Katz ADL Index: clinical calculator (2026)

inputs

Bathing

Dressing

Toileting

Transferring

Continence

Feeding

✓ when to use

Use to quantify basic functional independence in elderly patients, rehabilitation settings, and care planning discussions. Provides a standardised snapshot of self-care ability. Useful for tracking functional decline over time, discharge planning, and care package assessment.

✗ when not to use

Katz ADL measures BASIC activities only. It does not capture Instrumental ADLs (cooking, shopping, finances, transportation) — use the Lawton IADL scale for those. Not suitable for assessing acute changes in function (may reflect illness rather than baseline). The binary (independent/dependent) scoring loses nuance about partial assistance needs.

clinical pearls

ADL loss typically follows a hierarchical pattern: bathing is usually lost first, then dressing, toileting, transferring, continence, and feeding last. Recovery follows the reverse order. This hierarchy can guide rehabilitation goal-setting.
Katz ADL measures what the patient CAN do, not what they typically do. A patient who chooses not to bathe but is physically capable still scores 'independent' for bathing.
Pair Katz ADL (basic ADLs) with Lawton IADL (instrumental ADLs) for a complete functional picture. A patient may be independent in basic ADLs but unable to manage shopping, cooking, or finances.
Document both pre-illness and current ADL status. The change in function is often more informative than the absolute score for acute care decision-making.
In the UK, ADL assessment informs NHS Continuing Healthcare assessments and social care funding decisions. Accurate ADL documentation has direct implications for patients' care entitlements.

✓ when to use

✗ when not to use

clinical pearls

ADL loss typically follows a hierarchical pattern: bathing is usually lost first, then dressing, toileting, transferring, continence, and feeding last. Recovery follows the reverse order. This hierarchy can guide rehabilitation goal-setting.
Katz ADL measures what the patient CAN do, not what they typically do. A patient who chooses not to bathe but is physically capable still scores 'independent' for bathing.
Pair Katz ADL (basic ADLs) with Lawton IADL (instrumental ADLs) for a complete functional picture. A patient may be independent in basic ADLs but unable to manage shopping, cooking, or finances.
Document both pre-illness and current ADL status. The change in function is often more informative than the absolute score for acute care decision-making.
In the UK, ADL assessment informs NHS Continuing Healthcare assessments and social care funding decisions. Accurate ADL documentation has direct implications for patients' care entitlements.

Katz ADL Index

inputs

✓ when to use

✗ when not to use

clinical pearls

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