1- Total Assistance: a helper retrieves the device, changes it and disposes it.

1 -Incontinent; On foley catheter, totally dependent on all aspects of care

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7- Complete Independence: patient has complete control, is never incontinent, and does not require medication, a device or a
helper for management

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5- Mamdouh is continent uses urinal as device, staff or caregiver are the one who empties urinal

7-Mamdouh is contnent, Complete Independence: patient has complete control, is never incontinent, and does not require
medication, a device or a helper for management

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5-Ahmed is continent uses urinal as a device , helper places urinal within reach, helper empies it after patient use

6-Hamed is continent, takes 3 to 5 times longer in performing the task in comparison to the pre - illness stage

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5-Husin is continent ; uses urinal and the caregiver s the one who empty it

5-Husin is continent ; uses commode in going to the bathroom & caregiver is the one cleaning

7-Complete Independence: patient has complete control, is never incontinent, and does not require medication, a device or a
helper for management

6- Ali is continent Modified Independence: the patient requires medication or an assistive device that the patient manages, but
the patient does not have any accident.

Level descriptions
Bowel
Level 7- Complete Independence: patient has complete control, is never incontinent, and does not require medication, a device or
a helper for management

If with medication:

Level 6 - Modified Independence: the patient require medication, but the patient has not had any accidents.

If with absorbent pad/diaper

Level 6- Modified Independence: the patient retrieves the device, changes it and disposes it independently

Level 5- Supervision /Set-up: A helper sets up the device, supervises the patient as the patient puts on or take off the device (or
both), provides verbal cueing or performs more than one of the tasks

Level 2-4 The rating depends on the performance of the procedure and the amount of the assistance the patient requires from
the helper

Level 1 – Total Assistance: a helper retrieves the device, changes it and disposes it.

Assistive Device: Suppository

Level 6- Modified Independence: The patient inserts the suppository and performs all aspects of elimination and clean-up.

Level 5- Supervision /Set-up: A helper cues the patient to insert the suppository.

Level 4 – Minimal Assistance: a helper lubricates and inserts the suppository.

Level 2-3 The rating depends on the performance of the procedure and the amount of the assistance the patient requires from
the helper

Level 1 – Total Assistance: A helper positions the patient, places pad, lubricates and inserts the suppository, provides digital
stimulation, places the patient on a bedpan and takes off the bedpan.

Level 1 – Total Assistance: A helper positions the patient, places pad, lubricates and inserts the suppository, retrieves the pad,
changes it and disposes it

Assistive Device: Colostomy

Level 6- Modified Independence: the patient empties the ostomy and cares for all aspects of it.

Level 5- Supervision /Set-up: the patient requires set-up or assistance or verbal cues.

Level 4 – Minimal Assistance: The patient requires incidental help (eg. Removing the wafer)

Level 3- Moderate Assistance: the patient performs 50 percent to 74 percent of ostomy care.

Level 2- Maximal Assistance: the patient performs 25 percent to 49 percent of ostomy care.

Level 1- Total Assistance: the patient performs less than 25 percent of ostomy care.

Accidents:

Level 7- No accidents, no helper, no medication and no assistive device

Level 6- No accidents, no helper, with medication/or an assistive device

Level 5- One accident during the 3-day assessment time frame

Level 4 – Two accidents during the 3-day assessment time frame

Level 3- Three accidents during the 3-day assessment time frame

Level 2- Four accidents during the 3-day assessment time frame

Level 1- Five or more accidents during the 3-day assessment time frame

Bladder
7- Complete Independence, patient has complete control, is never incontinent, and does not require medication, a device or a
helper for management

Assistive Device: Urinal

Level 6- Modified Independence: the patient obtains, uses and empties the urinal without assistance

Level 5- Supervision /Set-up: a helper places the urinal within the reach of the patient, empties it after the patient uses it or
performs both tasks for the patient.

Level 4 – Minimal Assistance: a helper positions the patient's penis in the urinal, the patient holds the urinal in place while using it
and then hands it to the helper who empties the urinal.

Level 3- Moderate Assistance: a helper positions the patient's penis in the urinal, and the patient holds the urinal in place while
using it, after which the helper removes and empties the urinal

Level 2- Maximal Assistance: a helper positions the patient's penis in the urinal, holds the urinal in place and removes and empties
the urinal.

Level 1- Total Assistance: the patient spills the urinal, and a helper changes the patient's linen or clothing.

Assistive Device: Intermittent Catheterization

Level 6- Modified Independence: the patient gathers equipment, performs the self-catheterization independently and empties
the urine.

Level 5- Supervision /Set-up: a helper sets up the catheterization equipment, supervises the patient while the patient performs
the catheterization, or performs both of these tasks.

Level 2-4 The rating depends on the performance of the procedure and the amount of the assistance the patient requires from
the helper

Level 1: A helper performs the entire catheterization procedure.

Assistive Device: Bedpan

Level 6- Modified Independence: the patient obtains, uses and empties the bedpan without assistance

Level 5- Supervision /Set-up: a helper places the bedpan within the reach of the patient, empties it after the patient uses it or
performs both tasks for the patient.

Level 4 – Minimal Assistance: a helper provides less than 25 percent assistance to position the patient on the bedpan or remove
the bedpan.

Level 3- Moderate Assistance: a helper positions the bedpan for the patient and holds it in place while assisting the patient to roll
on or off the bedpan.
Level 2- Maximal Assistance: a helper positions the bedpan for the patient and holds it in place while assisting the patient to roll
on and off the bedpan

Level 1- Total Assistance: a helper rolls the patient on his side in a lying position, positions the bedpan, hold it in place, and assists
the patient in rolling on and off the bedpan, or the patient requires assistance from two helpers to complete the task.