Alzheimer's Functional Assessment Tool

This is a summary of scoring for the Alzheimer's Functional Assessment Tool. This tool can be used to document the progression of the symptoms, and it can also be helpful to evaluate the usefulness of any drug treatment or behavioral interventions. It is not intended to make the diagnosis of Alzheimer's Disease.

Toileting

1. Can use bathroom in familiar and unfamiliar environments independently
   
   
2. Goes to the toilet independently or asks for assistance; may need reminders to use toilet paper and wash hands
   
   
3. Has occasional toileting accidents; needs verbal reminders
   
   
4. Needs assistance going to the bathroom on a schedule (does not go to the bathroom independently); remains continent 90% of the time
   
   
5. Needs assistance going to the bathroom on a schedule (does not go to the bathroom independently); remains continent 50% of the time or less
   
   
6. No bowel or bladder control; may require frequent changing or special clothing (for example, pads, diapers)

Dining

1. Can prepare simple food (for example, sandwich, toast), can set table and clean up after meal, uses knife and fork to cut food, may or may not use adaptive equipment to eat independently
   
   
2. Can use fork and spoon to eat independently but needs food to be cut
   
   
3. Eats independently with the help of adaptive equipment
   
   
4. Can use fork and spoon to eat independently but may need occasional prompts to start or continue eating, may finger feed, needs food to be cut
   
   
5. Needs physical assistance to complete the meal
   
   
6. Develops swallowing problems, needs change in consistency of food or thick drinks
   
   
7. Completely dependent on assistance, may need specialized feeding program

Walking/motor

1. Independent walking (ambulation), able to walk steadily, able to start - stop - and change direction without falling, able to walk fast or run, able to ascend and descend stairs, capable of leaving premises without assistance
   
   
2. Independent ambulation for short distances, walks up and down the stairs one step at a time by holding rails, able to leave premises without assistance
   
   
3. Independent but cannot go up or down stairs, unable to leave premises without assistance
   
   
4. Can walk without support but requires supervision, may be unsteady, requires supportive measures at times
   
   
5. Needs assistance (for example, another person to hold, walker) to walk, "cruises" around using structures such as furniture and walls as support, unable to leave premises independently
   
   
6. Needs wheelchair but can move independently
   
   
7. Needs an adapted wheelchair and cannot move independently, needs to be pushed

Bathing

1. Can independently carry out an appropriate bathing routine (disrobing, washing, drying, and dressing)
   
   
2. Can carry out an appropriate bathing routine with occasional reminders to do a step or wash more thoroughly
   
   
3. Needs verbal prompts to initiate and/or complete some steps in the bathing process (because of low-level confusion and/or fear), continuous staff supervision at shower time not necessary, may use toiletries inappropriately
   
   
4. Requires continuous staff supervision at shower time to ensure complete bathing and safety (for example, problems due to confusion and/or fear), hand-over-hand assistance may be necessary at times, alternatives to showering or a specialized program may be recommended because of fear of showering, safe use of hot and cold water needs monitoring
   
   
5. Primarily passive during bathing, requires some form of assistance for all steps, may be able to stand and move a body part when given a verbal or touch cue, fear of water may be present
   
   
6. Physically and cognitively unable to participate actively in bathing process, may respond to stimulation during bathing with vocalizations or changes in facial expressions

Dressing (skills and appropriate dress)

1. Dresses independently or with physical assistance due to handicap, can choose appropriate clothing (for weather or activity of the day) and cares for own clothing (for example, places dirty clothes in hamper, hangs clothing, stores properly)
   
   
2. Occasionally needs reminders to dress appropriately ("It's cold out today") and to care for clothes ("Remember where your dirty socks go?")
   
   
3. Dresses with minimal assistance or verbal prompts
   
   
4. Dresses inappropriately for weather (layers clothing and/or puts clothing on inappropriately), may undress at an inappropriate time and/or place, may benefit from adaptive clothing to retain dressing skills; makes no attempt to care for own clothing
   
   
5. Needs assistance in dressing (50% or more of task) and may be resistive; may assist when compliant (for example, puts arm through sleeve)
   
   
6. Lies passively during dressing; does not respond to dressing or undressing

Personal/oral hygiene (hair brushing, teeth brushing, sanitary pad, shaving)

1. Able to perform all personal hygiene tasks
   
   
2. Able to perform all personal hygiene tasks within regular routines, may show difficulty in performing tasks if routine is changed (for example, hospitalized, moved)
   
   
3. Able to perform all personal hygiene tasks but requires occasional reminders from staff to complete the task
   
   
4. Able to perform personal hygiene tasks but requires frequent reminders from staff to complete the task, may need staff guidance (verbal and point cues) in some parts of some tasks (for example, may forget steps), may still be proficient in one area and lose ability in another area
   
   
5. Requires staff supervision (verbal and point cues) to complete some personal hygiene tasks and staff assistance (light, moderate physical cues) to complete others
   
   
6. May still be able to perform some steps of some personal hygiene tasks with staff assistance but depends on staff to meet other personal hygiene needs
   
   
7. Depends on staff to meet all personal hygiene needs

Environmental awareness

1. Aware (cognizant) and responsive, in a relevant way, to familiar and unfamiliar people and other environmental stimuli
   
   
2. Generally responsive to familiar and unfamiliar people and situations but seems self-absorbed and/or confused most of the time
   
   
3. Cognizant and responsive in a relevant way to familiar people and situations but shows a delayed or inappropriate response to unfamiliar people and situations
   
   
4. Cognizant and responsive to stimuli, but response is often inappropriate, even in familiar situations
   
   
5. Mostly awake but seems self-involved, showing little or inconsistent response to the environment
   
   
6. Sometimes awake but shows little interest in surroundings, sleeps at other times
   
   
7. Sleeps most of the day, needs to be aroused repeatedly to maintain interaction