We are active beings. As with other animals, humans must take several actions in order to survive.
We must eat, move to avoid dangers, protect ourselves from the cold … and all of this, we usually do almost without thinking, day by day and continuously. However, these actions are more complex than they appear, and although most of us have automated them, they require learning and can get lost under certain circumstances.
In many cases, due to medical or psychiatric problems (for example an accident, crippling illness or dementia), it is possible that the basic and fundamental activities that we used to carry out without problem on our own become a problem, requiring outside help to carry them out. outside. And knowing whether or not we are independent in the most basic functions can be helpful in providing the help we need or in analyzing rehabilitation processes.
In order to assess our situation, there are different indices or scales, such as the index or the Katz scale. It is this instrument that we will be talking about throughout this article.
The Katz scale / index: what is it and what is it for?
The Katz Index (sometimes also called the Katz Functional Scale) is an assessment tool that allows you to assess the degree of physical dependence of a subject to perform the so-called basic activities of daily living.
With this concept we refer to the set of essential and most relevant skills for survival, self-care and self-preservation without having to depend on external support.
It is a scale which makes it possible to assess the degree of dependence or independence of a subject in six major basic skills: washing, dressing, using the toilet, moving / moving, confining the sphincter and eating . These skills are organized in a hierarchical manner, ordered according to the progression a child would make in his development.
This is relevant because when the most basic activities require external support, it is common for other basic functions to need help as well. In other words, if a person has difficulty eating, they will likely also have difficulty dressing or performing any of these activities. Its use makes it possible both to assess the subject’s current situation and to assess the progress made in the rehabilitation process.
Originally, the Functional Scale or Katz Index was developed to help assess rehabilitation performed by people with hip fractures, although over time its function has declined. has become used to assess the degree of dependence that patients present with various types of conditions.
It is one of the most used in the functional evaluation of geriatric patients or in palliative careAs it provides information on the degree of help or dependence that the person needs in his daily life and to better adjust the aids provided to him or the rehabilitations to which he is subject. It is possible to fill in the basis of observation of the patient by professionals, or thanks to information provided by the subject himself or by caregivers.
The Katz scale or index is an assessment instrument that includes a total of six items to be assessed, Returned to each of them one of the basic skills of daily living. More specifically, the items noted on this scale are as follows.
Bathing or washing is considered a basic activity of daily living, although one of the most complex. A person who is able to wash part of themselves or completely without help will be considered independent, while a person who needs help washing, getting in or out of the tub, or bathing will be dependent if more than one part of the body.
Dressing is a complex core activity that requires some coordination, Planning skills and motor skills. Independence or autonomy in this skill involves being able to grab necessary clothing, put it on or take it off, and use items such as buttons and zippers to dress completely. Addiction is taken into account in all cases where the person cannot dress alone or does so partially.
3. Use of toilets
Basic activity but a little more complex than the next one, independent use of the toilet involves the ability to get in and out of the toilet, Use it correctly, clean and repair clothes yourself and without the need for external support. In case of addiction, help is needed in using this item or wedges or urinals are needed.
Mobilization refers to the ability to move around in the environment or perform acts such as getting up, sitting down, or lying down in a chair or bed.. This in turn allows you to perform other basic basic activities. A person dependent on this skill will need aids to move, sit or lie down, or use objects such as beds or chairs.
One of the most basic basic skills, which we mean by continence the ability to control the processes of urination and defecation. In other words, it involves the ability to contain feces and urine and to expel them voluntarily. Usual incontinence, whether total or partial, would be considered a dependency of this skill.
It is considered to be the most basic and the most relevant of all the basic activities of daily living. The capacity to feed expresses the possibility for the subject to mobilize food in his mouth and to ingest it without needing external help.
It is important to note that this does not include more complex processes such as cutting or spreading food with cutlery. If there is dependence on this basic skill, supports will be necessary to be able to feed oneself or to use enteral or parenteral tube feeding..
Assessment of the information provided by the scale
The Katz index does not provide a numerical score and does not require complex calculations. To assess an individual with this scale, it is necessary to note for each of the basic activities of daily life whether the subject is independent or dependent on external aids (including these aids the mechanical guide, the sense of action or the need for ‘framing) .
In previous versions, it was possible to mark a partial dependency for each of the activities, although at present they only consider the condition of independence and that of dependence.
Once all the items have been assessed, the number of activities for which the person is independent is analyzed and a letter is given which will be the total assessment of the subject’s dependence / independence for those activities.
Thus we can find an independent person in all functions (A), independent in everything except one (B), independent in everything except bath and other function (C), independent in everything except bath, dressing and other function (D), independent for all except taking a bath, dressing, using the toilet and one other function, independent for all except bathing, dressing, using the toilet, moving around and one more function (F), dependent of the six functions (G) or depending on at least two functions but without being able to be classified into C, D, E or F (H).
Creu, AJ (1991). The Katz Index. Rev Esp Geriatr Gerontol, 26: 338-48.
Trigás-Ferrín, M., Ferreira-González, L and Meijide-Míguez, H. (2011). Functional rating scales in the elderly. Galicia Clin., 72 (1): 11-16.