Unifying Concepts

Katz Index of Independence in Activities of Daily Living

The Index of Activities of Daily Living (ADL) encompasses six basic human functions: bathing, dressing, toileting, transfer, continence, and feeding. It provides an objective method of classifying heterogeneous groups of people with chronic illnesses, disabilities and impairments, and of describing their health needs and outcomes.

Katz Index of Independence in Activities of Daily Living (ADL)

Points (1 or 0)
NO supervision, direction or personal assistance
WITH supervision, direction, personal assistance or total care
BATHING (1 POINT) Bathes self completely or needs help in bathing only a single part of the body such as the back, genital area or disabled extremity. (0 POINTS) Needs help with bathing more than one part of the body, getting in or out of the tub or shower. Requires total bathing.
DRESSING (1 POINT) Gets clothes from closets and drawers and puts on clothes and outer garments complete with fasteners. May have help tying shoes. (0 POINTS) Needs help with dressing self or needs to be completely dressed.
TOILETING (1 POINT) Goes to toilet, gets on and off, arranges clothes, cleans genital area without help. (0 POINTS) Needs help transferring to the toilet, cleaning self or uses bedpan or commode.
TRANSFERRING (1 POINT) Moves in and out of bed or chair unassisted. Mechanical transferring aides are acceptable. (0 POINTS) Needs help in moving from bed to chair or requires a complete transfer.
CONTINENCE (1 POINT) Exercises complete self control over urination and defecation. (0 POINTS) Is partially or totally incontinent of bowel or bladder.
FEEDING (1 POINT) Gets food from plate into mouth without help. Preparation of food may be done by another person. (0 POINTS) Needs partial or total help with feeding or requires parenteral feeding.

6 = High (patient independent)
0 = Low (patient very dependent)



  1. Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist. 1970 Spring;10(1):20-30. [Medline]
  2. Buurman BM, van Munster BC, Korevaar JC, de Haan RJ, de Rooij SE.Variability in measuring (instrumental) activities of daily living functioning and functional decline in hospitalized older medical patients: a systematic review. J Clin Epidemiol. 2011 Jun;64(6):619-27. [Medline]


Created Nov 01, 2011.

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