Makindo Medical Notes

Choose the scoring point for the statement that most closely corresponds to the patient's current level of ability for each of the following 10 items. Record actual, not potential, functioning. Information can be obtained from self-report, family/relatives, or direct observation. Refer to the Guidelines below for details on scoring and interpretation.

📊 The Barthel Index (Activities of Daily Living)

📌 Guidelines for Use

• Index reflects what a patient does, not what they could do.
• Main aim = establish degree of independence from help (physical or verbal).
• Supervision = not independent.
• Performance should be based on best available evidence (patient, carers, nurses, observation).
• Direct testing not needed — practical judgement applies.
• Assess over preceding 24–48 hours (sometimes longer if relevant).
• Middle categories imply the patient supplies >50% of the effort.
• Use of aids (e.g., walking stick) counts as independent.

Clinical Pearl: The Barthel Index is quick (<10 minutes), reliable, and widely used in stroke, neuro-rehab, and frailty care. It measures functional independence in ADLs, not cognitive or social domains — so it complements, but does not replace, broader assessments (e.g. Lawton IADL or cognitive testing).