Stage

Skill level

1

No difficulty, either subjectively or objectively.

2

Complains of forgetting location of objects. Subjective work difficulties.

3

Decreased job functioning evident to coworkers; difficulty in traveling to new locations decreased organizational capacity.

4

Decreased ability to perform complex tasks, for example, planning dinner for guests, handling personal finances (forgetting to pay bills), marketing.*

5

Requires assistance in choosing proper clothing to wear for the day, season, or occasion, for example, patient may wear the same clothing repeatedly, unless supervised.*

6

6a

Improperly putting on clothes without assistance or cues (e.g., may put street clothes on overnight clothes, put shoes on wrong feet, or have difficulty buttoning clothing) occasionally or more frequently over the past weeks.*

6b

Unable to bathe (shower) properly (e.g., difficulty adjusting bathwater or shower temperature) occasionally or more frequently over the past weeks.*

6c

Inability to handle mechanics of toileting (e.g., forgets to flush the toilet and does not wipe properly or properly dispose of toilet tissue) occasionally or more frequently over the past weeks.*

6d

Urinary incontinence (occasionally or more frequently over the past weeks).*

6e

Fecal incontinence (occasionally or more frequently over the past weeks).*

7

7a

Ability to speak limited to approximately half a dozen or fewer intelligible different words in the course of an average day or in the course of an intensive interview.

7b

Speech ability limited to the use of a single intelligible word in an average day or in the course of an interview (the person may repeat the word over and over).

7c

Ambulatory ability lost (cannot walk without personal assistance).

7d

Cannot sit up without assistance (e.g., the individual will fall over if there are no lateral rests (arms) on the chair).

7e

Loss of ability to smile.

7f

Loss of ability to hold up head independently.