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1. |
No difficulties, either subjectively or objectively. |
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2. |
Complains of forgetting location of objects. Subjective word
finding difficulties.
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3.
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Decreased job functioning evident to co-workers; difficulty in traveling to
new locations. Decreased organizational capacity.*
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4.
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Decreased ability to perform complex tasks (e.g., planning dinner for
guests), handling personal finances (forgetting to pay bills), difficulty marketing,
etc.
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5. |
Requires assistance in choosing proper clothing to wear for the day,
season, or occasion.
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6a. |
Difficulty putting clothing on properly without assistance. |
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b. |
Unable to bathe properly; e.g., difficulty adjusting bath water
temperature) occasionally or more frequently over the past weeks.*
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c. |
Inability to handle mechanics of toileting (e.g., forgets to flush
the toilet, does not wipe properly or properly dispose of toilet tissue)
occasionally or more frequently over the past weeks.*
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d. |
Urinary incontinence, occasional or more frequent. |
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e. |
Fecal Incontinence, (occasional or more frequently over the
past week). |
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7a. |
Ability to speak limited to approximately a half dozen different words or
fewer, in the course of an average day or in the course of an intensive
interview.
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b. |
Speech ability limited to the use of a single intelligible
word in an average day or in the course of an interview (the person may repeat the word over and
over.
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c. |
Ambulatory ability lost (cannot walk without personal assistance). |
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d. |
Ability to sit up without assistance lost (e.g., the individual will fall
over if there are no lateral rests [arms] on the
chair).
|
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e. |
Loss of the ability to smile. |
|
f. |
Loss of the ability to hold up head independently. |