- Determine the nature of the presenting complaint (dyspnea in a fit 88 yo who has just flown back from Paraguay is different from dyspnea in a frail 72 yo who rarely leaves the house and requires daily home care);
- Start planning early for ED discharge (a left Colles fracture in a right-handed tennis-playing 82 yo vs in a walker-dependent 76 yo who lives alone)
Commonly Used Markers of Function
Activities of Daily Living
One way to remember them is: “the things you do during the first twenty minutes of your day.”
As a minimum:
For ED discharge the patient needs to be able to transfer out of bed and leave the department.
After ED discharge the patient needs to be able to use a toilet and be able to feed himself or be fed.
Instrumental Activities of Daily Living
One way to remember them is: “the things you learned to do when you left your parents’ house.”
- Meal preparation
- Medication management
- Phone and use of technology
Successful ED discharge will require a plan in place to ensure that at least the first three IADLs are intact – if not independently by the patient then provided by a caregiver.
Get Up and Go Test
“Get up and Go Test.” Instruct the patient to get out of the bed, walk 10 feet, turn around, walk back, and sit down. This also can be used to test cognitive ability since it involves following instructions and performing a complex task.
Reference: Timed Get and Go Test, Podsiadlo, JAGS; 1991, 39(2):142-148 – View the EuroPMC article
- Watch the video below for an example of the “Get Up and Go” test.