Activity Definitions Time Estimates Considerations How a person uses the toilet room (or commode, bedpan, urinal); transfers Bowel, bladder program, Toilet Use on/off toilet, cleanses, changes pad, 5 -15 minutes/use ostomy regimen, catheter manages ostomy or catheter and adjusts regimen, cognition clothes 20 min/day Washing face, hands, perineum, combing hair, shaving and brushing teeth Disability pain, Personal How a person maintains personal cognition, adaptive 20 min/week Hygiene hygiene (exclude and showers) equipment Shampoo (only if done separately) 15 min up to 3 times/week Nail Care 20 min/week Document time a. How a person walks for exercise only and number of Disability, cognition, b. How a person walks around own times in pain, mode of ambulation Walking room Authorized Plan (cane), prosthesis needed c. How a person walks within home of Care, and level for walking d. How a person walks outside of assistance needed How a person full-body If shower used and bath/shower, sponge bath (exclude shampoo done then Bathing 15 - 30 minutes washing of back, hair), and transfers consider as part of in/out of tub/shower activity, cognition
Activity Definitions Time Estimates Considerations Toilet Use How a person uses the toilet room (or commode, bedpan, urinal); transfers on/off toilet, cleanses, changes pad, manages ostomy or catheter and adjusts clothes 5 -15 minutes/use Bowel, bladder program, ostomy regimen, catheter regimen, cognition Personal Hygiene How a person maintains personal hygiene (exclude and showers) 20 min/day Washing face, hands, perineum, combing hair, shaving and brushing teeth 20 min/week Shampoo (only if done separately) 15 min up to 3 times/week Nail Care 20 min/week Disability pain, cognition, adaptive equipment Walking a. How a person walks for exercise only b. How a person walks around own room c. How a person walks within home d. How a person walks outside Document time and number of times in Authorized Plan of Care, and level of assistance needed Disability, cognition, pain, mode of ambulation (cane), prosthesis needed for walking Bathing How a person full-body bath/shower, sponge bath (exclude washing of back, hair), and transfers in/out of tub/shower 15 - 30 minutes If shower used and shampoo done then consider as part of activity, cognition
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