The Barthel Index, a well-known assessment tool for activities of daily living (ADLs), was first introduced in the 1960s. It has been widely used in chronic care hospitals in Maryland since 1955, based on the actual amount and type of physical assistance required. The index evaluates various ADLs, including eating and urinary control, with scores ranging from 0 to 100. A score of 10 indicates complete independence, while a score of 5 suggests some assistance is needed. The index is particularly weighty on incontinence management due to its impact on social acceptance and care needs. The Barthel Index has been a primary tool in rehabilitation, though it is now overshadowed by the Functional Independence Measure (FIM) in acute care settings. The main difference between the two is in their scoring systems: the Barthel Index assigns higher scores for independence in each activity, while the FIM has a uniform maximum score of 7. The FIM also lacks detailed scoring for activities like grooming and personal hygiene, making it less sensitive to patient changes. Despite its simplicity, the Barthel Index is not always easy to score accurately. Detailed criteria must be followed to avoid misinterpretation, as illustrated by the example of the eating activity. Additionally, the index includes some confusing definitions, such as allowing the use of crutches but not wheelchairs for walking.The Barthel Index, a well-known assessment tool for activities of daily living (ADLs), was first introduced in the 1960s. It has been widely used in chronic care hospitals in Maryland since 1955, based on the actual amount and type of physical assistance required. The index evaluates various ADLs, including eating and urinary control, with scores ranging from 0 to 100. A score of 10 indicates complete independence, while a score of 5 suggests some assistance is needed. The index is particularly weighty on incontinence management due to its impact on social acceptance and care needs. The Barthel Index has been a primary tool in rehabilitation, though it is now overshadowed by the Functional Independence Measure (FIM) in acute care settings. The main difference between the two is in their scoring systems: the Barthel Index assigns higher scores for independence in each activity, while the FIM has a uniform maximum score of 7. The FIM also lacks detailed scoring for activities like grooming and personal hygiene, making it less sensitive to patient changes. Despite its simplicity, the Barthel Index is not always easy to score accurately. Detailed criteria must be followed to avoid misinterpretation, as illustrated by the example of the eating activity. Additionally, the index includes some confusing definitions, such as allowing the use of crutches but not wheelchairs for walking.