I love to
use the flow chart in the RAI manual for this type of situation. Also the
examples in the manual where they code 3/2.
The ADL
support provided for extensive assist definition gives 2 options: that
Weight bearing assistance OR Full Staff performance occurred on 3 or more
occasions. 7 days x 3 meals is minimum of 21 opportunities. Add in
snacks and providing water in between meals. Even if the resident feeds
self part of the time, if during any meal or any other eating or drinking
activity the resident did not participate, i.e. required Full staff performance
to feed or hold and tip the cup or hold cup and place straw while resident
drinks, that is an occasion of full staff performance. This full staff
performance tends to occur on night shift even with staff trying to get res. to
hold cup by self. Often too tired or groggy to understand but swallow just
fine.
I agree with
the Weight bearing answers below, too. Don't forget that hand over hand
does not mean weight bearing. It's the gravity factor we're talking
about!
-----Original Message-----Thanks for all your input, but my question may not be completely understood. If you feed a resident part of the meal and the resident feeds herself part of the meal and you do not lift her arm, why is it coded as a 3/2? I need an answer right away for an inservice...thanks again.
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED]
Sent: Thursday, April 08, 2004 5:36 PM
To: [EMAIL PROTECTED]
Subject: Re: ADL Self-Performance
In a message dated 4/8/04 5:58:23 PM Eastern Daylight Time, [EMAIL PROTECTED] writes:
Although we usuallly think of weight bearing in relation to ambulation, if you lift a resident's legs when helping her into bed, you are bearing part of her weight. Likewise, if you lift her arm to assist her to get her spoon to her mouth, you are bearing part of her weight. We use the following to help clarify the intent of the MDS to our staff:
Independent: staff action="" talk, no touch
Supervision: staff action="" no touch
Limited assist: staff action="" and touch
Extensive assist: staff action="" touch, and lift
Total assist=resident does nothing
Does this help?
Renie
