The quality of life is determined by its activities. Aristotle
Functional Screening is important because…
• Chronological age is poor indicator of ability. • Hospitalized older adults are at high risk for loss of function skills.
– Environmental constraints
(IV’s, catheters, side rails)
– Decreased expectations for performance (ageism)
– New disabilities or illness
• Loss of functional abilities is a major cause of institutionalization.
What do you think?
What would be your first impression of this man if the first time you met him he was in a gown, lying in a hospital bed, trying to pull out his IV, and was confused? What if you knew he was 70 years old?
What would you assume about his level of function?
What if…..? you knew he was a regular surfer and ran a multi-million dollar company?
Would that change your expectations of his function?
Why or why not?
The goal of a functional assessment is to…
restore or improve health monitor changes enhance independence identify disabilities screen for issues needing further assessment and referral
evaluate the need for community resources and equipment
Living environme nt
Functional assessment includes all of these components. Functional Assessment
A systematic review of these areas
Vision / Hearing
Mobility (arms, legs)
Oral / Nutrition
ADL and IADL*
* ADL: Activities of Daily Living; IADL: Independent Activities of
When doing an assessment… • Assess, don’t assume.
• Watch, don’t just ask.
• Obtain baseline information: it is important to know what is normal for this individual.
• Identify what helpers, equipment, and supports make doing activities of daily life possible.
• Condition of glasses
• Snellen chart
• When was the last eye exam?
Minimum is every two years. If diagnosed with diabetes or an eye condition such as glaucoma, eye exams could be as frequent as every 6-12 months.
• Whisper test
(Stand behind the person and whisper a word in each ear.)
• Finger rub
(Stand behind the person and rub two fingers together by each ear.)
Keep going, there is more
– Build up interferes with the conduction of sound.
• Hearing aids
– Check batteries frequently; they last anywhere from less than a week to less than a month.
– Can cause an increase of cerumen impaction.
Can the individual…
• touch the palms of the hands to back of the head?
• reach up over the head? • touch the hands together behind the waist?
Upper Mobility is needed for…
• Combing and washing hair • Getting items off a shelf • Putting on a shirt
What other activities require upper mobility?
• “Get Up and Go” Test
Get up from a chair
Walk 10 feet
Turn around and walk back
Sit down again
• Problems with the above correlate with abnormal gait and increased risk of falling.
Inspect the oral cavity and check …
– the condition of teeth
– the condition and fit of dentures – for oral lesions or infections such as candidiasis
• Do you have any problems eating or swallowing?
• When was your last dental appointment? Quadruple A’s of
Does the person look well nourished? • Appetite
How is the person’s appetite?
Does the person have access to funds to buy food? Get to the store?
For more information: DETERMINE nutrition screen for older adults in
Optimal Aging Competency
Can the person prepare own meals? Open cans? Cook safely? Elimination:
- Delirium, Depression,
- Retention, Restricted mobility
Dementia and/or environment
- Infection, Inflammation,
- Pharmaceuticals, Polyuria
If incontinence is a new problem, it must be…