In an era where the aging population is rapidly increasing, the necessity of assessing the functional status of older adults cannot be overstated. Changes associated with aging, acute or worsening chronic illnesses, and the impacts of hospitalization significantly contribute to declines in the ability to independently perform daily tasks, making assessments like the Lawton Instrumental Activities of Daily Living (IADL) Scale critical. Developed as a tool to evaluate more complex life skills beyond basic self-care, the Lawton IADL Scale delves into eight domains of function, offering insights into an individual's capacity for independent living within the community. This instrument originally differentiated between gender in scoring, but has evolved to equally assess all domains regardless of gender, ensuring a more inclusive approach. Validity and reliability assessments have underscored its usefulness in both research and clinical settings, though it's best suited for community-dwelling adults rather than those in institutional settings. Administered through self or surrogate reports, the Lawton IADL Scale identifies specific deficits, guides rehabilitation or in-home service planning, and supports safe discharge planning from hospitals. Despite its limitations, including potential biases in self-reporting and sensitivity to minor functional changes, this tool remains instrumental in evolving the care provided to older adults, highlighting the urgent need for tailored interventions and resources to maintain and enhance their quality of life.
Question | Answer |
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Form Name | Lawton Instrumental Activities Form |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | activities, adl iadl blank fillable form, lawton scal fillable, daily |
general assessment series
Best Practices in Nursing
Care to Older Adults
From The Hartford Institute for Geriatric Nursing, New York University, College of Nursing
Issue Number 23, Revised 2013 |
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New York University College of Nursing |
The Lawton Instrumental Activities of Daily Living (IADL) Scale
By: Carla Graf, PhD(c), MS, RN,
WHY: The assessment of functional status is critical when caring for older adults. Normal aging changes, acute illness, worsening chronic illness, and hospitalization can contribute to a decline in the ability to perform tasks necessary to live independently in the community. The information from a functional assessment can provide objective data to assist with targeting individualized rehabilitation needs or to plan for specific in home services such as meal preparation, nursing and personal care,
BEST TOOL: The Lawton Instrumental Activities of Daily Living Scale (IADL) is an appropriate instrument to assess independent living skills (Lawton &
Brody, 1969). These skills are considered more complex than the basic activities of daily living as measured by the Katz Index of ADLs (See Try this: Katz Index of ADLs). The instrument is most useful for identifying how a person is functioning at the present time and for identifying improvement or deterioration over time. There are 8 domains of function measured with the Lawton IADL scale. Historically, women were scored on all 8 areas of function; men were not scored in the domains of food preparation, housekeeping, laundering. However, current recommendations are to assess all domains for both genders (Lawton, Moss, Fulcomer, & Kleban, 2003). Persons are scored according to their highest level of functioning in that category. A summary score ranges from 0 (low function, dependent) to 8 (high function, independent).
TARGET POPULATION: This instrument is intended to be used among older adults, and may be used in community, clinic, or hospital settings. The instrument is not useful for institutionalized older adults. It may be used as a baseline assessment tool and to compare baseline function to periodic assessments.
VALIDITY AND RELIABILITY: Few studies have been performed to test the Lawton IADL scale psychometric properties. The Lawton IADL Scale was originally tested concurrently with the Physical
STRENGTHS AND LIMITATIONS: The Lawton IADL is an easy to administer assessment instrument that provides
A limitation of the instrument includes the
MORE ON THE TOPIC:
Best practice information on care of older adults: www.ConsultGeriRN.org.
Gallo, J.J., & Paveza, G.J. (2006). Activities of daily living and instrumental activities of daily living assessment. In J.J. Gallo, H.R. Bogner, T. Fulmer,
&G.J. Paveza (Eds.), Handbook of Geriatric Assessment (4th ed., pp.
Graf, C. (2008). The Lawton Instrumental Activities of Daily Living Scale. AJN, 108(4),
Lawton, M.P., & Brody, E.M. (1969). Assessment of older people:
Lawton, M.P., Moss, M., Fulcomer, M., & Kleban, M. H. (2003).
Pearson, V. (2000). Assessment of function. In R. Kane, & R. Kane (Eds.), Assessing Older Persons. Measures, Meaning and Practical Applications (pp.
Permission is hereby granted to reproduce, post, download, and/or distribute, this material in its entirety only for
The Hartford Institute for Geriatric Nursing, New York University, College of Nursing is cited as the source. This material may be downloaded and/or distributed in electronic format,
including PDA format. Available on the internet at www.hartfordign.org and/or www.ConsultGeriRN.org.
The Lawton Instrumental Activities of Daily Living Scale
A. Ability to Use Telephone |
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1. |
Operates telephone on own initiative; looks up |
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and dials numbers |
1 |
2. |
Dials a few |
1 |
3. |
Answers telephone, but does not dial |
1 |
4. |
Does not use telephone at all |
0 |
B. Shopping |
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1. |
Takes care of all shopping needs independently |
1 |
2. |
Shops independently for small purchases |
0 |
3. |
Needs to be accompanied on any shopping trip |
0 |
4. |
Completely unable to shop |
0 |
C. Food Preparation |
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1. |
Plans, prepares, and serves adequate |
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meals independently |
1 |
2. |
Prepares adequate meals if supplied |
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with ingredients |
0 |
3. |
Heats and serves prepared meals or prepares meals |
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but does not maintain adequate diet |
0 |
4. |
Needs to have meals prepared and served |
0 |
E. Laundry |
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1. |
Does personal laundry completely |
1 |
2. |
Launders small items, rinses socks, stockings, etc |
1 |
3. |
All laundry must be done by others |
0 |
F. Mode of Transportation |
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1. |
Travels independently on public transportation |
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or drives own car |
1 |
2. |
Arranges own travel via taxi, but does not |
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otherwise use public transportation |
1 |
3. |
Travels on public transportation when assisted |
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or accompanied by another |
1 |
4. |
Travel limited to taxi or automobile with |
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assistance of another |
0 |
5. |
Does not travel at all |
0 |
G. Responsibility for Own Medications |
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1. |
Is responsible for taking medication in correct |
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dosages at correct time |
1 |
2. |
Takes responsibility if medication is prepared |
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in advance in separate dosages |
0 |
3. |
Is not capable of dispensing own medication |
0 |
D. Housekeeping
1. |
Maintains house alone with occasion assistance |
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H. Ability to Handle Finances |
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(heavy work) |
1 |
1. |
Manages financial matters independently (budgets, |
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2. |
Performs light daily tasks such as dishwashing, |
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writes checks, pays rent and bills, goes to bank); |
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bed making |
1 |
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collects and keeps track of income |
1 |
3. |
Performs light daily tasks, but cannot maintain |
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2. |
Manages |
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acceptable level of cleanliness |
1 |
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with banking, major purchases, etc |
1 |
4. |
Needs help with all home maintenance tasks |
1 |
3. |
Incapable of handling money |
0 |
5. |
Does not participate in any housekeeping tasks |
0 |
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Scoring: For each category, circle the item description that most closely resembles the client’s
highest functional level (either 0 or 1).
Lawton, M.P., & Brody, E.M. (1969). Assessment of older people:
Copyright © The Gerontological Society of America. Reproduced [Adapted] by permission of the publisher.
general assessment series
Best Practices in Nursing Care to Older Adults
A series provided by The Hartford Institute for Geriatric Nursing, New York University, College of Nursing
EMAIL hartford.ign@nyu.edu HARTFORD INSTITUTE WEBSITE www.hartfordign.org CLINICAL NURSING WEBSITE www.ConsultGeriRN.org