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ADCS-ADL Scale, Scoring and Manual - Dementia Outcomes ...

ADCS-ADL Scale, Scoring and Manual - Dementia Outcomes ...

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~ ~@J[ffi1)~~@(g@J~@ [Ri@~@[flt[P@[f[ffi1)<br />

Alzheimer's Disease<br />

Cooperative Study<br />

Yes<br />

Yes<br />

No<br />

Don't<br />

Know<br />

D<br />

0<br />

D<br />

0<br />

Don't<br />

No Know 22.<br />

D D<br />

0 0<br />

<strong>ADCS</strong> - Activities of Daily Living Inventory Page 7 of 8<br />

21. In the past 4 weeks, did {S} ever write things down?<br />

Note: If {S} wrote things only after encouragement or with help, the response<br />

should still be 'yes.'<br />

If yes, which best describes the most complicated things that he/she wrote:<br />

3 D letters or long notes that other people understood<br />

2 D short notes or messages that other people understood<br />

1 D his/her signature or name<br />

In the past 4 weeks, did {S} perform a pastime. hobby or game?<br />

If yes, which pastimes did he/she perform:<br />

Ask about all of the following, check all that apply:<br />

D card or board games (including bridge, chess, checkers)<br />

D bingo D crosswords Dart<br />

D musical instrument D knitting D sewing<br />

Dreading D gardening D golf<br />

D tennis<br />

D other<br />

D workshop D fishing<br />

Note: Walking does NOT count as a hobby/pastime for this scale.<br />

D If {S} performs hobbies/pastimes only at day care, check here.<br />

If yes, how did {S} usually perform his/her most common pastimes:<br />

3 D without supervision or help<br />

2 D with supervision<br />

1 D with help<br />

7<br />

<strong>ADL</strong> 1 .0 2/99

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