Resources for the Comprehensive Geriatric Assessment based

Proactive and Personalised Primary Care of the Elderly

Bristol ADL

Scale

Bristol Activities of Daily Living Scale

Purpose : Assessment of instrumental Activities of Daily Living

Admin time : 10-20 min. User

Friendly : High Administered

by : GP or nurse

Content : The Bristol ADL scale is an informant-rated measure that covers 20 ADLs, both basic
and instrumental. Items are rated on a four-point scale (from totally dependent to totally
independent, with an additional “not applicable” option).

Author : Bucks RS, et al 1996

Copyright : Public domain.

Please note the following conditions of use from the author, Prof. Romola S. Bucks:
● The work must be cited appropriately.

● No amendments permitted - do not change the wording, or item order, introductory text
etc. Doing so may invalidate the measure.
● No change of format permitted - do not change the layout beyond the minimal
requirements needed to fit this format into an electronic record.
● Anyone who uses this work must let the author, Prof. Romola S. Bucks, know what they
have used it for.
● Please contact the author if you are unsure whether a minor change of either content or
format would invalidate the test.
 ● The scan of the used paper version and storage within an Electronic Patient Record
is permitted.
● The creation of an electronic version accessed only within clinical systems such
as Electronic Patient Records is permitted.

https://www.cgakit.com/bristol-scale

*FOR YOUR ASSESSMENT, PLEASE PRINT THE 2ND & 3RD

PAGE ONLY.
Bristol ADL Scale
Name

Assessed by

1. FOOD 6. HYGIENE
a. Selects and prepares food as required []0 a. Washes regularly and independently []0
b. Able to prepare food if ingredients set out []1 b. Can wash self if given soap, towel, etc []1
c. Can prepare food if prompted step by step []2 c. Can wash self if prompted and supervised []2
d. Unable to prep food even w/ prompt & sup []3 d. Unable to wash self and needs full assist []3
e. Not applicable []4 e. Not applicable []4
2. EATING 7. TEETH
a. Eats appropriately using correct cutlery []0 a. Cleans own teeth/dentures regularly and I []0
b. Eats appropriately if food made b. Cleans teeth/dentures if given approp items [ ] 1
manageable and/or uses spoon []1 c. Requires some assist, toothpaste on brush []2
c. Uses fingers to eat []2 d. Full assistance given []3
d. Needs to be fed []3 e. Not applicable []4
e. Not applicable []4
8. BATH/SHOWER
3. DRINK a. Bathes regularly and independently []0
a. Selects and prepares drinks as required []0 b. Needs bath to be drawn/shower turned
b. Can prepare drinks if ingredients made avail [ ] 1
on but washes independently []1
c. Can prep drinks if prompted step by step []2
c. Needs supervision and prompting to wash []2
d. Unable to make drink even w/ prompt/sup []3
d. Total dependent, needs supervision []3
e. Not applicable []4
e. Not applicable []4
4. DRINKING
9. TOILET/COMMODE
a. Drinks appropriately []0
a. Uses toilet appropriately when required []0
b. Drinks appropriately w/ aids, beaker/
b. Needs to be taken to toilet, & given assist []1
straw etc. []1
c. Incontinent of urine or feces []2
c. Does not drink appropriately even with
d. Incontinent of urine and feces []3
aids but attempts to []2 e. Not applicable []4
d. Has to have drinks administered (fed) []3
e. Not applicable []4 10. TRANSFERS
a. Can get in/out of chair unaided []0
5. DRESSING b. Can get in chair but needs help to get out []1
a. Selects approp clothing & dresses self []0 c. Needs help getting in and out of a chair []2
b. Puts clothes on in wrong order and/or d. Totally dependent on being put into and
back to front and or dirty clothing []1 lifted from a chair []3
c. Unable to dress self, but moves limbs to e. Not applicable []4
assist []2
d. Unable to assist and requires total dsg []3
e. Not applicable []4
 11. MOBILITY 17. SHOPPING
a. Walks independently []0 a. Shops to previous standards []
0
b. Walks w/assist, ie. furniture, arm for []1 b. Only able to shop for 1- 2 items
supp
c. Uses aid to mobilize, ie. frame, stick, etc []2 w/ or w/o a list []
1
d. Unable to walk []3 c. Unable to shop alone, but participates
e. Not applicable []4 when accompanied []
2
d. Unable to participate in shopping even []
3
12. ORIENTATION-TIME when accompanied
a. Fully orientated to time/day/date etc. []0 e. Not applicable []
4
b. Unaware of time/day etc. but seems []1
unconcerned 18. FINANCES
c. Repeatedly ask the time/day/date []2 a. Responsible for own finances at prev []
level 0
d. Mixes up night and day []3 b. Unable to write check but can sign name
e. Not applicable []4 and recognizes money value []
1

13. ORIENTATION-SPACE 16. HOUSEWORK/GARDENING

a. Fully oriented to surroundings []0 a. Able to do housework/gardening to []0
b. Oriented to familiar surroundings only []1 previous standard
c. Gets lost in home, needs reminding b. Able to do housework/gardening but []1
where bathroom is, etc. []2 not to previous standard
d. Does not recognize home as own and c. Limited participation even with a lot of sup [ ] 2
attempts to leave []3 d. Unwilling unable to participate in
e. Not applicable []4 previous activities []3
e. Not applicable []4
14. COMMUNICATION c. Can sign name but unable to recognize
a. Able to hold appropriate conversation []0 money value []2
b. Shows understanding and attempts to d. Unable to sign name or recognize money
respond verbally with gestures []1 value []3
c. Can make self understood but difficulty []2 e. Not applicable []4
understanding others
d. Does not respond to or communicate []3 19. GAMES/HOBBIES
with others a. Participate in pastimes/activities to []
e. Not applicable []4 0 previous standards
b. Participates but needs instruction/
15. TELEPHONE supervision []1
a. Uses telephone appropriately, including c. Reluctant to join in, very slow, needs
obtaining correct number []0 coaxing []2
b. Uses telephone if number given verbally d. No longer able or willing to join in []3
visually or pre-dialed []1 e. Not applicable []4
c. Answers telephone but doesn’t make calls []2
d. Unable/unwilling to use telephone at all []3 20. TRANSPORT
e. Not applicable []4 a. Able to drive, cycle or use public
transportation independently []0
 b. Unable to drive but uses public
transportation or bike etc. []1
c. Unable to use public transportation alone []2
d. Unable/unwilling to use transport even
when accompanied []3
e. Not applicable []4
 Bristol ADL Scale
Guidelines
Select one choice for each of the 20 items.
Scores range from 0: independent – 3:dependent, and 4: NA

Scoring
Total possible scores 60.

A total score of 0 = totally independent A

total score of 60 = totally dependent