The Katz ADL index rates six basic self-care activities as independent or dependent: bathing, dressing, toileting, transferring, continence, and feeding. The total, from 0 to 6, shows how much hands-on help an older person needs. See how to rate each activity, what each total means, and record the result with the free template. Get the official sheet from the Hartford Institute for Geriatric Nursing.
Katz ADL result template
FreeKATZ ADL RESULT Date: [Date] Patient: [Name or ID, age] Setting: [Home visit, clinic, hospital ward, rehabilitation unit, or care home] Rated by: [Name, credentials] Sheet used: [Official Katz Index sheet from the Hartford Institute for Geriatric Nursing, or a local adaptation] RATING Based on: [Watched the person do it, what the patient reports, a family member or carer, or nursing records; say which for each activity if mixed] Informant: [Name and relationship, if anyone besides the patient] Period rated: [Today, the past week, or the usual state before a named illness] THE SIX ACTIVITIES Bathing: [Independent or dependent; what help, who gives it, how often] Dressing: [Independent or dependent; which garments or fastenings need help] Toileting: [Independent or dependent; getting there, clothing, cleaning] Transferring: [Independent or dependent; bed and chair, equipment used, hands-on help] Continence: [Independent or dependent; bladder, bowel, pads, catheter, or ostomy] Feeding: [Independent or dependent; hand to mouth, tube feeding if any] SCORE AND CHANGE Total: [0 to 6, one point per activity done independently] Meaning: [Full function, dependent in one activity, moderate impairment, or severe functional impairment] Baseline: [Earlier total, its date, and where it was rated] Difference: [Points gained or lost, and which activities changed] Likely cause: [Acute illness, surgery, fall, delirium, pain, a known condition progressing, or no change] HELP NEEDED Who helps now: [Spouse, family, paid carer, nursing staff, or no one] Gaps and risks: [Activities with no reliable helper, near falls, skin risk, carer strain] Equipment: [Shower seat, grab bars, raised toilet seat, commode, walker, or none] PLAN Actions: [Home care referral, therapy, equipment, carer support, placement discussion, or none] Other assessments: [Lawton IADL, cognitive screen, fall risk, frailty level, or a full geriatric assessment] Rescore: [Date, interval, or trigger such as discharge or a fall] Clinician: [Name, credentials]
Use it for
The Katz index rates actual performance in the six activities, not ability. Base each rating on what you see, what the person tells you, and what the people who help them every day report.
Avoid: Scoring what the person says they could do. “I could shower on my own if I had to” isn’t independence if their daughter helps every time.
Each activity scores 1 when it’s done with no supervision, direction, or personal help, and 0 when any of these is needed. Add them for a total from 0 to 6.
Avoid: Rounding up a borderline activity because the person mostly manages. If a person has to be there, the activity scores 0.
The source reads 6 as full function, 4 as moderate impairment, and 2 or less as severe functional impairment. Which activities were lost matters as much as the count.
Avoid: Treating two totals of 4 as the same need. Help with bathing and dressing is a different care plan from help with transfers and continence.
The index earns its place over time: a baseline when the person is well, then scores on admission, at discharge, and at home afterwards.
Avoid: Calling a score of 6 “no problems.” The index has a ceiling, so add instrumental activities and mobility to catch early decline.
Each dependent activity is a care need. The result should say who meets it, how often, and with what equipment.
Avoid: Recording the score and stopping there. A total without a plan for the help it shows doesn’t change anything for the person.
Each one follows the recording template. Use them to judge how much to write.
Home visit by a community nurse, 3 days after a 10-day hospital stay
Watched him rise from his armchair, walk to the bathroom with his walker, and use the toilet. Bathing, dressing, and continence from him and his wife, who gives all his care, over the 3 days since discharge.
86-year-old man. Bathing: dependent; can’t stand long enough to shower, and his wife helps him over the tub edge and washes his legs and feet. Dressing: dependent; she puts on his compression stockings, socks, and trousers over his swollen legs. Toileting: independent with the walker. Transferring: independent from bed and armchair, pushing up on the arms. Continence: dependent; urge incontinence since his furosemide was doubled, wets his pad most mornings. Feeding: independent; his wife cooks.
Total 3, moderate impairment. Baseline 6 before the admission in October, from his wife. Lost bathing, dressing, and continence. Likely cause: deconditioning after the admission, leg swelling, and the higher diuretic dose.
His wife, 83, does everything now. She has spinal stenosis and says lifting his legs into the tub hurts her back. Their daughter lives 2 hours away. He nearly fell climbing out of the tub on Sunday. Equipment: walker only; no grab bars or shower seat.
