Activities of Daily Living

Eating: Includes the use of suitable utensils, bringing food to mouth, chewing and swallowing once presented on table or tray, drinking from cup or glass.

7	Independent	Does not need help or any modifications.
6	Modified Independent	Needs assistive device, increased time, safety issues or modify consistency of food.
5	Supervision/Set-up	Needs cuing or set-up: Help required to open containers, pour liquids, cut food.
4	Minimal Assist	Needs incidental assistance such as placement of food, or scoop food (performs >75% of task).
3	Moderate Assist	Needs physical assist to eat 50-74% of task.
2	Maximal Assist	Needs Maximum physical assist (performs 25-49% of task).
1	Total Assist	Total assist; dependent or assist w/ tube feedings (performs <25% of task).
0	Activity Does Not Occur	Enter only for admission assessment. Pt. does not receive any nutrition during assessment. (rare)

Grooming: Includes oral care, hair grooming, washing and drying hands and face, shaving and applying make-up.

7	Independent	Does not need help or any modifications.
6	Modified Independent	Needs assistive device, increased time, or safety issues.
5	Supervision/Set-up	Needs cuing, coaxing or assistance organizing grooming supplies.
4	Minimal Assist	Needs incidental assistance such as placement of washcloth or help with specific task (performs >75% of task).
3	Moderate Assist	Needs physical assist to groom 50-74% of task.
2	Maximal Assist	Needs Maximum physical assist (performs 25-49% of task).
1	Total Assist	Total assist; helper provides most of the assistance (performs <25% of task).
0	Activity Does Not Occur	Enter only for admission assessment. Pt. does not perform any grooming activities. (rare)

Bathing: Includes bathing the body from the neck down excluding the back (washing, rinsing, drying in tub, shower or sponge bath).

7	Independent	Does not need help or any modifications.
6	Modified Independent	Needs assistive device, increased time, or safety issues.
5	Supervision/Set-up	Needs cuing, coaxing or assistance to set out bathing equipment.
4	Minimal Assist	Needs incidental assistance such as placement of washcloth (performs >75% of task).
3	Moderate Assist	Needs physical assist bathe one or two areas 50- 74% of task.
2	Maximal Assist	Needs Maximum physical assist (performs 25-49% of task).
1	Total Assist	Helper performs most/all of the activity <25%
0	Activity Does Not Occur	Enter only for admission assessment. Pt. does not bathe self or is not bathed by helper.

Dressing: Scored separately for upper and lower body. Includes dressing and undressing as well as obtaining clothing from storage location. Assessment should occur with persons own clothing.

7	Independent	Does not need help or any modifications.
6	Modified Independent	Needs assistive device, increased time, or safety issues.
5	Supervision/Set-up	Needs cuing, coaxing or assistance to set out bathing equipment.
4	Minimal Assist	Needs incidental assistance such as placement of washcloth (performs >75% of task).
3	Moderate Assist	Needs physical assist bathe one or two areas 50- 74% of task.
2	Maximal Assist	Needs Maximum physical assist (performs 25-49% of task).
1	Total Assist	Helper performs most/all of the activity <25%
0	Activity Does Not Occur	Enter only for admission assessment. Pt. does not dress self or is not dressed by helper.

Bowel and Bladder Management: Part I=level of assistance

7	Independent	Does not need help or any modifications.
6	Modified Independent	Needs assistive device, equipment, pads, or medicine.
5	Supervision/Set-up	Needs cuing, coaxing or assistance to set up equipment.
4	Minimal Assist	Needs incidental assistance such as placement of equipment (performs >75% of task).
3	Moderate Assist	Needs physical assist for more than one task or manage equip. 50-74% of task.
2	Maximal Assist	Needs Maximum physical assist (performs 25-49% of task).
1	Total Assist	Helper performs most/all of the activity and manages equipment <25%

Bowel and Bladder Management: Part II, Frequency of bowel or bladder accidents over the past 7 days.

7	No accidents	Does not need help or any modifications.
6	No accidents in past 7 days	Needs assistive device, equipment, pads, or medicine.
5	1 accident	Including bedpan or urinal spills
4	2 accidents	Including bedpan or urinal spills
3	3 accidents	Including bedpan or urinal spills
2	4 accidents	Including bedpan or urinal spills
1	5 or more accidents	Including bedpan or urinal spills

Toileting: Includes perineal hygiene and clothing management before and after use of toilet or bedpan.

7	Independent	Does not need help or any modifications.
6	Modified Independent	Needs assistive device and or more time to complete.
5	Supervision/Set-up	Needs cuing, coaxing or assistance to set up equipment.
4	Minimal Assist	Needs incidental assistance such as balance while cleaning or adjusting clothing.
3	Moderate Assist	Needs physical assist for more than one task or manage equip. 50-74% of task.
2	Maximal Assist	Needs Maximum physical assist (performs 25-49% of task).
1	Total Assist	Helper performs most/all of the activity and manages equipment <25%
0	Activity Does Not Occur	Enter only for admission assessment.

Transfers: Bed, Chair, W/C in both directions. Toilet and Tub are scored separately.

