Katz Index: A Test That Evaluates Daily Activities
We are active beings As with other animals, humans need to carry out multiple actions in order to survive.
We need to eat, move to avoid dangers, protect ourselves from the cold… and we tend to do all of this almost without thinking, day by day and continuously. However, these actions are more complex than they seem, and although most of us have automated them, they require learning and can be lost in certain circumstances.
In many cases, due to medical or psychiatric problems (for example, an accident, a disabling illness or dementia), it is possible that basic and fundamental activities that we once carried out without problems on our own become a problem, requiring external help to carry them out. And knowing whether or not we are independent in the most basic functions can be useful to provide the help we need, or to analyze rehabilitation processes.
In order to evaluate our situation, there are different indices or scales, such as the Katz index or scale. It is about this instrument that we are going to talk about throughout this article.
The Katz scale/index: what is it and what is it for?
The Katz Index (sometimes also called the Katz Functional Scale) It is an evaluation instrument that allows assessing the degree of physical dependence of a subject to carry out the so-called basic activities of daily living.
With this concept we refer to the set of essential and most relevant skills for survival, self-care and self-preservation without the need to depend on external support.
It is a scale that allows evaluating the degree of dependence or independence of a subject in six major basic skills: washing, dressing, using the toilet, moving, sphincter control and feeding. These skills are organized in a hierarchical way, ordered according to the progression that a child would carry out in their development.
This is relevant given that when the most fundamental activities require external support, it is common for the rest of the basic functions to also require help. In other words, if a person has difficulty eating, it is likely that they also have difficulties dressing themselves or carrying out any of these activities. Its use allows both to assess the current situation of the subject and to evaluate the progress made in rehabilitation processes.
Originally, the Functional Scale or Katz index was developed with the purpose of helping to assess the rehabilitation carried out by people with hip fractures, although over time its function has come to be used to assess the degree of dependency that Patients present with various types of conditions.
It is one of the most used in the functional assessment of geriatric patients or in palliative care, since it allows us to obtain information on the degree of help or dependency that the person needs in their daily life and to better adjust the help that is provided or the rehabilitation to which they undergo. It is possible to fill it out based on the observation of the patient by professionals, or through the information provided by the subject themselves or by caregivers.
Items included
The Katz scale or index It is an evaluation instrument that includes a total of six items to be assessed, each of them referring to one of the basic skills of daily life. Specifically, the items that are scored on this scale are the following.
1. Wash
The act of bathing or washing is considered a basic activity of daily life, although one of the most complex A person who is able to wash a single part or completely without help will be considered independent, while a person who requires help to wash, get in or out of the bathtub or wash more than one part of the body will be found in a dependent situation.
Getting dressed is a complex basic activity, which requires some coordination, planning ability and motor ability. Independence or autonomy in this skill implies being able to pick up the necessary clothing, put it on or take it off, and use elements such as buttons and zippers in order to dress completely. Dependency will be considered in all those cases in which the person cannot dress themselves or partially do so.
3. Use of toilet
A basic activity but somewhat more complex than those that follow, independent toilet use involves the ability to access and exit the toilet, use it correctly, clean and fix your clothes on your own and without the need for external support. When there is dependency, help is needed to use this element or bedpans or urinals are required.
4. Mobilization
Mobilization refers to the ability to move around the environment or perform acts such as getting up, sitting or lying down in a chair or bed This in turn allows other fundamental basic activities to be carried out. A person dependent on this ability will require help to move, sit or lie down, or use elements such as beds or chairs.
5. Continence
One of the most fundamental basic skills, we understand by continence the ability to control the processes of urination and defecation That is, it implies the ability to contain feces and urine and expel them voluntarily. Habitual incontinence, whether total or partial, would be assessed as dependence on this ability.
6. Food
It is considered the most basic and relevant of all the basic activities of daily life. The ability to feed expresses the possibility for the subject to move food to his or her mouth and ingest it without the need for external help.
It is important to note that this does not include more complex processes such as cutting or spreading food with cutlery. If there is dependency in this basic skill, support will be required to be able to feed or the use of enteral or parenteral tube feeding
Assessment of the information provided by the scale
The Katz index does not provide a numerical score and does not require complex calculations To evaluate an individual with this scale, it will be noted for each of the basic activities of daily living whether the subject is independent or dependent on external aids (including these aids, mechanical guidance, direction of action, or need for supervision). ).
In previous versions there was the possibility of marking a partial dependency for each of the activities, although currently they only consider the condition of independence and dependency.
Once all the items have been evaluated, the number of activities for which the person is independent is analyzed and a letter is awarded, which will be the total assessment of the subject’s dependence/independence for these activities.
Thus we can find a person independent in all functions (A), independent in all except one (B), independent in all except bathing and one other function (C), independent in all except bathing, dressing and one other function (D), independent for all except bathing, dressing, using the toilet and one other function (E), independent for all except bathing, dressing, using the toilet, moving and one other function (F), dependent for all six functions (G) or dependent on at least two functions but without being classifiable as C, D, E or F (H).
