Question 1

Washing the front of the upper body

Accepted Answer

Washing and drying the hands, face, arms, armpits and the front of the neck and chest.

Independent: The person can perform the described activity without personal assistance.
Predominantly independent: The person can perform the activity independently when required items (e.g. soap, flannel) are laid out, or when they receive prompting or targeted partial assistance, e.g. washing under the armpits or breasts.
Predominantly dependent: The person can only perform minor parts of the activity independently, e.g. wash only hands or face, or requires comprehensive guidance.
Dependent: The person cannot or can only minimally participate in the activity.

Question 2

Personal care of the head

Accepted Answer

Combing, dental care, denture cleaning, shaving.

Independent: The person can perform the described activities without personal assistance.
Predominantly independent: The person can perform the activities independently when required items are laid out or prepared, e.g. unscrewing the toothpaste cap, applying toothpaste to the brush, applying denture adhesive to the prosthesis, handing over or cleaning the shaver. Alternatively, prompting or targeted partial assistance is required, e.g. corrections after combing or only combing the back of the head, cleaning the back molars during dental/oral care or finishing the shave when otherwise independent.
Predominantly dependent: The person can only perform minor parts of the activity independently, e.g. begins brushing teeth or shaving without completing the activity.
Dependent: The person cannot or can only minimally participate in the activities.

Question 3

Washing the intimate area

Accepted Answer

Washing and drying the intimate area.

Independent: The person can perform the described activity without personal assistance.
Predominantly independent: The person can perform the activity independently when required items (e.g. soap, flannel) are laid out, or when they receive prompting or targeted partial assistance.
Predominantly dependent: The person can only perform minor parts of the activity independently, e.g. wash only the front intimate area.
Dependent: The person cannot or can only minimally participate in the activity.

Question 4

Showering and bathing including hair washing

Accepted Answer

Shower and bath including hair washing, drying and blow-drying. Safety aspects are to be taken into account.

Independent: The person can perform the described activity without personal assistance.
Predominantly independent: The person can perform the activity independently when utensils are prepared or provided, individual assistance is given (e.g. support getting in/out, operating a bath lift, help with hair washing or blow-drying, with drying), or when presence during showering and bathing is required for understandable safety reasons.
Predominantly dependent: The person can only perform minor parts of the activity independently, e.g. washing the front of the upper body.
Dependent: The person cannot or can only minimally participate in the activity.

Question 5

Dressing and undressing the upper body

Accepted Answer

Putting on and taking off items of clothing laid out, e.g. vest, T-shirt, shirt, blouse, jumper, jacket, bra, pyjama top or nightgown.

Independent: The person can perform the described activity without personal assistance.
Predominantly independent: The person can perform the activity independently when items of clothing are handed over or held in place, e.g. when putting on a shirt. If help is only needed with fasteners, the rating 'predominantly independent' also applies, as does when only checking whether clothing sits correctly and prompting to complete the action are required.
Predominantly dependent: The person can, for example, only push their hands into the sleeves of a T-shirt being held ready.
Dependent: The person cannot or can only minimally participate in the activity.

Question 6

Dressing and undressing the lower body

Accepted Answer

Putting on and taking off items of clothing laid out, e.g. underwear, trousers, skirt, stockings and shoes.

Independent: The person can perform the described activity without personal assistance.
Predominantly independent: The person can perform the activity independently when shoes or items of clothing are handed over or held (step-in help). The rating 'predominantly independent' also applies when help is only needed with fasteners (e.g. tying shoelaces, fastening buttons) or checking whether clothing sits correctly, and prompting to start or complete the action is required.
Predominantly dependent: The person can only perform a small part of the activity independently, e.g. only pulling trousers or a skirt from the thigh to the waist.
Dependent: The person cannot or can only minimally participate in the activity.

Question 7

Cutting food into bite-sized pieces and pouring drinks

Accepted Answer

Cutting food into bite-sized pieces (e.g. cutting meat, mashing potatoes) and pouring drinks.

Independent: The person can perform the described activity without personal assistance.
Predominantly independent: Only occasional help is required, e.g. opening a bottle or cutting hard foods.
Predominantly dependent: The person can only perform a small part of the activity independently, e.g. can cut open-faced sandwiches but cannot produce bite-sized pieces. The person cannot pour drinks.
Dependent: The person cannot or can only minimally participate in the activity.

Question 8

Eating (3× points)

Accepted Answer

Eating food that has been prepared in bite-sized pieces. This includes picking up food, bringing it to the mouth, biting off pieces where applicable, chewing and swallowing. It also takes into account the extent to which the need for adequate nutrition is recognised and the recommended or habitual amount is actually eaten.