Home care referral sent: a home care worker for showering and dressing 5 mornings a week, starting Thursday. Occupational therapy home visit for a tub transfer bench, grab bars, and a raised toilet seat. Home physical therapy for strength and walking. Asked his family doctor to review the diuretic timing and the new incontinence; pads supplied for now. Lawton IADL done the same visit. Carer support information given to his wife. Rescore in 4 weeks, or sooner after a fall or readmission.
Family practice, annual check-up, rated by the practice nurse
From her own account of a usual week. Watched her stand from the chair, climb onto the exam table, and undress and dress for the exam.
79-year-old woman, lives alone. Bathing: independent; showers by herself, with a stool to wash her feet. Dressing: independent; sits down now to put on trousers and shoes. Toileting: independent. Transferring: independent, including from a low sofa. Continence: independent, no leakage. Feeding: independent.
Total 6, full function. Also 6 at last year’s check-up. No change on the index, though she says dressing takes longer and she now sits for it, which a 6 can’t show.
No help with personal care. Second-floor apartment with an elevator; her son visits on Sundays. Grab bar already in the shower. Still manages her own medicines, banking, and shopping; stopped driving at night last winter.
Recorded as her baseline for any future hospital stay. Timed Up and Go 11 seconds; one stumble on the stairs, no falls. Referred to a community strength and balance class. Repeat at next year’s check-up, or after any fall, illness, or hospital stay.
The index asks what the person does. If their spouse dresses them every morning, dressing is dependent, even if they say they could manage.
Supervision and prompting both score 0. A person who showers only when someone waits outside the door isn’t independent in bathing.
A bare “Katz 4” doesn’t say which activities need help or who gives it. List each activity, its rating, and the detail behind it.
Most older adults living at home score 6. Ask about shopping, cooking, medicines, and money too, and watch them walk, to catch decline early.
A score taken during delirium or an acute illness shows today’s needs. Record the usual state before the illness as well, and say where it came from.
Vero Scribe records the Katz ADL result in your template from the visit, with the patient’s consent, or from your dictation: each activity and the help behind it, the total, the change from baseline, and the plan. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
Rate each of the six activities as independent or dependent. An activity scores 1 when the person does it with no supervision, direction, or personal help, and 0 when any of these is needed. Add them for a total from 0 to 6, where 6 is fully independent and 0 is very dependent. Score against the definitions on the official sheet.
The Hartford Institute’s guide reads 6 as full function, 4 as moderate impairment, and 2 or less as severe functional impairment. It doesn’t name 3 or 5: a 5 means one activity, usually bathing, needs help, and a 3 is usually read with moderate impairment. Always say which activities were lost, since the same total can mean different care needs.
Bathing, dressing, toileting, transferring, continence, and feeding. They’re the basic self-care activities a person needs to live without hands-on help. The official sheet sets out what counts as independent for each one.
The Katz index covers basic self-care, the activities lost late in decline. The Lawton IADL covers instrumental activities needed to live alone: using the telephone, shopping, preparing food, housekeeping, laundry, transportation, managing medicines, and handling money. Those usually go first, so the two are often given together.
The Barthel Index rates 10 activities, adding grooming, walking, and stairs, and splits bowel and bladder, for a score from 0 to 100. Its finer steps show small gains better, which is why rehabilitation teams prefer it. The Katz index is quicker and gives a plain picture of how much hands-on help someone needs.
Nurses use it most, but any clinician who knows the definitions can rate it: physicians, occupational and physical therapists, social workers, and trained care staff. It takes a few minutes when you can watch the person or ask someone who helps them every day.
The 1963 original graded people with letters instead of a number: A for independent in all six activities, G for dependent in all six, and the letters between for losses in the usual order, starting with bathing. Most services now use the 0 to 6 total, but older records may show the letters.
It’s free to download from the Hartford Institute for Geriatric Nursing as issue 2 of its Try This series, with a short guide. The Institute allows the whole issue to be reproduced and shared for not-for-profit education when it’s credited as the source; commercial use needs permission. The recording template on this page is free to copy or download.
Patient-reported measures of symptoms and function, scored as T-scores with 50 as the average: short forms, CATs, and the PROMIS-29.
Eight independent living tasks, from shopping to finances, each scored 0 or 1: a total from 0, dependent, to 8, independent.
Eleven questions on arm, shoulder, and hand function over the past week, scored 0 to 100: the higher, the more disability.
Twenty everyday activities rated for difficulty: lower limb function scored 0 to 80, higher is better, and 9 points is a real change.
Forty-two questions on one knee over the past week: five subscales, each scored 0 to 100, where 100 means no knee problems.
The full nursing assessment, with function alongside skin, mobility, and safety.
A 9-level judgment of overall frailty, built on how the person manages daily life.
Notes for function, frailty, falls, and care planning visits.
Every tool, by area, with what its scores mean.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
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