7	Independent	Does not need help or any modifications.
6	Modified Independent	Needs assistive device such as grab bar, sliding board or extra time.
5	Supervision/Set-up	Needs cuing, coaxing or assistance to set up equipment.
4	Minimal Assist	Needs incidental assistance such as placement of equipment (performs >75% of task).
3	Moderate Assist	Needs physical assist for more than one task or manage equip. 50-74% of task.
2	Maximal Assist	Needs Maximum physical assist (performs 25-49% of task).
1	Total Assist	Helper performs most/all of the activity and manages equipment <25%
0	Activity Does Not Occur	Enter only for admission assessment. Pt. does not transfer unable to get out of bed. (rare)

Locomotion: Walk or Wheelchair, to be scored on level surfaces.

7	Independent Walks >150ft	Does not need help or any modifications.
6	Modified Independent Walks >150ft	Needs assistive device, equipment, pads, or medicine.
5	Supervision/Set-up Walks >150ft	Needs cuing, coaxing or assistance to set up equipment.
4	Minimal Assist Walks >150ft	Needs incidental assistance such as contact guard or steadying (performs >75% of task).
3	Moderate Assist Walks >150ft	Needs physical assist for 50-74% of task.
2	Maximal Assist Walks 50-149ft	1 person Maximum physical assist (performs 25- 49% of task).
1	Total Assist Walks <50ft.	Walks less than 50ft and/or 2 person assist <25%
0	Activity Does Not Occur	Enter only for admission assessment.

Stairs: Scores to ascend and descend 1 flight of stairs.

7	Independent 12-14 stairs	Does not need help or any modifications.
6	Modified Independent 12-14 stairs	Needs assistive device, equipment, pads, or medicine.
5	Supervision/Set-up 12-14 stairs	Needs cuing, coaxing or assistance to set up equipment.
4	Minimal Assist 12-14 stairs	Needs incidental assistance such as contact guard or steadying (performs >75% of task).
3	Moderate Assist 12-14 stairs	Needs physical assist for 50-74% of task.
2	Maximal Assist 4-6 Stairs	1 person Maximum physical assist (performs 25- 49% of task).
1	Total Assist Less than 4 stairs	Less than 4 stairs and/or 2 person assist <25%
0	Activity Does Not Occur	Enter only for admission assessment.

Comprehension: Understands auditory or visual communication or both. Basic=pain, hunger etc. Complex=current events, finances etc.

7	Independent	Understand complex/abstract infor..
6	Modified Independent	Understands most situations readily or with mild difficulty. Does not need prompting can self-correct.
5	Stand by: Prompting	Understands directions and conversations about basic needs 90% or more.
4	Minimal Prompting	Understands directions and conversations about basic needs 75-89%
3	Moderate Prompting	Understands directions and conversations about basic needs 50-74% of the time.
2	Maximal Prompting	Understands directions and conversations about basic needs 25-49% of the time.
1	Total Assist	Understands basics less than 25% of the time. May understand simple common expressions.

Expression: Includes clear vocal and/or non-vocal expression of language.

7	Independent	Expresses complex/abstract ideas.
6	Modified Independent	Expresses complex ideas in most situations readily or with mild difficulty. Does not need prompting can self-correct.
5	Stand by: Prompting	Expresses basic daily needs and ideas 90% or more.
4	Minimal Prompting	Expresses basic daily needs and ideas 75-89%
3	Moderate Prompting	Expresses basic daily needs and ideas 50-74% of the time.
2	Maximal Prompting	Expresses basic daily needs and ideas 25-49% of the time. Uses only single words or gestures.
1	Total Assist	Expresses basic daily needs and ideas less than 25% of the time.

Social Interaction: Cooperates, gets along with staff, family & other patients.

7	Independent	Appropriate social interactions.
6	Modified Independent	Appropriate interactions most of the time. May require time and/or medication.
5	Stand by: Prompting	Need supervision under stressful situations. Interacts appropriately 90% or more.
4	Minimal Prompting	Interacts appropriately 75-89%
3	Moderate Prompting	Interacts appropriately 50-74% of the time.
2	Maximal Prompting	Interacts appropriately 25-49% of the time.
1	Total Assist	Interacts appropriately less than 25% of the time.

Problem solving: Participates in decisions regarding personal, financial and social.

7	Independent	Able to recognize, initiate & carries out steps to solve complex problems.
6	Modified Independent	Recognizes and resolves most problems. May need more time.
5	Stand by: Prompting	Requires assistance to solve less routine problems 10% of the time.
4	Minimal Prompting	Solves routine problems 75-89%
3	Moderate Prompting	Solves routine problems 50-74% of the time.
2	Maximal Prompting	Solves routine problems 25-49% of the time.
1	Total Assist	Solves routine problems less than 25% of the time. May require 1:1 assistance

Memory: Recognizes familiar faces, recalling routine & complex.

7	Independent	Able to recall, remember routines and complex requests.
6	Modified Independent	May use cues or aids to help recall.
5	Stand by: Prompting	Needs only cueing in stressful or new situations.
4	Minimal Prompting	Recalls people and routine 75-89%
3	Moderate Prompting	Recalls people and routine 50-74% of the time.
2	Maximal Prompting	Recalls people and routine 25-49% of the time.
1	Total Assist	Recalls people and routine less than 25% of the time. May require 1:1 assistance

Return to OT Module Three

Return to OTA Module Three