Functional assessment in a community setting

Functional assessment for persons with disabilities has been an important component of the traditional inpatient rehabilitation process. Recently there has been increasing interest in functional assessment for persons residing in the community as a means to understanding the role of rehabilitation in community integration and the effects of aging on persons with disabilities. The instruments used for in-hospital functional assessment (e.g., the Functional Independence Measure and the Barthel Index) measure aspects of disability, specifically basic self-care and mobility skills, and may not be adequate for community assessment. Most often the functional activities that are of interest for persons I iving in the community include instrumental activities of daily living such as housekeeping and shopping; components of handicap such as social integration, community mobility, and productive use of time; and community participation. Instruments used to measure components of handicap (i.e., the Craig Handicap Assessment and Reporting Technique) and community participation (i.e., the Self-Observation and Report Technique) may be more appropriate for the evaluation of functional status for persons living in the community.