Show:
BED MOBILITY
TRANSFER
EATING
TOILET USE
ADL HODGEPODGE
100
If the team member supports some of the weight of the resident’s hand while helping the resident to eat (e.g. lifting a spoon or a cup to mouth), or performs part of the activity for the resident, this is what type of assistance provided?
What is extensive/one person physical assist Rationale: team member is supporting some of the weight which meets the definition of extensive; limited assist is non-weightbearing
200
Mr. Austin has Parkinson's disease and needs weightbearing assist of 2 team members to transfer using the sit/stand lift. During your shift, you & another team member transferred Mr. Austin from his bed to wheelchair using the sit/stand lift. He was able to hold the hand grips during the transfer. What is the appropriate coding for transfers?
What is extensive/2+persons physical assist Rationale: Extensive assist is defined by the resident involved in the activity; the resident was able to hold the hand grips on the lift during the transfer
200
It is meal time and you are present in the dining room. You are delivering meals to the residents as they arrive. Mrs. Wild arrives to her table. You deliver her meal to her and she requires no assistance. However you remain in the dining room observing all the residents as they finish eating. How you do you code self-performance and support for eating for Mrs. Wild for this meal?
What is independent/No set up Rationale: Mrs. Wild required no help or staff oversight at any time during her meal. She also required no set up or physical help. To code "supervision" the team member would need to provide "direct supervision or cueing" to her. Just observing the entire dining room is not "direct supervision".
200
On your shift, Mr. Smith is on a walk to dine program. One staff member assists Mr. Smith with guided maneuvering while the other staff member follows along with a wheelchair for safety purposes. How do you code the ADL for Locomotion on unit?
What is Limited assist of one….2/2 Rationale: The resident required limited assist of 1 staff member, the second person is not touching the resident.
300
Staff must assist Mr. P. to zip his pants, hand him a washcloth, and remind him to wash his hands after using the toilet daily. How do you document “toileting” for this task that was performed?
What is limited assistance/one person physical assist
300
Mrs. Tyler has always loved Halloween and being a resident of the nursing home has not changed her mind about this fun holiday. The facility is having a party and she wants to dress up. Due to her past CVA she is no longer able to dress herself. One of the CNAs assists her in donning her costume. Her adult daughter is going to help her pass candy out to the children and pushes Mrs. Tyler in her wheel chair down to the lobby area with her foot pedals on the w/c. How do you document the adl task of Locomotion Off Unit?
What is activity did not occur. Rationale: Since the daughter is not an employee of the facility, team members should code "activity did not occur" Important note: We must be cautious when non employees are pushing our residents in their wheel chairs. We need to ensure that they are following our safety policy and have foot pedals on at all times while pushing.
400
On your shift, Mrs. Davis has slid to the foot of the bed. You and another team member had to physically lift and reposition her toward the head of the bed. According to her care plan, Mrs. Davis is able to assist by bending her knees and pushing with her legs during the reposition. During the reposition, she was able to bend her knees and push with her legs. How would you code the ADL of bed mobility?
What is extensive assist with 2 personal physical assist Rationale: Resident required weight-bearing assistance, but not total assist, with two team members
400
Mr. Solomon begins eating each meal daily by himself. After he had eaten only his bread, he stated he was tired and unable to complete the meal. One staff member physically supported his hand to bring the food to his mouth and provided verbal cues to swallow the food. The resident was then able to complete the meal.
What is extensive assistance/one person physical assist Rationale: Resident partially participated in the task daily at each meal, but one staff member provided weight-bearing assistance with some portion of each meal.
400
Mr. Becker had a private duty aide with him all night on the night shift. When the CNA repositioned him in bed every 2 hours, the resident did not participate at all. As the CNA how would you code bed mobility for Mr. Becker?
What is activity did not occur? Rationale: To capture assistance provided it must be performed by the facility staff
500
It is 2am and you have just assisted Mrs. Brown to/from the bathroom. She is back in bed and you have offered her a drink. For her to drink, you need to hold the glass and position the straw in her mouth while she drinks. How do you document “eating” for this task that was performed?
What is TOTAL DEPENDENCE/one person physical assist Rationale: full staff performance was required to hold the glass and position the straw for the entire task
500
Mrs. Rubble is a post right ankle fracture and has orders for non-weight bearing to her right foot. This is also stated on her care plan. During your shift you took her to the bathroom 2 times and each time you physically transferred her from the wheelchair to toilet and then back from the toilet to the wheelchair. She was able to do her peri care, wash her hands and adjust her clothing herself each time. How do you code toileting based on the assistance you provided?
What is extensive assistance/one person physical assist Rationale: Transferring is included in the ADL task of toileting and you provided weight bearing assistance due to her non-weightbearing status.