Functional Status

In this section we answer questions related to the Functional status screen.

To resolve your issue

• Check your manual first
• See if it’s covered here.
• Still no answer? Contact us at interRAI@tas.health.nz or 0800 10 80 44.

Factsheets

• ADL Functional Performance coding flowchart (PDF)
• ADL which level of assistance flowchart (PDF)
• Guide for coding IADLs and ADLs (PDF)

Questions

Would you code a person as independent in shopping if they went online, purchased items, paid for goods and put shopping away when it was delivered?

How is the use of blister packs captured for this item?

What is the starting position for bed mobility?

Can a person be coded for bed mobility if they sleep in a chair?

What are the guidelines for coding 'Set up' help only?

Can a mobility scooter be used as a 'driving self' scenario?

How do you know if a person is completing 'Moderate physical activity' when they have heart medication? 

Answers

Question: Would you code a person as independent in shopping if they went online, purchased items, paid for goods and put shopping away when it was delivered?

Answer:

No, this item is concerned with the physical activity of shopping only.

If a person has completed their shopping ‘online’ then performance is ‘8’. Capacity is where to code what the client’s 'presumed ability' is.

The intent of the item is to capture in store shopping activities. Activities before or after in store shopping are not to be considered when coding this item

Question: How is the use of blister packs captured for this item?

Answer: 

1. Performance - if a blister pack is always used then this item is coded at least '4' = extensive assistance. Need to also check -if there are no further prompts/ assistance to open pack etc.
2. Capacity - if a person is able to use bottles / understands dosage and time of taking medications then capacity is ‘independent’ but for convenience prefers to use blister packs.

 Note: getting the script is not considered a sub-task for this item as this involves transport/phone use too.

Question: What is the starting position for bed mobility?

Answer:

The starting position for bed mobility is when the person is fully lying  on the bed or other sleeping surface e.g. couch or lazy boy

To move from lying to sitting up, in bed, is counted as bed mobility.

Rationale: Lifting the legs in and out of the bed is considered a sub-task of 'transfer'into or out of bed.

Question: Can a person be coded for bed mobility if they sleep in a chair?

Answer:

YES: Bed mobility is relevant when the person is fully lying on  other sleeping surfaces e.g. couch or lazy boy.

Question: What are the guidelines for coding 'Set up ' help only?

Answer: 

 It is that activity which the caregiver/someone else completes to enable the person to complete the task independently, for example:

1. if the person was given the phone on the table beside them before the caregiver left, but the person was able to select number dial and speak/receive incoming calls then they have been ‘set up’ to facilitate the task of making phone calls.
2. If a person has the walker placed within reach every time they want to walk, then this is set up help.

NB: If they have been provided with a frame/ raised toilet seat/grab rail one month ago. They continue to use this item(s) alone then they are independent and not ‘set up’ in the last 3 days.

Section: G1ha and b: Transportation

Question: Can a mobility scooter be used as a 'driving self' scenario?

Answer:

The item's intent is to assess how independently the client is able to get to places beyond walking distances. The mode of transportation used is a secondary concern - how will they complete the task in poor weather.

Question: How do you know if a person is completing 'Moderate physical activity' when they have heart medication?

Answer:

If the person states, when they complete a physical activity, they notice their breathing is more difficult and  they feel warm / starting to sweat, then this is an indication they are exercising at a 'moderate' level of activity.

For the BORG activity descriptor chart see: BORG

Question: How do you code for a person who sometimes walks between locations indoors on the same level and sometimes uses a wheelchair?

A: They are two separate assessment items to consider: 'Walking' and 'Mobility'.

WALKING

Code this item according to how much support the person required when walking between locations, indoors, same level in the last three days.

Code ‘8’ – Activity did not occur during entire period’ for anybody who only uses a wheelchair to mobilise

MOBILITY

Code this item according to how did the person move between locations, indoors, same level?

If the person only ever walks, in this situation, then the code will be the same as for the walking item.

If the person sometimes uses a wheelchair code for mobility using a wheelchair, considering all episodes this occurred in the 3 day look back.

If they vary in the assistance they require once seated in a wheelchair use the ADL flow chart and code accordingly.

OR:

If the person only uses a wheelchair and never walks then code walking as ‘did not occur’ and mobility according to how they moved once in the wheelchair, between locations, indoors and same level.

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