Katz Index of Independence (ADL) Calculator
Score all 6 basic Activities of Daily Living — Bathing, Dressing, Toileting, Transferring, Continence, and Feeding — with complete independence and dependence criteria. Classifies functional status from fully independent (6) to fully dependent (0) with EMR documentation.
NMClinically reviewed byDr. Nikhil Mahajan, PT, MPT · Jan 15, 2026Katz ADL Index — Score Interpretation Reference
| Katz Score | Classification | Functional Description | Care Implications |
|---|---|---|---|
| 6 | Fully Independent | Independent in all 6 basic ADLs | Community living; independent home care |
| 5 | Mildly Impaired | Dependent in 1 ADL only | Minimal home assistance; monitoring recommended |
| 4 | Mild–Moderate | Dependent in 2 ADLs | Home care services; occupational therapy evaluation |
| 3 | Moderate | Dependent in 3 ADLs | Assisted living or significant home support |
| 2 | Moderate–Severe | Dependent in 4 ADLs | Skilled nursing or comprehensive home care |
| 1 | Severely Dependent | Dependent in 5 ADLs | Skilled nursing facility strongly indicated |
| 0 | Fully Dependent | Dependent in all 6 ADLs | 24-hour nursing care required |
What Is the Katz Index of Independence?
The Katz Index of Independence in Activities of Daily Living (Katz ADL) is the most widely used standardised measure of basic functional status in older adults. Developed by Sidney Katz and colleagues at the Benjamin Rose Hospital in Cleveland, Ohio and published in JAMA in 1963, it evaluates independence in six basic self-care activities: Bathing, Dressing, Toileting, Transferring, Continence, and Feeding. Each activity is scored as Independent (1) or Dependent (0) for a maximum of 6 points.
Why These 6 Activities?
Katz selected these six ADLs because they follow a hierarchical pattern of loss and recovery. Bathing is typically the first ADL to be lost and the last to be regained; feeding is typically the last lost and first regained. This hierarchy means that a patient who is independent in bathing is usually independent in all other ADLs, while a patient dependent in feeding is usually dependent in all others. This pattern makes the Katz ADL both a measure of current function and a predictor of recovery trajectory.
Katz ADL vs Lawton IADL — Basic vs Instrumental ADLs
The Katz ADL measures basic self-care activities (bathing, dressing, feeding). The Lawton IADL Scale measures instrumental activities — more complex tasks required for independent living in the community (using a telephone, managing finances, transportation, housekeeping, medication management, shopping, meal preparation, laundry). Use both together for a comprehensive functional assessment — the Katz identifies who needs physical care, the Lawton identifies who can live independently in the community.
Clinical Applications
- Hospital admission assessment — Baseline Katz ADL documents pre-morbid functional status for discharge planning and rehabilitation goal setting
- Skilled nursing facility (SNF) admission — Required as part of the Minimum Data Set (MDS 3.0) for all Medicare/Medicaid residents
- Home care eligibility — Medicare home health benefit requires dependence in at least 1 ADL; Katz score documents this objectively
- Rehabilitation outcomes — Serial Katz scores track functional recovery in PT/OT rehabilitation programs after hip fracture, stroke, or surgery
- Prognostic indicator — Katz ADL score at hospital admission predicts length of stay, discharge destination, and 30-day readmission risk