Table 1. Functional Status Coding Guidelines1.
| Instrumental Activity of Daily Living Coding Guidelines | |
| Meal Preparation | |
| • Can client prepare and cook a full meal? | 1 |
| • Can manage light snack meals by him/herself (not a full meal - i.e., breakfast, lunch)? | 2 |
| • Can client prepare any part of the meal him/herself? | 2 |
| • Does client need help with all/most of meal preparation tasks? | 3 |
| Shopping | |
| • How does client get groceries? | |
| - Can client shop for groceries him/herself? | 1 |
| - Does someone go along with client? | 2 |
| - Can client order by telephone and then put groceries away when delivered? | 2 |
| - Does client make his/her own shopping list then have someone purchase, deliver and put away the groceries? | 3 |
| - Does client need help with all shopping activities? | 3 |
| Routine Housework | |
| • Can client do all routine housework such as vacuuming, mopping floors, cleaning kitchen, and bathroom? | 1 |
| • Can client do light housework, such as dusting, tidying up, washing dishes? | 2 |
| • Is client unable to do housework at all? | 3 |
| Managing Money | |
| • Does client need help managing his/her own money? | 1 |
| • Does client need help writing his/her own checks? | 2 |
| • Does client need help balancing his/her own account? | 2 |
| • Does client need help paying his/her own bills? Can client keep track of them (does all of the above)? | 2 |
| • Can client manage day-to-day purchases? | 2 |
| • Is client unable to handle money at all? | 3 |
| Doing Laundry | |
| • Can client launder his/her own clothes? | 1 |
| • Can client do small items by him/herself? | 2 |
| • Does someone else do client's laundry? | 3 |
| Taking Medications | |
| If client does not currently take medications, try to estimate whether or not help would be needed and code accordingly. | |
| • Can client take his/her medications by him/herself? | |
| • Does client need reminders? | 1 |
| • Does anyone set them up for client? | 2 |
| • Does client need any one to give him/her his/her medications? | 2 |
| Using the Telephone | |
| • Can client use the telephone by him/herself? | 1 |
| • Does client need help with dialing, looking up numbers? | 2 |
| • Is client completely unable to use the telephone? | 3 |
| • Does client have vision or hearing problems that prevent him/her from using the phone? | 3 |
| Heavy Chores | |
| • Can client do the heavy chores around the house such as window washing, gardening, mowing the lawn? | 1 |
| • Who does general repairs? | |
| - Can client do any of this him/herself? | 2 |
| - Is client completely unable to do any heavy chores? | 3 |
| Activity of Daily Living Coding Guidelines | |
| Transportation Out of Walking Distance | |
| • When client has to travel to places out of walking distance, how does s/he usually get there? (For example, if client had to go to the doctor today, how would s/he get there?) | |
| •Does client need help in: | |
| - Getting to and from the car/bus/taxi (including stairs)? | 2 |
| - Getting in or out of the car/bus/taxi? | 2 |
| - Does someone always go along with client? | 2 |
| - If you were not available, could client go alone by bus or taxi? | 1 |
| - Does client need special arrangements such as ambulance; specially equipped vehicle; maximum help from one or more people; travel only for medical appointments? | 3 |
| Walking | |
| • Can client walk indoors without anyone helping him/her? | 1 |
| • Does client need: | |
| - Support just now and again? | 2 |
| - Just standby supervision? | 2 |
| - Continuous physical support of another person or does not walk? | 3 |
| Wheelchair Mobility | |
| • Can client propel the wheelchair indoors by him/herself (get to the bathroom, kitchen etc., independently) | 1 |
| • Does client need help with: | |
| - Locking/unlocking brakes? | 2 |
| - Getting through doorways? | 2 |
| - Getting up and down ramps? | 2 |
| - Is client pushed on occasion only for longer distances or outdoors? | 2 |
| - Does someone push client all or most of the time? | 3 |
| Activity of Daily Living Coding Guidelines | |
| Transfers (Bed/Chair) | |
| • Can client get in/out of bed/chair by him/herself? | 1 |
| • Does client need: | |
| - Support just now and again? | 2 |
| - Standby supervision? | 2 |
| - Does client have to be lifted by another person? | 3 |
| Grooming | |
| • Can client comb and shampoo his/her hair by him/herself? | 1 |
| • Can client shave himself? | 1 |
| • What about taking care of fingernails and toenails? | 1 |
| • Does client need help with: | |
| - Any of these activities? | 2 |
| - Some part of the activity? | 2 |
| - Is client unable to do any of these? | 3 |
| Bathing | |
| • Can client take his/her own bath? | 1 |
| • Does client need any help with: | |
| - Getting in/out of tub/shower? | 2 |
| - Turning on or bringing the water? | 2 |
| - Washing any part of the body? | 2 |
| - Towel drying? | 2 |
| - Sandby supervision, someone just to be there? | 2 |
| • Does someone have to bathe client? | 3 |
| Dressing | |
| • Can client get dressed by him/herself? | 1 |
| • Does client need any help with: | |
| - Getting clothes from the drawer or closet? | 2 |
| - Putting on pants ot shirt? | 2 |
| - Fasteners? | 2 |
| - Shoes (except for tying shoes)? | 2 |
| • Is client mainly dressed by a helper? | 3 |
| • Does client often stay partly or completely undressed? | 3 |
| Eating | |
| • Can client feed him/herself? | 1 |
| • Does client need help with: | |
| - Cutting meat, buttering bread? | 2 |
| - Opening cartons, pouring liquid? | 2 |
| - Holding glass or cup? | 2 |
| • Does someone feed client? | 3 |
| Using the Toilet | |
| • Can client go to the bathroom and use the toilet by him/herself? | 1 |
| • Does client need help with: | |
| - Getting there? | 2 |
| - Cleaning him/herself? | 2 |
| - Getting on or off the toilet seat? | 2 |
| - Arranging his/her clothes? | 2 |
| If client uses bedpan or commode: | |
| • Does client need help with this at night or help in disposing of contents? | 2 |
| • Is client unable to use the bathroom at all? | 3 |
| • Does someone help client with a bowel or bladder program? | 3 |
| If client has catheter/ostrmy: | |
| • Does client take full care of it? | 1 |
| • Does client need help with cleaning, changing bag, or disposing of contents? | 2 |
| • Is client unable to do any of this? | 3 |
| Bowel/Bladder Accidents | |
| • Is client able to control urination and bowel elimination all the time? | 1 |
| • If client has bowel or bladder accidents: | |
| - Does client have occasional accidents (once a week or less)? | 2 |
| - Is client incontinent frequently or most of the time (more than once a week)? | 3 |
1
1-No help needed; 2-some help needed; 3-maximum help needed.
SOURCE: UCSF/IHA Medicare Alzheimer's Disease Demonstration and Research Project, 1989.