Know thy proxy: Using patient proxies to assess functional status after critical illness.

Dr. Ahasic is an Assistant Professor in the Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Yale University School of Medicine. The study described here was performed in collaboration with investigators from the Yale Claude D. Pepper Older Americans Independence Center and the Yale Program on Aging. 

Functional impairment is a measure of disability that can include ability to perform activities of daily living (ADLs). Basic ADLs include self-care such as dressing, bathing and toileting. Instrumental ADLs are important to living independently such as using the telephone, taking medications, and shopping for groceries.

Functional impairment is commonly assessed using patient interviews, but there are many times when patients themselves may be unable or unwilling to be interviewed, particularly when they are ill or recovering from major illness. This may be particularly relevant during critical illness requiring admission to an intensive care unit (ICU), or during recovery after an ICU stay.

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There’s an order to things: Item response theory as a way to make sense of functional decline in dementia

Sarah McGrory is a PhD Student at the Alzheimer Scotland Dementia Research Centre at the University of Edinburgh. She Tweets at @ alzscotdrcfunctional decline

Are some activities harder than others for people with dementia? In our research, recently reported in Age and Ageing, we looked at how people with dementia differed in their day to day activities. 202 people with mostly mild to moderate dementia in Scotland were asked about their activities

Activities (using the telephone, shopping, food preparation, housekeeping, laundry, travelling, taking medications, handling finances) can be measured using a questionnaire called the Lawton Instrumental Activities of Daily Living (IADL) scale. Usually scores on the individual tasks are added together to give a total score ranging from 0 to 8. This number can hide a lot of information about a patient’s functional ability. It assumes every functional activity is equally difficult, which is rarely the case. For example, being able to manage your finances is likely to be harder for most people than being able to eat. Continue reading