<P> Katz et al. (1963) made a claim that became the basis for the ontological assumptions of the ADL research tradition . In their suggestion that there was an "ordered regression (in skills) as part of the natural process of aging" (p. 918), there was an implicit generalization, from their sample of older persons with fractured hips, to all older persons . </P> <P> Porter emphasizes the possible disease - specific nature of ADLs (being derived from hip - fracture patients), the need for objective definition of ADLs, and the possible value of adding additional functional measures . </P> <P> A systematic review examined the effectiveness of imparting activities of daily life skills programmes for people with chronic mental illnesses: </P> <Table> Life skills programme compared to standard care <Tr> <Th> Summary </Th> </Tr> <Tr> <Td> Currently there is no good evidence to suggest ADL skills programmes are effective for people with chronic mental illnesses . More robust data are needed from studies that are adequately powered to determine whether skills training is beneficial for people with chronic mental health problems . </Td> </Tr> <Tr> <Td> <Table> <Tr> <Th> (show) Outcome </Th> <Th> Findings in words </Th> <Th> Findings in numbers </Th> <Th> Quality of evidence </Th> </Tr> <Tr> <Th_colspan="4"> Life skills - no important change </Th> </Tr> <Tr> <Td> - in household activity skills . Follow - up: mean 12 weeks </Td> <Td> Life skills programmes may reduce the risk of not improving in day - to - day functioning for general household activity skills when compared with standard care, but, at present it is not possible to be confident about the difference between the two treatments and data supporting this finding are very limited . </Td> <Td> RR 0.24 (0.01 to 4.72) </Td> <Td> Very low </Td> </Tr> <Tr> <Td> - in laundry skills . Follow - up: mean 12 weeks </Td> <Td> Life skills programmes may reduce the risk of not improving in day - to - day functioning for laundry skills when compared with standard care, but, at present it is not possible to be confident about the difference between the two treatments and data supporting this finding are very limited . </Td> <Td> RR 0.14 (0.01 to 2.38) </Td> <Td> Very low </Td> </Tr> <Tr> <Td> - in self - care skills . Follow - up: mean 12 weeks </Td> <Td> Life skills programmes make no difference to self - care when compared with standard care, but, at present it is not possible to be confident about the difference between these two treatments . This finding is based on data of very limited quality . </Td> <Td> RR 1 (0.28 to 3.54) </Td> <Td> Very low </Td> </Tr> <Tr> <Th_colspan="4"> Leaving the study early </Th> </Tr> <Tr> <Td> Leaving the study early Follow - up: 6 to 16 weeks </Td> <Td> Life skills programme make no clear difference to the risk of loss to follow up compared with standard care . Data supporting this finding are very limited . </Td> <Td> RR 1.16 (0.4 to 3.36) </Td> <Td> Very low </Td> </Tr> <Tr> <Th_colspan="4"> Mental state </Th> </Tr> <Tr> <Td> Average score . (Positive and Negative Syndrome Scale - positive syndrome). Follow - up: mean 24 weeks </Td> <Td> People receiving life skills programme scored the same as people receiving standard care . Findings are based on data of very limited quality. * </Td> <Td> MD 0 (3.12 lower to 3.12 higher) </Td> <Td> Very low </Td> </Tr> <Tr> <Th_colspan="4"> Quality of life </Th> </Tr> <Tr> <Td> Average score (Quality of Well - Being Scale index). Follow - up: mean 24 weeks </Td> <Td> On average, people receiving life skills programme scored 0.02 lower than people treated with standard care . There was no clear difference between the groups and this finding is based on data of very limited quality. * </Td> <Td> MD 0.02 lower (0.07 lower to 0.03 higher) </Td> <Td> Very low </Td> </Tr> <Tr> <Td> </Td> <Td> * At present the meaning of these scores in day - to - day care is unclear . </Td> <Td> </Td> <Td> </Td> </Tr> </Table> </Td> </Tr> </Table>

All of the following are considered to be activities of daily living (adls) except