Barthel Index Calculator

Created by Dominika Śmiałek, MD, PhD candidate
Reviewed by Dominik Czernia, PhD candidate and Jack Bowater
Last updated: Apr 10, 2022

The Barthel index calculator allows you to check the independence of your patient regarding their daily self-care and mobility. This tool also provides you with information on how to interpret Barthel index scoring. Stay with us - in the article below, there are answers to such questions as "what is ADL," "why is the Barthel ADL index calculated," and some more details on the everyday variables used in this tool.

What is ADL?

ADL, short for Activities of Daily Living, is a term used to describe the daily activities that a person performs to maintain themselves. ADL-centered tests mostly contain questions about feeding, bathing, dressing, grooming, work, cleaning oneself, and leisure time. Independence in performing these tasks serves as a quick assessment to see if a person requires any day-to-day care. This assessment is mostly used on the elderly with numerous comorbidities, such as diabetes or kidney failure, and on those who have suffered from injuries. In case of unsatisfactory results, a person may need help from skilled professionals, such as nurses or other qualified personnel.

For patients in bad conditions, recently admitted to hospital you may use Glasgow Coma Scale. It's a neurological scale that describes the level of a patient's consciousness objectively.

Barthel index in clinical use

The Barthel ADL index aims especially at specific groups of patients, such as those after a stroke, those with neurological disorders, as well as general oncology patients. The physician may calculate the score when the patient is discharged from the hospital or during a primary care visit.

In the Barthel ADL index, there are ten variables on ADL and mobility. In each question, the time needed to perform a task, as well as any verbal and physical help from others, plays a crucial role when determining the self-care level. The higher the number of points given for each answer, the more independent the person is.

Barthel index scoring - explanation

In our Barthel index calculator, you will find ten questions concerning ADL and mobility. Ready? Let's go through them and explain some of the terms. The points assigned to each answer are given in brackets:

  1. Feeding
    • Independent, food may be within reach (10)
    • Needs help with spreading butter, cutting bread etc. (5)
    • Unable (0)
  2. Bathing
    • Independent or in shower (5)
    • Unable (0)
  3. Grooming
    • Independent in face, hair, teeth cleaning, shaving (5)
    • Unable (0)
  4. Dressing
    • Independent, including buttoning, doing laces and zips (10)
    • Needs help with some parts of dressing up (5)
    • Unable (0)
  5. Bowel control
    • Continent (10)
    • Occasional incontinence, maximum 1 per week (5)
    • Incontinent or needs enema (0)
  6. Bladder control
    • Continent, for at least a week (10)
    • Occasional incontinence (maximum 1 per 24 hours); watch out for patients after prostate cancer treatment - in those cases, incontinence may be due to radiation or surgery (5)
    • Incontinent or catheterized (and cannot hold) (0)
  7. Toilet use
    • Independent use, included getting on, off and wiping (10)
    • Needs help with some parts (5)
    • Unable (0)
  8. Transfer
    • Independent (15)
    • Needs minor help of one person, verbal or physical (10)
    • Major help of one or two people, physical, can sit (5)
    • Unable, the patient has no sitting balance(0)
  9. Mobility
    • Independent, but may use some aid, e.g., a walking stick. The patient doesn't have to run marathons. Even if they can walk alone (or with aid) more than 50 yards, doctors consider them independent. (15)
    • Walks with the help of one person, verbal or physical (10)
    • Wheelchair independent, including corners (5)
    • Immobile. In case of immobile patients you should not forget that they are at greater risk of pneumonia. (0)
  10. Stairs
    • Independent going up and down (10)
    • Needs help, verbal, physical or aid (5)
    • Unable (0)

Once you choose all of the answers, you will receive the correct score. The higher the number, the more independent the patient is. Just below, there's a short interpretation of the result.

Score Interpretation
80-100 Independent
60-79 Minimally dependent
40-59 Partially dependent
20-39 Very dependent
<20 Totally dependent

Barthel index calculator in practice

Enough with the theory, let's move on to an example. Lucy is a 75-year-old woman, suffering from various diseases, among which atrial fibrillation and kidney failure seem to be the most significant. She's lived alone since the death of her husband ten years ago. Recently she had a stroke and spent some nights at a hospital. When discharging her home, the doctor decided on calculating her Barthel index scoring.

  • Feeding - needs help (5)
  • Bathing - independent, as she has a shower (5)
  • Grooming - independent (5)
  • Dressing - needs help, especially with complex movements, such as buttoning (5)
  • Bowel control - continent (10)
  • Bladder control - occasional incontinence (5)
  • Toilet use - independent (10)
  • Transfer - needs minor help (10)
  • Mobility - walks with help (10)
  • Stairs - needs help (5)

Total score: 70

Interpretation: Lucy needs minor help with her daily activities.

Dominika Śmiałek, MD, PhD candidate
Daily activities
Independent, food within reach
Independent or in shower
Independent (face, fair, teeth, shaving)
Independent, including buttons, zips, laces
Bowel control
Bladder control
Continent, for more than 7 days
Toilet use
Independent (may use aid)
Barthel score
Interpretation: Independent
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