APH 1998, 56, 291-303:

Activities of daily living scales and the needs for care and help among elderly before and after geriatric hospitalization.

T. Pepersack, I. Beyer, and the Study Group on Dependence in the French Community of Belgium

Keywords: autonomy, the elderly, ADL

Introduction. In Belgium, assessment of the economic charges allocated to care and help is based respectively on scale for activities of daily living (ADL) and on a local scale entitles "échelle d'aides aux personnes âgées" (APA).

Aims of the study. 1) To characterize the need for care and help of the elderly before an acute geriatric hospitalization and at discharge; 2) to study the validity of the scales used to assess the financial charges for care and help; and 3) to assess the effect of an acute geriatric hospitalization on the functional status and on the needs for care and help.

Methods. The need for care and help of 655 subjects were prospectively assessed according to their functional status using Katz's and APA-ADL scales. The needs for care and help were determined using the frequencies of interventions for care and for help.

Results. The needs before admission were respectively 18 ± 21 interventions/month (mean ± SD) for care and 40 ± 39 for help. Katz's and APA scales were respectively 15 ± 6 and 11 ± 6. The correlation between Katz's scale and the care index was statistically significant but concordance remained poor. Correlation between APA scale and the help index was significant and concordance better. Functional status slightly improved at discharge.

Discussion. There is no ground, according to the analysis of concordance between the Katz's scales and the needs for care, for dedicating more specifically Katz's scale for the assessment of the charges for care. APA scale seems to be a quite good reflection of the needs for help.