Eating

Gets food from plate into mouth without help

Food may be prepared by another person

Eats without assistance

1

Needs partial or complete assistance in eating or is fed intravenously

0

Dressing

Gets clothes from closets and drawers and puts on clothes and outer garments complete with fasteners. May have help tying shoes.

1

Needs help with dressing or needs to be completely dressed

0

Bathing (sponge bath, tub bath, shower)

Bathes self completely or needs help in bathing only a single part of the body such as the back, genital area, or disabled extremity

1

Needs assistance in bathing more than one part of the body, getting in and out of the tub or shower, or needs total assistance

0

*Transferring

Moves in and out of bed or chair unassisted (mechanical transfer aids are acceptable)

1

Needs help in moving from bed to chair or requires a complete transfer

0

Toileting

Goes to toilet, gets on and off, arranges clothes, and cleans genital area without help

1

Needs help transferring to the toilet, cleaning self or uses bedpan or commode

0

Continence

Controls bladder and bowel completely (without occasional accidents)

1

Is partially or totally incontinent of bowel or bladder

0