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Run: ADL Self-Care Assessment

Assess bathing, dressing, grooming, toileting, and feeding independence in one observed ADL Self-Care Assessment. Track assistance levels over time and docum...

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Assessment Details

Assessment date and time

Assessor name and role

Assessment setting

Assessment type

Bathing

Bathing independence level

Note (optional)

Bathing task performance observed

Bathing assistance required

Note (optional)

Dressing and Grooming

Dressing independence level

Note (optional)

Grooming independence level

Note (optional)

Dressing and grooming barriers observed

Toileting and Feeding

Toileting independence level

Note (optional)

Feeding independence level

Note (optional)

Toileting and feeding assistance required

Note (optional)

Summary and Follow-Up

Overall ADL independence summary

Change since last assessment

Note (optional)

Recommended follow-up interval

Assessor signature critical (required)

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