I-SUPPORT project

The past century has witnessed unprecedented gains in the life expectancy of European population and population in the rest of the developed countries. However, these gains may be accompanied by increased morbidity due to age-related chronic conditions and loss of abilities.

One important measure of morbidity and quality of life is a person‘s ability to perform Activities of Daily Living (ADL) such as bathing, dressing, transferring, toileting and feeding. When people are unable to perform even one of these basic personal care tasks, they become dependent on help from either informal or formal caregivers. As a result, difficulties in performing ADLs are a significant predictor of nursing care home use, use of hospital services, use of physician services, and mortality.

A number of studies have assessed the extent to which loss of function across ADLs progresses hierarchically and it has been shown that just as there is an orderly pattern of development of function in the child, there is an ordered regression as part of the natural process of aging [1] and quite often the order of the later is the reverse of the order of the former.

Loss of function typically begins with those activities, which are most complex1 and least basic2, while these functions that are most basic and least complex can be retained to the last. Shower and bathing is one of the complex and least basic activities and, thus, it is among the first that are lost. In addition it is among the last that are regained during post-surgery recovery.

Once again, it has been reported that the pattern of recovery from a disabling illness in later life parallels the primary development of function in the child. Furthermore, older adults’ bathing is reported as one of the first ADLs that residents of a nursing home population lost the ability to perform]. This clearly suggests that support in bathing activities, as an early marker of ADL disability, will foster independent living for persons prone to loss of autonomy and relieve the caring and nursing burden of the family, domiciliary services, medical centers and other assisted living environments.