Assessing resistance to activities of daily living in long-term care

The Psychosocial Resistance to Activities of Daily Living Index (PRADLI) was developed for psychiatric nurses, geropsychologists, and clinical social workers to assess the level of long-term care (LTC) residents' resistance to and cooperation with staff in performing activities of daily living.

The PRADLI consists of 8 activities of daily living that commonly trigger a psychiatric or psychologic referral when residents resist necessary care in these domains. The PRADLI items were examined for internal consistency and test-retest reliability. Four of the 8 items overlap with most standard ADL scales, and convergent and discriminant validity was investigated using the ADL index from Katz, Ford, Moskowitz, and colleagues.

Four hundred six residents of LTC facilities were rated for levels of the previously mentioned ADL indices.

The PRADLI was evidenced to be a reliable and valid assessment tool for assessing resistance to ADLs in LTC facilities.

The PRADLI is an instrument that can potentially be used by LTC staff to assess ADLs. Research on the use of the PRADLI as a treatment outcome instrument in multidisciplinary LTC settings is warranted. Assessing ADLs within the context of residents' cooperation with LTC is an important part of understanding residents' overall quality of life.