For each category, circle the item description that most closely resembles the client’s highest functional level.
29.2
A. Ability to Use Telephone
29.3
B. Shopping
29.4
C. Food Preparation
29.5
D. Housekeeping
29.6
E. Laundry
29.7
F. Mode of Transportation
29.8
G. Responsibility for Own Medications
29.9
H. Ability to Handle Finances
29.10
Score
Lawton_telephone
1.0000: Operates telephone on own initiative-looks up and dials numbers, etc.
1.00001: Answers telephone but does not dial
1.00002: Dials a few well-known numbers
0: Does not use telephone at all
Lawton_shopping
1.00000: Takes care of all shopping needs independently
0.00000: Shops independently for small purchases
0.00001: Needs to be accompanied on any shopping trip
0.00002: Completely unable to shop
Lawton_food
1.0000: Plans, prepares and serves adequate meals independently
0.0000: Prepares adequate meals if supplied with ingredients
0.0001: Heats, serves and prepares meals, or prepares meals, or prepares meals but does not maintain adequate diet
0.0002: Needs to have meals prepared and served
Lawton_housekeeping
1.000: Maintains house alone or with occasional assistance (e.g. "heavy work domestic help")
1.001: Performs light daily tasks such as dish washing, bed making
1.002: Performs light daily tasks but cannot maintain acceptable level of cleanliness
1.003: Needs help with all home maintenance tasks
0.000: Does not participate in any housekeeping tasks
Lawton_laundry
1.000: Does personal laundry completely
1.001: Launders small items-rinses stockings, etc.
0.000: All laundry must be done by others
Lawton_transportation
1.000: Travels independently on public transportation or drives own car
1.0001: Arranges own travel via taxi, but does not otherwise use public transportation
1.0002: Travels on public transportation when accompanied by another
0.0000: Travel limited to taxi or automobile with assistance of another
0.0001: Does not travel at all
Lawton_medications
1.000: Is responsible for taking medication in correct dosages at correct time
0.000: Takes responsibility if medication is prepared in advance in separate dosage
0.001: Is not capable of dispensing own medication
Lawton_finances
1.000: Manages financial matters independently (budgets, writes checks, pays rent, bills, goes to bank), collects and keeps track of income
1.001: Manages day-to-day purchases, but needs help with banking, major purchases, etc.
0.000: Incapable of handling money