FUNCTIONAL ASSESSMENT STAGING TOOL | ||
Check if present |
Stage |
Assessment |
|
1 |
No difficulties, either subjectively or objectively. |
|
2 |
Complains of forgetting location of objects; subjective word finding difficulties only. |
|
3 |
Decreased job functioning evident to coworkers; difficulty in traveling to new locations. |
|
4 |
Decreased ability to perform complex tasks (e.g., planning dinner for guests; handling finances; marketing). |
|
5 |
Requires assistance in choosing proper clothing for the season or occasion. |
|
6a |
Difficulty putting clothing on properly without assistance. |
|
6b |
Unable to bathe properly; may develop fear of bathing. Will usually require assistance adjusting bath water temperature. |
|
6c |
Inability to handle mechanics of toileting (i.e., forgets to flush; doesn't wipe properly). |
|
6d |
Urinary incontinence, occasional or more frequent. |
|
6e |
Fecal incontinence, occasional or more frequent. |
|
7a |
Ability to speak limited to about half a dozen words in an average day. |
|
7b |
Intelligible vocabulary limited to a single word in an average day. |
|
7c |
Nonambulatory (unable to walk without assistance). |
|
7d |
Unable to sit up independently. |
|
7e |
Unable to smile. |
|
7f |
Unable to hold head up. |