Functional health involves the assessment of the client’s physical and mental capacity to participate in day-to-day activities. It includes assessment of:
- Activities of Daily Living (ADL) as illustrated in Figure 2.7 are daily basic tasks that are fundamental to everyday functioning (e.g., hygiene, elimination, dressing, eating, ambulating/moving).
- Instrumental Activities of Daily Living (iADL) as illustrated in Figure 2.8 are more complex daily tasks that allow clients to function independently (e.g., managing finances, paying bills, purchasing and preparing meals, managing one’s household, taking medications, facilitating transportation). Assessment of iADL may be particularly important to inquire about with adolescents or young adults who have just moved into their first place and clients who are older and/or have disabilities.
It is important to assess functional health because the data collected could expose an opportunity for preventive action and health promotion, palliation, or assistance. Because health extends beyond the absence of disease, it is important to consider broader dimensions of health as a holistic and complete assessment.
You may start this section of the interview by saying, “Next, I would like to ask you some questions related to your day-to-day life and factors that affect your ability to function in your day-to-day life.” Table 2.6 outlines possible questions and statements to apply to the various sub-categories of functional health, along with some considerations. For interview demonstrations, see Film Clip 2.4 about elimination and Film Clip 2.5 about substance use.
Film Clip 2.4: Interview demonstrating assessment of elimination
Film Clip 2.5: Interview demonstrating assessment of substance use
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Refers to food and fluid intake, financial ability to purchase food, time and knowledge to prepare and make meals, and appetite or change in appetite. You also want to elicit data related to a client’s usual diet and goals related to their nutrition. Additionally, you need to probe so that an adequate amount of detail is obtained.
This is an opportune time to engage in health promotion discussions about healthy eating. It is also important to be aware of risks for malnutrition and obesity, specifically assessing for patterns of rapid and excessive weight loss or weight gain.