National Occupational Therapy Month

Written By: Kathy Boyarko, PT, CDP, Program Development Manager

Occupational Therapists are experts on function, particularly with Activities of Daily Living.  They are specifically trained to modify the physical environment and use adaptive equipment to help people regain independence.  But often times, it seems insurance companies only focus on a patient’s ability to walk and their Physical Therapy progress.  So how important is Occupational Therapy and a person’s ability to perform ADLs? 

Well in March of 2012 the Journal of the American Geriatrics Society published an article by Stineman MG et al, which examined the association between various stages of ADL abilities and mortality.  They studied 9,447 community dwelling people aged 70 and above.

They staged the ADL abilities from no limitations, stage l, stage ll, stage lll and stage lV (from mild limitations to complete dependence).  They then followed them to measure their life expectancy until the time of death. 

Results:

ADL Category                                                            Median Life Expectancy 

No ADL Limitations                                                                10.6 Years

I                                                                                               6.5 Years

II                                                                                               5.1 Years

III                                                                                             3.8 Years

IV                                                                                             1.6 Years

Conclusion:

ADL stage continued to explain mortality risk after adjusting for known risk factors including advanced age, stroke, and cancer. ADL stages might aid clinical care planning and policy as a powerful prognostic indicator particularly of short-term mortality, improving on current ADL measures by profiling activity limitations of relevance to determining community support needs.

So as you can see, ADL performance is very relevant and important to a patient’s prognosis.  So much so that the University of Nebraska Medical Center actually uses this mnemonic to describe ADLS:

"DEATH".  D ress, E at, A mbulate, T ransfer/T oilet, H ygiene. "If you can't do your ADL's, your dead".  They also state that “Declines in these functions are predictive of poor outcomes in hospitalization, illness and higher mortality”. 

Regarding this outlook, you could say that our Occupational Therapists are really impacting lives at work every day!   So keep up the great job and know that your hard work is appreciated!