ADL

• Memory Tip: Visualize what you do when you wake up in the morning.
• B-Bed Mobility
• T-Transfer
• W- Walk in Room
• L-Locomotion in Room
• L-Locomotion outside Room
• D-Dressing
• E-Eating
• T-Toilet Use
• P-Personal Hygiene
• B-Bathing

Self-performance is trying to capture how a client performed a task during the past 7 days/24 hours, after setup and with the use of assistive devices.

• Independent - None OR (any type of assistance only 1 or 2 times) or Activity did not occur in last 7 days because either client was not able, there was no provider available, the client declined. 
• Supervision - 3 or more times: Verbal, no physical contact
• Limited - 3 or more times, physical assistance. 
• Extensive - 3 or more times full CG help on subtask or full CG help of task but not all time or physical assistance with weight bearing with task 3 or more times. 
• Total Dependence - Task occurred and client did not participate.

• 1. No set up or physical assist from caregiver
• 2. Setup help only
• 3. One person physical assist
• 4. Two plus person physical assist
• 5. Activity did not occur

It is trying to capture the highest level of support provided to the client during the last 7 day/24 hour period.

• Who is available (and willing) to help client with tasks. Does anyone share in the benefit of the task being performed by the paid provider. 
• *Remember: Services we provide help fill in the gap.

• Met: Informal resources will meet all of this need.
• Partially Met: Informal resources will meet part of this need.
• Unmet: There are no other available resources to meet the client's need. 
• Client Declines
• Shared Benefit

• Less than 1/4
• 1/4 to 1/2
• Over 1/2 to 3/4
• Over 3/4 but not all the time

The amount of time that informal supports are able to help with a task. 

Non-ADSA paid (except adult day health and skilled care).

Number of times task occurred divided by number of times informal (non-ADSA) assistance is available to assist client with task.

• e.g.
• 21 meals during past 7 days
• Informal help everyday for breakfast (7 times)

7/21 = .33, so category equals 1/4 to 1/2

So units could be times per day/week or hours per day, etc.

Client and paid caregiver both share in the benefit of an IADL task being performed or two or more client's in a multi-client household benefit from the same IADL task(s) being performed.

When provider does task, is part of task being done for their own benefit 

OR

In a multi-client household, when the task is performed, is it being done for more than one person?

How the client moves to and from a lying position, turns from side to side, and positions body while in bed, recline or other type of furniture.

How the client moves between surfaces-i.e., to/from bed, chair, wheelchair, standing position. Excluded from this definition is movement to/from bath, toilet and car which is covered under the definitions of toilet use, bathing and transportation.

Hallway and rest of immediate living environment. How client walks between locations in his/her room and immediate living environment. Immediate living environment is defined as areas adjacent to the client's room.

How client moves between locations in his/her room and immediate living environment; if in a wheelchair code for how self sufficient once in the wheelchair.

How client moves outside of immediate environment to include outdoors, going to and from patio or porch, to mailbox to see the next door neighbor.

How the client puts on, fastens, and takes off all items of clothing, including donning/removing a prosthesis.

• How the client uses the:
• toilet room,
• commode,
• bedpan, or
• urinal,
• transfers on/off toilet,
• cleanses,
• changes pads,
• manages ostomy or catheter and
• adjusts clothing

How the client eats and drinks, regardless of skills or gets nourishment (e.g. tube feeding or getting nutrients intraveneously)

• How client maintains personal hygiene, including
• combing hair,
• brushing teeth,
• shaving,
• applying make-up,
• washing/drying face,
• hands (including nail care)
• and perineum (menses care).