ask the patient a general question, such as "How are you doing in your daily activities?"
Taking a Functional History
Based on these circumstances, the doctor should ask more focused questions about how well the patient is doing in the activities of daily living. For example, if the patient appears underdressed or poorly groomed, the doctor might ask about basic activities. If the patient is well groomed, and accompanied to the visit by a family member, the doctor might ask about instrumental activities of daily living. If the patient has come alone, the doctor might ask about advanced activities.
The doctor should begin my asking about the most appropriate activites of daily living, based on the observed circumstances. For example, asking about BADLs when a patient comes to the office appropriately dressed and groomed would probably be inefficient.