The Lawton and Brody scale allows us to measure the degree of autonomy that the elderly maintain, providing us with valuable information for a possible intervention.
One of the main consequences of aging is the progressive loss of autonomy. Deteriorating physical and mental health leads the elderly to be increasingly dependent, especially if they suffer from some type of dementia or brain damage. The Lawton and Brody scale allows to detect the first signs of difficulty and lack of autonomy in the person.
This short tool is one of the most used internationally and the most used in geriatric units in Spain.
It allows to measure the degree of autonomy in elderly people, institutionalized and not. Also, it should be noted that it does so through the assessment of instrumental activities of daily living (AIVD).
Instrumental activities of daily life
In analyzing addiction, we must look at the person’s ability to carry out activities of daily living. To classify them we can divide them into two groups, basic and instrumental:
- The former refer to the most basic aspects of personal caresuch as nutrition, personal hygiene or mobility.
- Instrumental activities, on the other hand, are more complex tasks, but no less important for leading an independent life. They include activities that require the ability to make decisions and solve problems. The Lawton and Brody scale addresses these.
The scale of Lawton and Brody
This simple yet comprehensive screening tool takes no more than five minutes to apply. It consists of eight items with different answer alternatives which together evaluate the ability of the elderly to carry them out independently.
The answer options have a score of 1 (the person performs them autonomously) or 0 (dependent).
The total score is obtained by adding the values obtained in each item and ranges from 0 (totally dependent) to 8 (absolutely independent). Depending on the case, the scale will be completed by the patient himself or by a caregiver of trust (if the elderly person is not capable of it).
Aspects that are evaluated
Ability to use the telephone
- Using the phone on your own initiative (1 point)
- Dial some known numbers (1)
- Answer the phone, but don’t dial (1)
- Not being able to use the phone (0)
Go shopping
- Make all the necessary purchases independently (1)
- Buying small things independently (0)
- Need help making any purchases (0)
- Totally impossible to buy (0)
Food preparation
- Plan, prepare and serve meals yourself (1)
- Prepares them correctly if given the ingredients (0)
- Heats and serves meals, but does not maintain adequate diet (0)
- Needs meals prepared and served (0)
Home care
- Caring for the house alone or with occasional help (1)
- Doing light tasks like washing the dishes or making the bed (1)
- Carrying out light tasks, but failing to maintain an acceptable level of cleanliness (1)
- Need help with all tasks (1)
- Does not participate in any house cleaning (0)
Laundry
- Wash all his clothes by himself (1)
- Washing small items (1)
- Needs someone else to do laundry (0)
Means of transport
- Travel alone on public transport or use your own car (1)
- Can take a taxi, but does not use other means (1)
- Traveling by public transport accompanied by another person (1)
- Travel by taxi or car only with the help of others (0)
- Does not travel (0)
Drugs: scale item
- Take your medications at the correct time and according to the indicated dosage (1)
- Takes his meds if the dose was previously prepared (0)
- Unable to take prescribed medication(0)
Economy and finance
- He manages his own financial affairs (1)
- Handles day-to-day affairs, but needs help with important purchases and going to the bank (1)
- Can’t handle money (0)
Utility of the Lawton and Brody scale
This tool 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, which approximates a degree of deterioration, but also gives us information about the areas where this deterioration has occurred.
In other words, not only does it provide us with useful information for the “diagnosis”, but also for a possible intervention.
This last point is essential for designing and implementing 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 been shown to be more reliable when applied to women, as many of the aspects it assesses have traditionally been assigned to the female role.
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