Your Katz ADL score indicates the level of independence in six basic activities of daily living. A score of 6 means full independence in bathing, dressing, toileting, transferring, continence, and feeding — the person can perform all these activities without human assistance. A score of 4 to 5 indicates moderate functional impairment, with dependence in one or two activities, suggesting that some supervised or hands-on assistance is needed but the person retains significant independence.

A score of 2 to 3 indicates significant functional impairment requiring substantial daily assistance, while scores of 0 to 1 indicate severe dependence, meaning the person requires help with nearly all basic self-care activities. Beyond the total score, the specific activities where dependence occurs are clinically important. Functional decline typically follows a predictable hierarchy: bathing ability is usually lost first, followed by dressing, toileting, transferring, continence, and finally feeding.

This hierarchical pattern is useful for anticipating future care needs and setting realistic rehabilitation goals. For example, a patient who has lost the ability to bathe and dress independently but remains independent in other areas is at an earlier stage of functional decline than one who also requires assistance with transferring and feeding. Recovery during rehabilitation tends to follow the reverse order, with feeding regained first.

The Katz ADL Index should be used as part of a comprehensive geriatric assessment for older adults, particularly during hospital admission, discharge planning, rehabilitation evaluation, and long-term care placement decisions. It provides a standardized baseline of functional status that can be tracked over time to detect improvement or decline.

This tool is especially valuable when making decisions about the level of care a patient requires — whether they can live independently, need home health assistance, require assisted living, or need skilled nursing facility placement. It is also used in research on aging, disability, and outcomes of geriatric interventions. The Katz ADL Index is appropriate for any clinical setting where an objective, standardized measure of basic functional ability is needed.

The Katz ADL Index assesses only basic activities of daily living and does not capture instrumental activities of daily living (IADLs) such as managing medications, finances, cooking, shopping, and transportation, which are often lost earlier in the course of functional decline. A patient may score 6 on the Katz ADL but still require significant assistance with these higher-level activities. The Lawton IADL scale should be used as a complement.

The scoring is binary (independent or dependent) for each activity, which does not capture the degree of difficulty or the amount of assistance needed. A person who needs minimal cueing to dress is scored the same as someone who requires full physical assistance, limiting the sensitivity of the tool to detect incremental changes in function.

The Katz ADL Index does not account for the use of adaptive equipment or environmental modifications that may enable independence. A person who bathes independently using a shower chair and grab bars is scored the same as someone who bathes without any aids. Additionally, assessment may be affected by the acute illness or hospitalization itself, and scores obtained during acute illness may not reflect the patient's baseline functional status.