* The patient / carer makes comments that point to problems with ADL

* Decrease or avoiding ADL

* Neglect

* The patient is able to perform his/her ADL.

• functional loss of extremities because of contractures

• exercises to increase function of

  extremities and counteract the effects of the contractures

• functional loss of hand because of webbing, acquired syndactyly

• recommend aids, such as:
• single grip-controlled tap;

- electric toothbrush.

• functional loss of hand because of dressing

• recommend performing tasks without

dressings

• fear of injury

• recommend protecting the hands (for
• example, with cotton gloves)
• recommend organising the space in
• which tasks are performed in such a

  way that injuries will be prevented (for example, by protecting edges and sharp corners with foam plastic)

• fear of pain

• work out how the task may be per- formed differently without

  causing pain (possibly with aids)

• deficient eyesight

• recommend structuring of the
• activities
• recommend storage of the materials
• in a regular place
• consider the use of aids

• fatigue due to poor

  nutritional status

• optimise nutritional status
• work out how the tasks may be

  performed differently (possibly with aids) so activities will be less tiring

• lack of adaptations to the

  house or aids

• recommend adaptation of housing conditions and living environment such as:

• taking over ADL