Barthel Index of Activities of Daily Living
Measures functional independence in activities of daily living (ADLs) in patients with neurological or physical disability. Score 0–100; higher = more independent.
Score interpretation
Barthel 0–20: Total or severe dependence.
→ Full nursing care required. Inpatient rehabilitation. Pressure care, nutrition, hygiene, continence management. Assess for nursing home or 24h care package.
Barthel 21–60: Severe dependence. Significant carer burden.
→ Intensive rehabilitation. OT/physiotherapy. Carer assessment. Adapted accommodation. Assistive technology referral.
Barthel 61–90: Moderate dependence. Some assistance required.
→ Community rehabilitation. Home care package. OT home visit. Consider day hospital. Driving assessment if eligible.
Barthel 91–99: Nearly independent but requires minimal help.
→ Outpatient physiotherapy. Safety review at home. Review driving eligibility (DVLA guidelines). Psychosocial support.
Barthel 100: Fully independent in ADLs.
→ Discharge planning. Secondary prevention. Community follow-up. Note: Barthel 100 does not mean ready for unsupported discharge — social factors still apply.
Interpretation bands for the Barthel Index. Apply clinical judgement and local guidance.
References
- Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–65.
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Curated clinical cross-links plus same-class fallbacks.
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Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.