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What are the tasks included in the CARE ADL category?
- Memory Tip: Visualize what you do when you wake up in the morning.
- B-Bed Mobility
- W- Walk in Room
- L-Locomotion in Room
- L-Locomotion outside Room
- T-Toilet Use
- P-Personal Hygiene
What is the self-performance category for ADLs trying to capture?
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.
How is self-performance coded for ADL categories?
- 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.
How is support provided coded for ADLs?
- 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
What is the support provided category for ADLs trying to capture?
It is trying to capture the highest level of support provided to the client during the last 7 day/24 hour period.
What is the status category trying to capture?
- 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.
How is status coded for ADLs?
- 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
If partially met, you have to calculate how much of task is partially met by informal supports. What are the options to choose from?
- Less than 1/4
- 1/4 to 1/2
- Over 1/2 to 3/4
- Over 3/4 but not all the time
What is assistance available trying to capture?
The amount of time that informal supports are able to help with a task.
How is informal support defined?
Non-ADSA paid (except adult day health and skilled care).
How is assistance available calculated?
Number of times task occurred divided by number of times informal (non-ADSA) assistance is available to assist client with task.
- 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.
What is a shared benefit?
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.
What are some questions you can ask about shared benefit?
When provider does task, is part of task being done for their own benefit
In a multi-client household, when the task is performed, is it being done for more than one person?
How is bed mobility defined?
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 is transfer defined?
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.
How is walk in room defined?
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 is locomotion in room defined?
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 is locomotion outside of room defined?
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 is dressing defined?
How the client puts on, fastens, and takes off all items of clothing, including donning/removing a prosthesis.
How is toilet use defined?
- How the client uses the:
- toilet room,
- bedpan, or
- transfers on/off toilet,
- changes pads,
- manages ostomy or catheter and
- adjusts clothing
How is eating defined?
How the client eats and drinks, regardless of skills or gets nourishment (e.g. tube feeding or getting nutrients intraveneously)
How is personal hygiene defined?
- How client maintains personal hygiene, including
- combing hair,
- brushing teeth,
- applying make-up,
- washing/drying face,
- hands (including nail care)
- and perineum (menses care).