Sheffield Memory Service & Complex Geriatric Care

Specialist in Memory, Parkinson’s disease, Stroke, Dizziness, Falls & Complex Ageing

Sheffield Memory Service &
Complex Geriatric Care

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Sheffield Memory Service & Complex Geriatric Care

Specialist in Memory, Parkinson’s disease, Stroke, Dizziness, Falls & Complex Ageing

Changes in Daily Function and Independence Questionnaire (BADLS)

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- Step 1 of 3

This should be best completed by a family member or carer who is familiar with the patient's daily functioning.

Purpose is to evaluate the patient's average everyday abilities and responses should reflect typical performance rather than exceptional instances.

Informant detail

Informant full name *

Phone *

Email *

Relationship *

Patient detail

Patient name *

Patient date of birth *

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There are 20 short questions. Thinking of the last 2 weeks, tick the box that represents your relative’s/friend’s AVERAGE ability. Tick ‘Not applicable’ if your relative never did that activity when they were well.

Most carer complete this in under 10 minutes.

1. How well does the patient select and prepare food? *

Selects and prepares food independently
Prepares food if ingredients are set out
Prepares food only with step-by-step prompting
Unable even with prompting/supervision
Not applicable

2. How well does the patient eat? *

Eats appropriately using correct cutlery
Eats if food is prepared/manageable
Uses fingers to eat
Needs to be fed
Not applicable

3. How well does the patient prepare drinks? *

Selects and prepares drinks independently
Prepares drinks if items provided
Needs prompting step-by-step
Unable even with prompting
Not applicable

4. How well does the patient drink? *

Drinks appropriately
Drinks with aids (cup/beaker/straw)
Does not drink appropriately even with aids but attempts to
Has to have drinks administered (fed)
Not applicable

5. How well can the patient dress themselves? *

Dresses independently and appropriately
Dresses incorrectly (wrong order/back to front/dirty clothes)
Needs help but assists
Fully dependent
Not applicable

6. How well can the patient maintain personal hygiene as daily washing of face, hands, general cleanliness)? *

Washes regularly and independently
Washes self if items provided
Needs prompting/supervision
Fully dependent
Not applicable

7. How well can the patient brush teeth or clean dentures regularly? *

Washes regularly and independently
Washes if items provided
Needs prompting/supervision
Fully dependent
Not applicable

8. How well can the patient bathe or shower safely and thoroughly? *

Regularly and Independently
Needs setup but washes independently
Needs prompting/supervision
Fully dependent
Not applicable

9. How well can the patient recognise the need to go and use the toilet appropriately? *

Uses toilet appropriately
Needs to be taken to the toilet and given assistance
Incontinent of urine or faeces
Fully incontinent of urine and faeces
Not applicable

10. How well can the patient transfer (e.g. getting in/out of bed or chair)? *

Independent
Needs help getting out
Needs help getting in and out of a chair
Fully dependent
Not applicable

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10 more questions to go...

11. How safely can the patient move around indoors? *

Independent
Walks with support (furniture, wall, arm etc)
Uses walking aid
Unable to walk
Not applicable

12. How well is the patient oriented to awareness of time, day, and normal daily routine? *

Fully oriented
Unaware but unconcerned
Repeatedly asks time/date/day
Mixes up day and night
Not applicable

13. How well is the patient oriented to their familiar places (e.g. recognising home)? *

Fully oriented
Oriented to familiar surroundings only
Gets lost at home
Does not recognise home and tries to leave
Not applicable

14. How well is the patient able to understand others and express needs clearly. *

Normal conversation
Understands but attempts to respond verbally with gestures
c) Can make self understood but difficulty understanding others
No meaningful communication
Not applicable

15. How well is the patient in answering or making a phone call. *

Uses telephone normally
Uses if number provided
Answers but cannot make calls
Unable/unwilling
Not applicable

16. How well is the patient in doing everyday housework such as cleaning, tidying, or basic chores. *

Same standard as before
Reduced standard
Limited participation under supervision
Unable/unwilling
Not applicable

17. How well is the patient in shopping to buy items independently or with assisstance. *

Shops independently
Shops for 1 or 2 items with or without a list
Shops only with assistance
Cannot participate
Not applicable

18. How well is the patient in handling money, bills, or understanding value of money. *

Fully manages finances
Limited (can sign cheque, understands value of money)
Can sign but doesn’t understand value
Cannot manage at all
Not applicable

need think answering

19. How well is the patient think about hobbies, interests, or usual leisure activities. *

Normal participation
Needs guidance
Reluctant / slow
No participation
Not applicable

20. How is the level of independence in using mode of transport *

Independent (driving/cycling/public transport)
Unable to drive but uses public transport or bike etc
Unable to use public transport alone
No engagement
Not applicable

Consent *

I confirm that the information provided is accurate to the best of my knowledge.
I consent to this information being used for clinical assessment and stored securely in accordance with data protection regulations.

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