Independent (0 pts): The person can perform the described activity without personal assistance.
Predominantly independent (3 pts): The person can mostly eat independently but needs occasional guidance, e.g. needs to be prompted to start or continue eating. Occasional assistance is required, e.g. picking up food that has slipped from the hand or handing the cutlery.
Predominantly dependent (6 pts): Extensive motivation to eat is required, or food must be fed for the most part, or constant and immediate readiness to intervene by the carer is required due to the risk of aspiration.
Dependent (9 pts): Food must be fed (almost) completely. Persons who cannot swallow are also rated as dependent.

Question 9

Drinking (2× points)

Accepted Answer

Taking available drinks, if necessary using objects such as a straw or special cup with drinking attachment. It also takes into account the extent to which the need for fluid intake is recognised and the recommended or habitual amount is actually drunk.

Independent (0 pts): The person can perform the described activity without personal assistance.
Predominantly independent (2 pts): The person can drink independently when a glass or cup is positioned directly within the person's reach beyond simply being provided, or when they are reminded to drink.
Predominantly dependent (4 pts): The drinking vessel must, for example, be placed in the person's hand, yet the person drinks independently; or the person must be motivated for almost every sip; or constant and immediate readiness to intervene by the carer is required due to the risk of aspiration.
Dependent (6 pts): Drinks must be administered (almost) completely. Persons who cannot swallow are also rated as dependent.

Question 10

Using a toilet or commode (2× points)

Accepted Answer

Going to the toilet, sitting down and standing up, sitting during bladder or bowel emptying, intimate hygiene and adjusting clothing. The assessment is also to be made when aids are used instead of the toilet, e.g. incontinence products, catheter, urostomy, ileo- or colostomy.

Independent (0 pts): The person can perform the activity without personal assistance.
Predominantly independent (2 pts): Largely independent. Assistance is limited to individual steps:
Providing/emptying the commode
Prompting or accompanying to the toilet
Handing toilet paper, intimate hygiene after bowel movement
Assistance sitting down/standing up
Occasional help adjusting clothing
Predominantly dependent (4 pts): The person can only perform a small part of the activity independently, e.g. only adjusting clothing or intimate hygiene only after urination.
Dependent (6 pts): The person cannot or can only minimally participate in the activity.

Question 11

Managing the consequences of urinary incontinence and handling urinary catheter and urostomy

Accepted Answer

Using incontinence and stoma systems correctly, changing and disposing of them as needed. This also includes emptying or changing a urine bag with an indwelling catheter or urostomy, or using a urinary condom. Only complete if urinary incontinence, indwelling catheter or urostomy is present.

Independent: The person can use aids independently.
Predominantly independent: The person can perform the activity predominantly independently when incontinence systems are handed over or disposed of, or the person is reminded to change.
Predominantly dependent: The person can participate in changing incontinence systems, e.g. only inserting pads or only removing incontinence pants.
Dependent: Participation is not or only minimally possible.

Question 12

Managing the consequences of faecal incontinence and handling stoma

Accepted Answer

Using incontinence and stoma systems correctly, changing and disposing of them as needed. This also includes using an anal tampon or emptying or changing a stoma bag with an enterostomy. Only complete if faecal incontinence or stoma is present.

Independent: The person can use aids independently.
Predominantly independent: The person can perform the activity predominantly independently when incontinence systems are laid out and disposed of, or the person is reminded to change.
Predominantly dependent: The person can participate in changing incontinence systems, e.g. helping with changing a stoma bag. With faecal incontinence, resources for changing incontinence products are less common.
Dependent: Participation is not or only minimally possible.

Question 13

Proportion of artificial nutrition in total food intake

Accepted Answer

Nutrition via a parenteral access (e.g. a port) or via an access to the stomach or small intestine (PEG/PEJ). Specify whether nutrition is provided parenterally, e.g. via a port, via percutaneous endoscopic gastrostomy (PEG), percutaneous endoscopic jejunostomy (PEJ) or a nasogastric tube.

