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Functional Assessment in End‐Stage Renal Disease: Enhancing Quality of Life
Authors:Adam Saby  Lawrence S. Miller
Affiliation:1. Department of Physical Medicine & Rehabilitation, Greater Los Angeles Veterans Administration Health Care System, David Geffen School of Medicine‐UCLA, Los Angeles, California;2. Department of Medicine, David Geffen School of Medicine‐UCLA, Los Angeles, California
Abstract:Why do functional assessments in patients with end‐stage renal disease (ESRD) matter? Multiple studies show that new dialysis patients undergo a substantial decline among activities of daily living. Moreover, poor functional status in ESRD patients is associated with early morality. That is why CMS has developed new criteria to assess ESRD patients in regards to their functional, psychologic, and cognitive capabilities. Functional assessments by health providers have been used in field of Rehabilitation Medicine for over 50 years; rehabilitation physicians have found them effective in establishing goals and monitoring improvement. Assessments can provide guidance by identifying the needs and types of intervention most suited for patients. Impairments can be addressed with referrals to physical therapy for gross motor issues, occupational therapy for self‐care problems, psychiatry for mental disorders, and neurology for cognitive deficits. The more accurate the assessments over time, the more targeted and effective the therapies become. We believe that the new CMS goals to assess functionality will improve ESRD patient's quality of life, longevity, and long‐term healthcare costs.
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