DEATH
Dressing,
Eating
Ambulating (1)
Toileting
Hygiene (bathing) (1st to go)
"Does anyone help you with ___ ?"
"Who in the household does the ___ ?”
If they need help, WHEN and WHY did they start needing help?
| Independent | Supervision | Assit | Dependent | |
|---|---|---|---|---|
| bathing | ||||
| dressing | ||||
| grooming | ||||
| toileting | ||||
| ambulation/gait aids | ||||
| +/- stairs | ||||
| +/- transferring |