Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 1 - General Requirements Applicable to All Service Categories › Section 246-335-310 - Definitions-General

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section apply throughout this
					 chapter unless the context clearly indicates otherwise:
(1) "Activities of daily living" or "ADL"
				  means routine activities performed around the home or in the community and
				  includes:
(a) "Ambulation" means how an
				  individual moves between locations in their immediate living environment and
				  how they move to and return from more distant areas. Assistance with ambulation
				  includes supervising or guiding the client or patient when walking alone or
				  with the help of a mechanical device such as a walker, assisting with difficult
				  parts of walking such as climbing stairs, supervising or guiding the client or
				  patient if they are able to propel a wheelchair, pushing of the wheelchair, and
				  providing constant or standby physical assistance to the client or patient if
				  totally unable to walk alone or with a mechanical device.
(b) "Bathing" means how an individual takes a
				  full-body bath or shower, sponge bath, and transfers in and out of the tub or
				  shower. Assistance with bathing includes supervising or guiding the client or
				  patient to bathe, assisting the client or patient with difficult tasks such as
				  getting in or out of the tub or shower, washing their back and other hard to
				  reach areas, and completely bathing the client or patient if they are totally
				  unable to wash themselves.
(c)
				  "Body care" means how an individual performs applications of dressings and
				  ointments or lotions to their body, trims their toenails, and applies lotion to
				  their feet. Assistance with body care includes general skin care and the
				  application of over-the-counter ointments or lotions. Body care excludes foot
				  care for clients or patients who are diabetic or have poor circulation, and
				  changing bandages or dressings when sterile procedures are required.
(d) "Dressing" means how an individual puts
				  on, fastens, and takes off all items of clothing, including donning or removing
				  a prosthesis. Assistance with dressing includes supervising or cueing the
				  client or patient to dress and assisting them with difficult tasks such as
				  putting on socks, pants, shoes, and fastening, zipping, or tying clothing
				  related items.
(e) "Eating" means
				  how an individual eats and drinks, regardless of skill. Assistance with eating
				  includes supervising or guiding the client or patient when they are able to
				  feed themselves, assisting with difficult tasks such as cutting food or
				  buttering bread, and orally feeding the client or patient when they are unable
				  to feed themselves.
(f) "Medication
				  management" means how an individual ingests or applies medications or herbal
				  supplements. Assistance with medication management includes reminding,
				  coaching, and handing medication containers to the client or patient.
(g) "Personal hygiene" means how an
				  individual maintains their personal hygiene. Assistance with personal hygiene
				  includes helping the client or patient with combing hair, brushing teeth,
				  shaving, applying makeup, washing and drying face, trimming finger nails,
				  applying nail polish, and menses care.
(h) "Positioning" means how an individual
				  moves to and from a lying position, turns side to side, and positions their
				  body while in bed, in a recliner, or other type of furniture. Assistance with
				  positioning includes helping the client or patient to assume a desired
				  position, helping with turning, and setting up for the client or patient to
				  perform exercises or active range of motion. Positioning assistance may also
				  include passive range of motion to maintain joint flexibility or prevent
				  complications, such as contractures and pressure sores.
(i) "Toileting" means how an individual uses
				  the toilet room, commode, bedpan, or urinal. Assistance with toileting includes
				  helping the client or patient to and from the bathroom, assisting with bedpan
				  routines, using incontinent briefs, cleaning after elimination, and assisting
				  the client or patient on and off the toilet.
(j) "Transfer" means how an individual moves
				  between surfaces such as to and from a bed, chair, wheelchair, or standing
				  position. Assistance with transferring includes helping the client or patient
				  with getting in and out of a bed or wheelchair or on and off the toilet or in
				  and out of the bathtub. Transfer includes supervising or guiding the client or
				  patient when they are able to transfer, providing steadying assistance, and
				  helping the client or patient when they are able to assist in their own
				  transfers. This does not include transfers when the client or patient is unable
				  to assist in their own transfer or needs assistive devices unless specific
				  training or skills verification has occurred consistent with agency policies
				  and procedures.