Bed Mobility
Personal Hygiene
Locomotion off unit
Toilet use
Dressing
100
Resident is independent with turning side to side when lying in bed throughout your shift.
What is: Independent (Self Performance) and No setup or physical help from staff. (Support Provided)
100
Resident required staff to set out, and apply toothpaste to toothbrush every am. She was then able to brush her teeth by herself.
What is Supervision (Self Performance) and Set up help only. (Support Provided)
100
Resident lives on HH3. He has refused to leave his room throughout the entire shift.
What is Activity did not occur (Self Performance) & Activity did not occur. (Support Provided)
100
Morgan takes himself to the bathroom throughout the entire shift. He has occasional dribbling and wears disposable briefs.
What is Independent. (Self Performance) & No setup or physical help from staff. (Support Provided)
100
10-6 shift lay out all residents clothing, at the foot of their bed every day. Mrs. Jones wakes up and dresses herself.
What is Independent (Self-performance) & No setup or physical help from staff. (Support Provided)
200
Resident favors lying on her right side. Because she has had a history of skin breakdown, staff (1) must sometimes cue her and guide the resident to place her hands on the side rail and encourage her to change positions when in bed throughout the entire shift
What is limited assistance (Self-Performance) and one person physical assistance.(Support Provided)
200
Mr. J normally takes care of his own oral care. Today however he is voicing discomfort in his elbow which is preventing him from completing the task so a staff member brushed his teeth for him.
What is Total Dependence (Self Performance) and one person physical assist. (Support Provided)
200
Resident is at risk for wandering. Resident is free to roam between floors but can not go outside without staff being present. This date he rode the elevator down to the dining room to get a glass of tea.
What is Supervision (Self-Performance) & no set up or physical help from staff. (Support Provided)
200
Resident is on a check and change toileting plan. He is unable to tell staff when he has voided or help in the process. It takes 2 staff to change and provide peri-care after each incontinent episode.
What is Total Assistance. (Self Performance) & Two person physical assistance. (Support Provided)
200
Mrs. C. did not feel well and chose to stay in her room. She requested to stay in night clothes and rest in bed during breakfast. Mrs. C. washed up after breakfast and changed her night clothes with staff assistance to guide her arms and guided her nightgown over her head and buttoned the front.
What is Limited Assistance. (Self Performance) & One person physical assist. (Support Provided)
300
2 staff turned resident side to side throughout the entire night. Resident did not participate.
What is Total Dependence (Self-Performance) and two persons physical assist. (Support Provided)
300
Staff handed resident a wet washcloth to wash her face. Due to residents diagnosis of Alzheimer's she was unable to follow through with task. Staff then guided her hand, while resident holding washcloth, to her face. Resident then proceeded to wash her face.
What is Limited assistance (Self Performance) & One person physical help. (Support Provided)
300
Resident was pushed by staff in his w/c to an activity occurring in the main dining room.
What is Total Dependence (Self-Performance) & One person physical assist. (Support Provided)
300
Staff member reminded resident to toilet frequently during the day and to unzip and zip pants and to wash his hands after using the toilet.
What is Supervision. (Self Performance) & No setup or physical help from staff. (Support Provided)
300
Anne is in the late stages of Alzheimer's and is unable to dress herself due to contractions. It takes 2 staff to dress and undress her.
What is Total Assistance. (Self-Performance) & 2 Staff Assistance. (Support Provided)
400
Resident favors lying on her right side. Because she has a history of skin breakdown, staff must verbally remind her to reposition off her right side daily when in bed.
What is Supervision (Self-Performance) and No setup or physical help from staff.(Support Provided)
400
Resident refused to brush his teeth throughout your entire shift.
What is Activity did not occur. (Self performance) & ADL activity itself did not occur. (Support Provided)
400
JP leaves early in the morning and returns late in the evening.
What is Independent. (Self Performance) & No setup or physical help from staff. (Support provided)
400
Resident keeps his urinal hanging on his trash can close to his bed so that he can use it during the night. Staff empty it periodically throughout the shift for him and place it back on the trash can.
What is Independent. (Self Performance) & No setup or physical help from staff.
400
Adam gets up early in the morning and the 10-6 shift helps him get dressed. You are working the 6-2 shift and have not had to help resident change his clothes during your shift.
What is Activity did not occur. (Self performance) & ADL activity did not occur. (Support Provided)
500
Resident is involved in bed mobility but staff (1) provided weight-bearing support.
What is Extensive Assistance (Self-Performance) & One person physical assist (Support Provided)
500
Resident required staff to manually wipe her peri-area following the toileting process.
What is example is not part of Personal Hygiene but part of Toileting.
500
Bonnie eats all her meals on the unit in the "on unit" dining room. Staff set-up all residents trays in the dining room. She remained on the unit throughout your entire shift. She moves around the unit in a wheelchair, self propelled to her designations.
What is Independent. (Self Performance) & No setup or physical help from staff. (Support Provided)
500
Mr. T has Dementia and urinates in the potted plant that sits at the end of the hall throughout the day. They walk with him to his room and show him where the toilet is.
What is Supervision (Self Performance) and No setup or physical help from staff. (Support Provided)
500
Staff allow Mary to choose what clothes she wants to wear for the day. They lay it out on her bed, in order and give instructions on what to do throughout the dressing process.
What is Supervision. (Self Performance) & Setup help only. (Support provided)
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