Guideline for Level of Care Assessment

These are general guidelines used by the Care Planning Team to determine the appropriate level of care for an individual. A deficit in any area may require a change in care levels.

ASSISTED LIVING

(Able to function safely with some assistance or supervision from staff)

Activities of Daily Living:

• May need help with meal preparation or reminders to eat at mealtime.
  
• May need help getting in and out of shower safely.
  
• May need help washing thoroughly or require reminders about personal hygiene.
  
• May need help with zippers, stockings, shoes, or buttons.
  
• May need help with personal laundry

Ambulation:

• Able to ambulate safely without staff assistance about apartment
  
• Able to transfer from bed to chair without staff assistance
  
• Able to exit in an emergency with staff cuing only

Continence:

• Able to get to and from toilet without assistance
  
• Able to manage incontinence appropriately (including odor control) with staff supervision

Cognition:

• Can be re-oriented to person, place and time by staff
  
• Able to recognize safety hazards and respond appropriately
  
• May need staff assistance to schedule and keep appointment
  
• Able to vacate in an emergency

General Health Status:

• May have trouble hearing warning signals
  
• May be unwilling or unable to use telephone in emergency
  
• May be unable to read printed materials
  
• May have difficulty recognizing faces
  
• May experience mild anxiety or depression
  
• May need encouragement to socialize and maintain relationships
  
• May need supervision to take medication, may forget doses or have a pattern of medication abuse.
  
• General health status – would benefit from general oversight and supervision

NURSING CARE

(Requires extensive assistance and/or daily oversight of health status by Registered Nurses)

Activities of Daily Living:

• Unable or unwilling to attend to personal hygiene without assistance
  
• Requires extensive assistance to dress, does not dress, or has tendency to remove clothing during the day.
  
• May need to be fed by someone, refuses to eat, or is nourished through a tube or IV line.
  
• Unable to maintain clean, laundered clothing without assistance.

Ambulation:

• Unable to ambulate safely without staff supervision/assistance
  
• Unable to transfer independently
  
• May be confined to bed or wheelchair

Continence:

• Unable to get to and from toilet without assistance
  
• Requires assistance to manage incontinence

Cognition:

• Easily disoriented / Not reoriented easily
  
• Unable to recognize safety hazards and respond appropriately
  
• Unable to vacate in an emergency without direct assistance

General Health Status:

• General health status that benefits from regular supervision by Registered Nurses
  
• Unable to understand what others are saying or appear unwilling to communicate.
  
• Impaired vision or speech that endangers personal safety
  
• Moderate to severe depression or anxiety
  
• Abusive or disturbing personality traits
  
• Unable to manage medication