|
Check if present |
Stage |
Assessment
(score is highest consecutive level of disability) |
|
|
1 |
No difficulties, either subjectively or
objectively. |
|
|
2 |
Complains of forgetting location of
objects; subjective word finding difficulties only. |
|
|
3 |
Decreased job functioning evident to
coworkers; difficulty in traveling to new
locations. |
|
|
4 |
Decreased ability to perform complex
tasks (e.g., planning dinner for guests; handling finances;
marketing). |
|
|
5 |
Requires assistance in choosing proper
clothing for the season or occasion. |
|
|
6a |
Difficulty putting clothing on properly
without assistance. |
|
|
6b |
Unable to bathe properly; may develop
fear of bathing. Will usually require assistance adjusting bath
water temperature. |
|
|
6c |
Inability to handle mechanics of
toileting (i.e., forgets to flush; doesn't wipe
properly). |
|
|
6d |
Urinary incontinence, occasional or more
frequent. |
|
|
6e |
Fecal incontinence, occasional or more
frequent. |
|
|
7a |
Ability to speak limited to about half a
dozen words in an average day. |
|
|
7b |
Intelligible vocabulary limited to a
single word in an average day. |
|
|
7c |
Nonambulatory (unable to walk without
assistance). |
|
|
7d |
Unable to sit up
independently. |
|
|
7e |
Unable to smile. |
|
|
7f |
Unable to hold head
up. |
with Grandpa Julius