Lawton and Brody used the Physical Self-Maintenance Scale to evaluate the ability of a patient to live with complete independence. While developed for the elderly it can be used in other persons with disabilities. The authors are from the Philadelphia Geriatric Center.
NOTE: The scale shows similarities to other scales in this section, such as the Katz Index of Independence in ADL. It was based on a scale developed by Lowenthal at Langley-Porter Neuropsychiatric Institute.
Parameters:
(1) use of toilet
(2) feeding
(3) dressing
(4) grooming (neatness, hair, nails, hands, face, clothing)
(5) physical ambulation
(6) bathing
|
Parameter |
Finding (Paraphrased from the Original Text) |
Original Points |
Modified Points |
|
use of toilet |
complete care for self on toilet and no incontinence |
1 |
4 |
|
|
needs to be reminded or help in cleaning self or has rare accidents |
0 |
3 |
|
|
soils or wets self while asleep more than once a week |
0 |
2 |
|
|
soils or wets self while awake more than once a week |
0 |
1 |
|
|
no control of bowel or bladder |
0 |
0 |
|
feeding |
prepares meals, eats and cleans up without assistance |
1 |
4 |
|
|
requires minor assistance |
0 |
3 |
|
|
requires moderate assistance and is untidy |
0 |
2 |
|
|
requires extensive assistance for all meals |
0 |
1 |
|
|
does not feed self at all and resists efforts of other to feed |
0 |
0 |
|
dressing |
does completely on own |
1 |
4 |
|
|
dresses and undresses self with minor assistance |
0 |
3 |
|
|
needs moderate assistance |
0 |
2 |
|
|
needs major assistance and cooperates with others |
0 |
1 |
|
|
completely unable to do and resists efforts of others to help |
0 |
0 |
|
grooming |
always neatly dressed and groomed without assistance |
1 |
4 |
|
|
grooms self adequately but needs help occasionally with some activities |
0 |
3 |
|
|
needs moderate and regular assistance or supervision |
0 |
2 |
|
|
needs total grooming care but can remain well-groomed |
0 |
1 |
|
|
actively works against any effort to groom |
0 |
0 |
|
ambulation |
completely independent |
1 |
4 |
|
|
ambulates about residence or for up to a block outside |
0 |
3 |
|
|
ambulates with assistance of a person or mobility device (cane, walker, wheelchair, etc.) |
0 |
2 |
|
|
sits unsupported in chair or wheelchair but cannot propel self without help |
0 |
1 |
|
|
bedridden most of the time |
0 |
0 |
|
bathing |
bathes self without help |
1 |
4 |
|
|
bathes self but needs help getting in and out of tub |
0 |
3 |
|
|
washes face and hands but needs help elsewhere |
0 |
2 |
|
|
does not wash self but cooperates with efforts to clean |
0 |
1 |
|
|
does not wash self and resists efforts of others to wash |
0 |
0 |
where:
• The original scale awards points only to full independence.
• Something not seen in many scales is the description of the patient working against attempts to dress, feed, groom or bathe.
• Use of toilet could be broken up into 2 parameters - use of toilet and incontinence. These could then be combined into a single result.
total score in original scale =
= SUM(points for all 6 items)
total score in modified scale =
= SUM(points for all 6 items)
number of items at a given level in modified scale =
= SUM(number of parameters at given level)
Interpretation:
• minimum score in original or modified scale: 0
• maximum score in original scale: 6
• maximum score in modified scale: 24
• The higher the score the greater the independence.
Purpose: To evaluate the degree of independence in self-maintenance for a patient using the Physical Self-Maintenance Scale of Lawton.
Specialty: Sports Medicine & Rehabilitation
Objective: physical and lifestyle, disability and performance
ICD-10: Z73.6,
