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28 Cards in this Set
- Front
- Back
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ADL Self-Performance:
CODE 0 - INDEPENDENT |
No help or staff oversight at any time.
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ADL Self-Performance:
CODE 1 - SUPERVISION |
Oversight, encouragement or cueing
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ADL Self-Performance:
CODE 2 - LIMITED ASSISTANCE |
Resident highly involved in acitivty; staff provided guided maneuvering of arms and/or legs -or- other non-weightbearing assistance
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ADL Self-Performance:
CODE 3 - EXTENSIVE ASSIST |
Resident involved in activity; Staff provided weight-bearing support
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ADL Self-Performance:
CODE 4 - TOTAL DEPENDENCE |
Full staff performance every time during the entire shift
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ADL Self-Performance:
CODE 8 - DID NOT OCCUR |
Activity (or any part of the ADL) was not performed by resident or staff at all over the entire shift.
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ADL Support Provided:
CODE 0 - NO |
No support or physical help form staff
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ADL Support Provided:
CODE 1- SETUP |
Setup help only
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ADL Support Provided:
CODE 2 - ONE |
One person physical assist
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ADL Support Provided:
CODE 3 - TWO |
Two or more persons physical assist
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ADL Support Provided:
CODE 8 - DID NOT OCCUR |
ADL activity itself did not occur during the entire shift
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BED MOBILITY
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How resident moves to and from a lying positon, turns side to side, and positions body while in bed or alternate sleep furniture
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TRANSFER
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How resident moves between surfaces including to or from: bed, chair, wheelchair. standing position (*EXCLUDES to/from bath/toilet)
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WALK IN ROOM
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How resident walks between locations in his/her room
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WALK IN CORRIDOR
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How resident walks in corridor on neighborhood
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LOCOMOTION ON NEIGHBORHOOD
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How resident moves between locations in his/her room and adjacent corridor on the same floor level. *If in a wheelchair, self-sufficiency once in chair
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LOCOMOTION OFF NEIGHBORHOOD
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How resident moves to and returns from off-neighborhood locations(e.g. areas set aside for dining, activities or treatments). *If facility has only one floor, how resident moves to and from distant areas on the same floor. If in wheelchair, self-suffiency once in chair
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DRESSING
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How resident puts on, fastens and takes off all items of clothing, including donning /removing a prosthesis or TED hose. Dressing includes putting on and changing pajamas and housedresses
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EATING
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How resident eats and drinks, regardless of skill. Do not include eating/drinking during medication pass. *Includes intake of nourishment by other means (e.g., tube feeding, total parenteral nutrition, IV fluids administered for nutrition or hydration)
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TOILET USE
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How resident uses the toilet room, commode, bedpan or urinal; transfers on/off toilet; cleanses self after elimination; changes pad (or absorbant brief); manages ostomy or catheter; and adjusts clothes. *Do Not include emptying of bedpan, urinal, bedside commode, catheter bag or ostomy bag.
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PERSONAL HYGIENE
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How resident mantains personal hygiene, including combing hair, brushing teeth, shaving, applying makeup, washing/drying face and hands (excludes baths and showers)
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BATHING
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How resident takes full-body bath/shower, sponge bath, and transfers in/out of tub/shower ( excludes washing of back and hair) CODE ability separate from ADL
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BATHING SELF-PERFORMANCE:CODE 0-INDEPENDENT
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No help provided in bathing
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BATHING SELF-PERFORMANCE: CODE 1-SUPERVISION
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Oversight help only with bathing
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BATHING SELF-PERFORMANCE: CODE 2- PHYSICAL HELP
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Limited to transfer only in/out of tub/shower
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BATHING SELF-PERFORMANCE: CODE 3- PHYSICAL HELP
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In part of bathing activity
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BATHING SELF-PERFORMANCE: CODE 4- TOTAL DEPENDENCE
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Full staff performance of bath every time
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BATHING SELF-PERFORMANCE: CODE 8- DID NOT OCCUR
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Activity did not occur at all
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