The ability or inability to perform Independent Living Skills (ILS) can be used as a practical measure when determining a person’s need for long-term care services and risk of institutionalization.
The ILS include:
Rolling and Sitting
Crawling and Standing
Ambulation
Climbing Stairs or Ramps
Wheelchair Mobility
Dressing
Personal Hygiene
Bathing or Showering
Toileting
Level of Bladder Control
Orientation to Settings Familiar to Individual
Gather information about the customer's ILS from the past year with emphasis on current performance.
ILS may consist of several tasks. Consider ALL parts of the ILS that are relevant to the customer when scoring. Do not score just on the performance of part of the task. See the scoring section of the specific ILS for more details.
Use investigative interviewing skills to gather enough information for the PAS.
When it is clear that a customer needs more assistance than is received, that may be considered when scoring. This should be done conservatively, as it may be difficult to determine the exact amount of assistance needed. Comments must include a thorough explanation of this need and must state “scored based on need.” See examples below.
NOTE Generally, a score based on need would not be higher than a 1.
Consider the use of a service animal in scoring when the animal has been trained to assist the customer in performing specific ILS.
Score based on what the customer actually does, not what the customer “could do” or “might be able to do.”
NOTE See the specific ILS sections for possible exceptions when the customer does not have a physical or developmental barrier to performing the ILS.
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Term |
Definition |
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Limited hands-on assistance |
A small portion of an entire task. For example, a caregiver only washes the customer’s back during bathing. |
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Occasional hands-on assistance |
When the customer needs hands-on help to complete an entire task sometimes, but not most of the time. For example, a customer needs her caregiver to pull her to a stand from bed each morning because her joints are stiff. As soon as she gets out of bed, she takes her medication and is then able to transfer independently to all other surfaces throughout the day. |
|
Physical lift |
When a caregiver actively bears some part of the customer’s weight during movement or activity. NOTE This does not include steadying or guiding the customer. |
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Physical participation |
The customer’s active participation, not just being passive or cooperative. This includes the ability to complete a part of the task. |
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Service animal |
A dog or miniature horse that is individually trained to do work or perform tasks for the benefit of an individual with a disability. Other species of animals, whether wild or domestic, trained, or untrained, are not considered service animals. |
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Supervision |
When a caregiver observes the customer and is readily available to provide assistance, including verbal cues or reminders and set-up activities. |
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Typical performance |
In general, means the level of skill or function the customer achieves most of the time. |
Examples only provide guidance on scoring. They do not cover every possible situation.
The following table gives examples of cooperation as compared to participation
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Cooperation |
Participation |
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The customer raises her arms, and the caregiver threads the customer’s hands and arms through shirtsleeves and pulls the shirt down. |
The caregiver holds the customer’s shirt so that the sleeves are easy to get to. The customer threads her arms through and tugs her shirt into place. |
|
The customer turns his face toward the caregiver when asked to do so during face washing. |
The customer washes his face once the caregiver prepares the washcloth and hands it to him. |
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The customer allows the caregiver to lean her to the side and place a slide board under her. |
The customer leans over to her side, the caregiver places the slide board under her, and the customer slides onto the slide board. |
Personal Hygiene – Score based on need
The customer is a six-year-old female diagnosed with Autism and Fetal Alcohol Syndrome. She currently lives with her mother. The Department of Child Safety (DCS) is involved due to reports from neighbors that the mother often leaves the customer with her 11-year-old brother (who is also DD eligible) for “days”. The neighbors also report they suspect her mother is involved with methamphetamines. The CPS worker reports the customer appears unkempt, has matted long hair, dirty long fingernails, and discolored teeth. The mother refused to participate in the PAS interview.
The Division of Developmental Disabilities Support Coordinator (DDD SC) reported that on her most recent visit, the customer’s hair was disheveled and matted, her hands were dirty with dirt beneath her fingernails, and the amount of plaque and food particles in her teeth indicate she has not been brushing.
The customer is given a score of 1 for personal hygiene, as she appears to need more assistance than she is currently receiving.
Bathing or Showering – Score based on need
The customer is an 11-year-old male diagnosed with Autism and Mild Intellectual Disability. He currently lives with his mother, but CPS is involved due to reports from neighbors that the mother often leaves the customer by himself for “days.” The neighbors also report they suspect his mother is involved with methamphetamines. The CPS worker reports the customer appears unkempt, extremely dirty, and has bad body odor. The customer is non-verbal, he only communicates by pointing at things he wants, so he was unable to answer questions for the PAS. The mother refused to participate in the PAS interview.
The DDD SC reported that on her most recent visit, the customer’s hair was dirty and oily, and his body appeared dirty and had an unpleasant odor.
The customer is given a score of 1 for bathing or showering, as he appears to need more assistance than he is currently receiving.