Barthel Index

Activity	Score
Feeding 0 = unable 5 = needs help cutting, spreading butter, etc., or requires modified diet 10 = independent	0 5 10
Bathing 0 = dependent 5 = independent (or in shower)	0 5
Grooming 0 = needs to help with personal care 5 = independent face/hair/teeth/shaving (implements provided)	0 5
Dressing 0 = dependent 5 = needs help but can do about half unaided 10 = independent (including buttons, zips, laces, etc.)	0 5 10
Bowels 0 = incontinent (or needs to be given enemas) 5 = occasional accident 10 = continent	0 5 10
Bladder 0 = incontinent, or catheterized and unable to manage alone 5 = occasional accident 10 = continent	0 5 10
Toilet Use 0 = dependent 5 = needs some help, but can do something alone 10 = independent (on and off, dressing, wiping)	0 5 10
Transfers (bed to chair and back) 0 = unable, no sitting balance 5 = major help (one or two people, physical), can sit 10 = minor help (verbal or physical) 15 = independent	0 5 10 15
Mobility (on level surfaces) 0 = immobile or < 50 yards 5 = wheelchair independent, including corners, > 50 yards 10 = walks with help of one person (verbal or physical) > 50 yards 15 = independent (but may use any aid; for example, stick) > 50 yards	0 5 10 15
Stairs 0 = unable 5 = needs help (verbal, physical, carrying aid) 10 = independent	0 5 10
TOTAL (0 - 100)	________
Patient Name: __________________ Rater: ____________________ Date: / / :

THE BARTHEL ADL INDEX: GUIDELINES

1. The index should be used as a record of what a patient does, not as a record of what a patient could do.

2. The main aim is to establish degree of independence from any help, physical or verbal, however minor and for whatever reason.

3. The need for supervision renders the patient not independent.

4. A patient's performance should be established using the best available evidence. Asking the patient, friends/relatives and nurses are the usual sources, but direct observation and common sense are also important. However direct testing is not needed.

5. Usually the patient's performance over the preceding 24-48 hours is important, but occasionally longer periods will be relevant.

6. Middle categories imply that the patient supplies over 50 per cent of the effort.

7. Use of aids to be independent is allowed.