Why something that seems ‘bad’ can, in fact, be brilliant news.
The Barthel Index is a scale used to measure performance in activities of daily living (ADL). Each performance is rated with a given number of points. It uses ten variables describing ADL and mobility. A higher number is “better”.
The ten variables addressed in the Barthel scale are:
- Presence or absence of fecal incontinence
- Presence or absence of urinary incontinence
- Help needed with grooming
- Help needed with toilet use
- Help needed with feeding
- Help needed with transfers (e.g. from chair to bed)
- Help needed with walking
- Help needed with dressing
- Help needed with climbing stairs
- Help needed with bathing
You don’t have to be an expert to realise that Pádraig needs help with all of the above. And that he will score low using this index. Yet, it has recently been used to describe how he is doing.
And here comes the surprise: even the very idea of using the Barthel Index to capture Pádraig’s condition would have been completely out of the question not that long ago and has never been done. Initially, the matters to be addressed had nothing got to do with ‘activities of daily living’, they were much more serious. So this is a first.
Because earlier, what doctors used to describe his condition was the Glasgow Coma Scale (GCS). And using this scale, he scored – initially – the lowest possible score, working his way up, slowly.
The lesson: things that initially may sound negative can highlight brilliant developments if put into proper context!