[Basic activities of daily living of elderly inpatients]

Basic activities of daily living (ADL) together with communication ability (visual, auditory and speech) and frequency of bedside visits by a nurse were assessed in 672 elderly inpatients staying on a certain day in Tokyo Metropolitan Geriatric hospital, which is a specialized general hospital for geriatrics but not a long-stay chronic care hospital. Diseases were divided into seven groups: neurological (N), circulatory (C), respiratory (P), bone and joint (B), malignant (M), dementia (D) and other disorders (O). The purpose of the study was to clarify the functional state of elderly inpatients and to correlate the Barthel indices (BAI) of ADL with disease group, communication ability, frequency of bedside visits, age and gender. Multivariate analysis revealed a significant association of BAI with frequency of bedside visits by a nurse, communication ability, disease group and age. Scores in patients of N and D groups were significantly decreased compared with other diseases in many items composing the BADL. Patients of B group showed significantly decreased scores in mobility, stairs and bathing, while patients of P group had decreased scores for stairs and bathing. Bathing and stairs were the most difficult activities in the BADL. BAI were linearly correlated with transfer. When independence of feeding was lost, the patients were almost totally dependent. The functional state should be assessed in geriatric inpatients where the quality of life of the patients must take priority over other considerations in the decision making for interventions. The BAI is easy to use and reliable and is probably a suitable tool evaluating the BADL in a comprehensive geriatric assessment.