Criterion	Independent 0 pts	Predominantly independent 1 pts	Predominantly dependent 2 pts	Dependent 3 pts
Washing the front of the upper body 4.4.1 · Washing and drying the hands, face, arms, armpits and the front of the neck and chest.
Washing the front of the upper body 4.4.1 · Washing and drying the hands, face, arms, armpits and the front of the neck and chest.
Personal care of the head 4.4.2 · Combing, dental care, denture cleaning, shaving.
Personal care of the head 4.4.2 · Combing, dental care, denture cleaning, shaving.
Washing the intimate area 4.4.3 · Washing and drying the intimate area.
Washing the intimate area 4.4.3 · Washing and drying the intimate area.
Showering and bathing including hair washing 4.4.4 · Shower and bath including hair washing, drying and blow-drying. Safety aspects are to be taken into account.
Showering and bathing including hair washing 4.4.4 · Shower and bath including hair washing, drying and blow-drying. Safety aspects are to be taken into account.
Dressing and undressing the upper body 4.4.5 · Putting on and taking off items of clothing laid out, e.g. vest, T-shirt, shirt, blouse, jumper, jacket, bra, pyjama top or nightgown.
Dressing and undressing the upper body 4.4.5 · Putting on and taking off items of clothing laid out, e.g. vest, T-shirt, shirt, blouse, jumper, jacket, bra, pyjama top or nightgown.
Dressing and undressing the lower body 4.4.6 · Putting on and taking off items of clothing laid out, e.g. underwear, trousers, skirt, stockings and shoes.
Dressing and undressing the lower body 4.4.6 · Putting on and taking off items of clothing laid out, e.g. underwear, trousers, skirt, stockings and shoes.
Cutting food into bite-sized pieces and pouring drinks 4.4.7 · Cutting food into bite-sized pieces (e.g. cutting meat, mashing potatoes) and pouring drinks.
Cutting food into bite-sized pieces and pouring drinks 4.4.7 · Cutting food into bite-sized pieces (e.g. cutting meat, mashing potatoes) and pouring drinks.
Eating (3× points) 4.4.8 · Eating food that has been prepared in bite-sized pieces. This includes picking up food, bringing it to the mouth, biting off pieces where applicable, chewing and swallowing. It also takes into account the extent to which the need for adequate nutrition is recognised and the recommended or habitual amount is actually eaten.
Eating (3× points) 4.4.8 · Eating food that has been prepared in bite-sized pieces. This includes picking up food, bringing it to the mouth, biting off pieces where applicable, chewing and swallowing. It also takes into account the extent to which the need for adequate nutrition is recognised and the recommended or habitual amount is actually eaten.
Drinking (2× points) 4.4.9 · Taking available drinks, if necessary using objects such as a straw or special cup with drinking attachment. It also takes into account the extent to which the need for fluid intake is recognised and the recommended or habitual amount is actually drunk.
Drinking (2× points) 4.4.9 · Taking available drinks, if necessary using objects such as a straw or special cup with drinking attachment. It also takes into account the extent to which the need for fluid intake is recognised and the recommended or habitual amount is actually drunk.
Using a toilet or commode (2× points) 4.4.10 · Going to the toilet, sitting down and standing up, sitting during bladder or bowel emptying, intimate hygiene and adjusting clothing. The assessment is also to be made when aids are used instead of the toilet, e.g. incontinence products, catheter, urostomy, ileo- or colostomy.
Using a toilet or commode (2× points) 4.4.10 · Going to the toilet, sitting down and standing up, sitting during bladder or bowel emptying, intimate hygiene and adjusting clothing. The assessment is also to be made when aids are used instead of the toilet, e.g. incontinence products, catheter, urostomy, ileo- or colostomy.
Managing the consequences of urinary incontinence and handling urinary catheter and urostomy 4.4.11 · Using incontinence and stoma systems correctly, changing and disposing of them as needed. This also includes emptying or changing a urine bag with an indwelling catheter or urostomy, or using a urinary condom. Only complete if urinary incontinence, indwelling catheter or urostomy is present.
Managing the consequences of urinary incontinence and handling urinary catheter and urostomy 4.4.11 · Using incontinence and stoma systems correctly, changing and disposing of them as needed. This also includes emptying or changing a urine bag with an indwelling catheter or urostomy, or using a urinary condom. Only complete if urinary incontinence, indwelling catheter or urostomy is present.
Managing the consequences of faecal incontinence and handling stoma 4.4.12 · Using incontinence and stoma systems correctly, changing and disposing of them as needed. This also includes using an anal tampon or emptying or changing a stoma bag with an enterostomy. Only complete if faecal incontinence or stoma is present.
Managing the consequences of faecal incontinence and handling stoma 4.4.12 · Using incontinence and stoma systems correctly, changing and disposing of them as needed. This also includes using an anal tampon or emptying or changing a stoma bag with an enterostomy. Only complete if faecal incontinence or stoma is present.

Self-care