The Lawton and Brody scale to evaluate autonomy in the elderly

One of the main consequences of aging is the progressive loss of autonomy. The deterioration of physical and mental health causes the elderly to become increasingly dependent, especially if they suffer from some type of dementia or brain damage. The Lawton and Brody scale allows us to detect the first signs of difficulty and lack of autonomy in the person.

This brief instrument is one of the most used internationally and the most used in geriatric units in Spain. It allows measuring the degree of independence in elderly people, both institutionalized and not. Furthermore, highlight that It does so through the evaluation of instrumental activities of daily living (IADL).

Instrumental activities of daily living

When analyzing dependency we must look at the person’s ability to carry out the activities of daily living. To classify them we can divide them into two groups, basic and instrumental:

The first refer to those most basic aspects of personal care.such as feeding, sphincter control or mobility.Instrumental activities, on the other hand, are more complex tasks, but no less important to be able to lead a life with autonomy. They include activities that require decision-making and problem-solving skills. The Lawton and Brody scale deals precisely with these.

The Lawton and Brody scale

This simple, but complete screening instrument does not require more than five minutes to apply. It is made up of eight items with several response alternatives. which together evaluate the elderly person’s ability to carry them out autonomously.

The total score is obtained by adding the values ​​obtained in each item and ranges between 0 (totally dependent) and 8 (absolute independence). Depending on the case, The scale will be completed by the patient himself or by a reliable caregiver (in case the elderly person is not capable).

Aspects that are evaluated

Ability to use telephone

Uses the telephone on his own initiative (1 point) Dials a few well-known numbers (1) Answers the phone, but does not dial (1) Is not able to use the telephone (0)

Go shopping

Makes all necessary purchases independently (1)Buys small things independently (0)Needs company to make any purchase (0)Totally unable to buy (0)

Food preparation

Plans, prepares and serves meals independently (1) Prepares meals adequately if given ingredients (0) Heats and serves meals, but does not maintain an adequate diet (0) Needs meals to be prepared and served (0)

Home care

Takes care of the house alone or with occasional help (1)Performs light tasks such as washing or making the bed (1)Performs light tasks, but does not maintain acceptable cleanliness (1)Needs help with all tasks (1)Does not participate in any work (0)

Laundry

Washes all his clothes himself (1)Washes small items (1)Needs someone else to take care of the washing (0)

Means of transport

He travels alone by public transport or uses his car (1) He is able to take a taxi, but does not use any other means (1) He travels by public transport accompanied by another person (1) He only travels by taxi or car with the help of others (0 )Does not travel (0)

Medication

Takes his medication at the correct time and dose (1)Takes his medication if the dose is prepared in advance (0)Is not able to administer his medication (0)

Economic Affairs

Manages his financial affairs on his own (1)Manages everyday affairs, but needs help with large purchases and going to the bank (1)Unable to manage money (0)

Usefulness of the Lawton and Brody scale

This instrument has proven to be effective in the objective assessment of dependency in the elderly. Its main advantage is that it not only offers a total score, approximating a degree of deterioration, but also gives us information about the areas in which this deterioration has occurred. In other words, Not only does it give us useful information for “diagnosis,” but it also does so for possible intervention.

This last point is essential to design and implement a therapeutic plan. That is, to be able to provide the person with new strategies to preserve their independence. Finally, it should be noted that the scale has proven to be more reliable when applied to women, given that many of the aspects it evaluates have traditionally been assigned to the female role.

You might be interested…