Katz Basic Activities of Daily Living
Bathing:
[select name="Q1" value="Bathes self completely or needs help with only single part of body, such as back, genital area, or disabled extremity =1|Needs help with bathing more than one part of body, getting in or out of bathtub or shower; requires total bathing =0"]
Dressing:
[select name="Q2" value="Gets clothes from closets and drawers, and puts on clothes and outer garments complete with fasteners; may need help tying shoes =1|Needs help with dressing self or needs to be completely dressed =0"]
Toileting:
[select name="Q3" value="Goes to toilet, gets on and off, arranges clothes, cleans genital area without help =1|Needs help transferring to toilet and cleaning self, or uses bedpan or commode =0"]
Transferring:
[select name="Q4" value="Moves in and out of bed or chair unassisted; mechanical transfer aids are acceptable =1|Needs help in moving from bed to chair or requires a complete transfer =0"]
Fecal & urinary continence:
[select name="Q5" value="Exercises complete self-control over urination and defecation =1|Is partially or totally incontinent of bowel or bladder =0"]
Feeding:
[select name="Q6" value="Gets food from plate into mouth without help; preparation may be done by another person =1|Needs partial or total help with feeding or requires parenteral feeding =0"]
SCORE: [calc value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)" memo="score"]/6: [calc value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6);score>5?'High independence':score>0?'Intermediate independence':'Low independence'" memo="interpretation"]