The Application - Page 6
FUNCTIONAL ASSESSMENT FOR PLACEMENT:
More that the doctor needs to fill out.
Here there are several sections with check boxes to check off.
- Ambulation - whether they require aids like a wheelchair, walker, cane, etc. and any assistance required, if they fall, if they are bedridden, etc.
- Transfer - Do they need help moving from one place to another, from bed, to a chair, etc.
- Limbs - normal, amputation, prostesis, etc.
- Bowel - full control, incontinent, occasionally incontient, using an incontinent product, etc.
- bladder - much the same as the bowel one but also include more info required as well as includes a cathether, etc.
- Ostomy - their ability to care for it, if they have it, etc.
- Dialysis - yes or no and what kind and what facility
- Skin condition - this section also includes footcare
- Cognitive function - this section includes memory loss, impaired judgement, lacks attention, forgetful, and forgetful for what.. (personal hygeine, electrical devices, medication), etc.
- As well as memory loss it includes 'disoriented to'. Options here to check off include time, person, place, etc. and how severe are they effected.
- Behavioural - lots of options to check off here.
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