Table 1.

Adapted CFS Items.

Screening CFS statement	Score
I am terminally ill and at the end of my life	9
I am completely dependent for all of my personal care	8
I need help with all of my personal care	7
I need assistance with out of home activities, require help with bathing or medications, or struggle with stairs	6
I need physical or practical assistance with finances, transportation, or heavy housework	5
I am more tired than I used to be, and have more trouble obtaining supports than before, but can still coordinate things myself	4
My health conditions are well managed, but I am generally inactive. I may require advice on how to obtain supports with finances, transportation, or heavy housework	3
I am well, but only occasionally active. I can manage finances, transportation, and heavy housework on my own	2
I am active, energetic, and exercise regularly	1