see Functional Status Section of CCD Excerpt

including bathing, dressing, grooming, eating, toileting, transfers

acuity, frailty, severity of condition, end of life, symptom complexity, pressures ulcers as pertains to function

Including issues with social cognition, participation with friends and acquaintances other than family members, contact with friends/relatives, participation in activities, work, volunteering, going out, conflict in relationships, including activities partly or directly related to working, housework or volunteering, family and home responsibilities or activities related to home and family

including issues with speech, writing or cognition required for communication, understands, make self understood, augmentative communication devices, clarity of speech

including vision, hearing, taste, skin sensation, kinesthetic sense, proprioception, balance, devices

to include gait, balance, type of mobility aid (eg wheelchair), falls (in a specific time frame), endurance, speed, distance wheeled or walked, stairs, going outdoors, community mobility

coma, alertness, cognitive status, memory, orientation

meal preparation, housework, managing finances, managing meds, transportation

living arrangements, availability of helper when needed, negative aspects- caregiver distress

financial stress, inadequate home physical environment, abuse,

sadness, crying, withdrawal from activities, expressions of hopelessness or self reported mood problems

wandering, aggression (verbal or physical), inappropriate types of behavior

interfering with function, intensity, frequency, managed by medications

bladder, bowel, type of device, frequency (note that the risk factors for incontinence are similar to those for falls, and decline in function. This is one rationale for including incontinence in functional status)

oral intake eg eats 75% of meals, weight loss, BMI

hours of exercise, comparison with standard recommendations

drinking, smoking

immunizations, dental visits, mammograms, within expected time frame