Assessments Evaluating Activities of Daily Living and Instrumental Activities of Daily Living for Adults Receiving Home Health Occupational Therapy Services: A Scoping Review

Research Objectives: 1.To investigate validated assessments able to be performed by occupational therapists (OTs) that evaluate activities of daily living (ADLs) or instrumental activities of daily living (IADLs) for adults in a home health setting.

2. To determine which ADLs and IADLs have validated assessment tools that require patient performance (not self-report) in a home environment.

Design: This was a scoping review based upon the methodology of the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). Search completion was any peer-reviewed full text available English language article published through February 7th, 2024 (the date of extraction) that discussed ADL and/or IADL assessments that could be administered by an occupational therapy practitioner in the home health environment.

Setting: All studies had to have been performed in the United States. If a part of a systematic review, there had to be at least one study included with a validated assessment measuring ADLs and/or IADLs or an assessment being validated, from the United States. Studies must have been performed in the patient's home environment.

Participants: Participants with all diagnoses receiving home health services were eligible, but must have been 18 years of age or older, live in the United States and reside at home. Participants must have participated/performed in the assessment. Outcomes pertained to the patient and not caregivers.

Interventions: Home health services were provided by occupational therapists, nurses, and physical therapists with the assessments included for analysis if an occupational therapist was able to administer the assessment to a patient.

Main Outcome Measures: ADLs and/or IADLs from patient performance on validated assessments.

Results: Out of the 84 studies included, 62 different assessments were used. The most frequently used assessments were as follows: Outcomes and Assessment Information Set (OASIS) (n = 23), Functional Independence Measure (FIM) (n = 10), Timed Up and Go (TUG) (n = 8), and Berg Balance Scale (BBS) (n = 7). ADLs were evaluated more frequently than IADLs with functional mobility (n=157) the most frequently assessed ADL. The most frequently evaluated IADL was medication management (n=38).

Conclusions: There is a need for occupational therapists to have knowledge of and use validated assessments to be able to objectively document patient progress for ADLs and IADLs.

Author(s) Disclosures: The authors have no conflicts of interest.