Physician ranking of activities of instrumental activities of daily living domains

Abstract

<p>Independent aged in the community: The importance of individual instrumental activities of daily living skills . Although there is no agreement on the causes of heterogeneity of function among the aged, there is agreement among scholars that there is much variation in the way humans age (Heikkinen et al.,1983; Crews, 1990; Rowe and Kahn, 1987; Manton et al., 1987, Vaupel, 1997). Demographers, gerontologists, anthropologists and epidemiologists generally agree that if aging is defined as the time-related changes in a biological organism over its life span, then these universal processes are reflected in the function and the survival of this organism. Although scholars from these four disciplines study the function of the aged, their theoretical orientations and the methods (measures of independence) they use to wdract and interpret these data may be as varied as the heterogeneity of the aging process itself. Measuring independence using the instrumental activities of daily living skills . The Instrumental Activities of Daily Living (IADL) are a set of skills used by health care professionals and researchers to determine whether an Individual is able to function independently in a community. These skills include the ability to feed oneself, maintain one's hygiene, dress oneself, toilet oneself, perform indoor mobility tasks such as transfer from bed to chair and bed to commode, use a telephone, handle one's finances, do one's laundry, perform outside mobility tasks, perform one's shopping, medicate oneself, perform housekeeping, and use some form of transportation (Kane and Kane, 1981, 2000; Appendix, III). The independence of an older individual is most often based on the judgement of physicians, as representatives of the biomedical system. Although other health care professionals assess independence in the aged, in most health care systems, it is the physicians who are the gatekeepers who prescribe assistive services if independence is compromised. Researchers most often assess independence at an international level. Many populations have growing numbers of aged individuals. The literature in all four disciplines that study aging deals with concerns over the assessment and care of these individuals. Anthropologists are interested in the dynamics of ethnic groups or distinct populations. The objective of this study is to determine whether physicians grouped by geographical area rank the importance of the IADL skills differently. (Abstract shortened by UMI.)</p>