The functional sphere

It might describe as the capacity that the person has to carry out his own auto care, physical activities and social role. This sphere serves us to a great extent to realize if our patient needs more support or rehabilitation for example; from the lacks that we could see in his life.

The functional valuation is a process for which we obtain information about the capacity of the elder to realize the activities of the daily life (AVD) that can be basic (ABVD: Bathroom, garment, supply) or sets of instruments (ABVI: Use of the telephone, to cook, I handle of the money).

In an article I thought that near 25 % 65-year-old major persons need help for the AVD and that the major ones of 85 years need it in 50 %.

The scales to evaluate the ABVD are:

 - Index of activities of the daily life (KATZ): it is qualitative and is evaluated: the bath, to dress, I use of lavatory, mobility (6 activities) etc.. East index will say to us if it has maximum independence or maximum dependence.

- Barthel's Index: It is most known, evaluates 10 activities: To rise and to lower stairs, mobility, continence, use of the lavatory, etc … East index will show us if it has slight or serious dependence.

- Scale of physical disability of the Red Cross: It is evaluated: AVD, instrumental help for the mobility, level of mobility and continence of sphincters; this index will show us if it is dependent or independent.

 - Plutchik's Scale: He evaluates 7 activities: Supply, incontinence, to wash and to dress and to be fallen of the bed or armchair, etc..

These scales are necessary because if there weren’t scales or rules for saying it as well as we would judge when an elder has dependence or total independence; though it would be easy if his dependence was moderated you it cannot be equal like to the rest of the patients; by it with the scales this activity is done much easier, just and equalized to all the elders.

Though I think that here there is a variable that we lack and that does not bear in mind that it is that of the age; there is not the same 65-year-old man who could not dress only to one that has 90 years.

The scale to evaluate the AIVD is:

- Index of Lawton and Brody that values 8 activities: To use the telephone, go shopping, to prepare the food, to realize tasks of the home, etc .. it will show us the degree of dependence that has the person to whom we realize the scale.

The punctuation can be dual if it answers only with it or not or linear if it answers with phrases. The capacity of the persons to realize the AVD depends to a great extent on the mobility and vision; because though you are nice of health but you can move or see well; there will be many activities that you will not be able to realize. If on the contrary we have mobility and suffer a deterioration this is a factor of risk to suffer major number of falls; for what we will need major help.

To sum up I want refer that To measure the capacity of an old person in relation to everyday activities using the Barthel Scale (ABVD) Basic Activities of Daily Life; and the Lawton Scale (AIVD) Instrumental Activities of Daily Life.

BIBLIOGRAPHY:

- Céline Farez, Virginie Rio; Prevention of falls in the elderly living at home; INPES. [quoted in 16/04/2013] and available on:
http://www.inpes.sante.fr/CFESBases/catalogue/pdf/1160.pdf

- HOFFMAN, Gloria Basic Geriatric Nursing 5th Edition. Elsevier 2012.