CAP ADL Select Version: SUITE10_CAP_HC_ADL_G2_V1.0_P_2024-08-29.txt Input Parameters Easily distracted (iC3a) [0-2] 0 - No 1 - Modified 2 - Serious Mental function varies (iC3c) [0-2] 0 - No 1 - Modified 2 - Serious Acute change in mental status (iC4) [0,1] 0 - No 1 - Yes Changing decision making (iC5) [0-2,8] 0 - Improved 1 - No change 2 - Declined 8 - Activity did not occur ADL Decline (iG8a2) [0-2,8] 0 - Improved 1 - No change 2 - Declined 8 - Activity did not occur (long lookback) Hip fracture (iI1a) [0-3] 0 - No 1 - Yes, last 30 days 2 - Yes, 31-180 days ago 3 - Yes, >180 days ago Pneumonia (iI1q) [0-3] 0 - No 1 - Yes, last 30 days 2 - Yes, 31-180 days ago 3 - Yes, >180 days ago Falls in the last 30 days (iJ1g) [0-2] 0 - No falls 1 - One fall 2 - Two or more falls Falls 31 to 90 days (iJ1h) [0-2] 0 - No falls 1 - One fall 2 - Two or more falls Experiencing a flare up (iJ6b) [0,1] 0 - No 1 - Yes Less than six months to live (iJ6c) [0,1] 0 - No 1 - Yes Physical therapy (iN3ea) [0-7] 01234567 Admit to hospital (iN5a) [0-90] 0123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990 Overall change in care needs (iR2) [0-2] 0 - No increase 1 - Increase in care needs 2 - Major increase in care needs ADL Hierarchy (sADLH) [0-6] 0 - Independent 1 - Supervision required 2 - Limited impairment 3 - Extensive Assistance Required - 1 4 - Extensive Assistance Required - 2 5 - Dependent 6 - Total Dependence Cognitive performance scale (sCPS) [0-6] 0 - Intact 1 - Borderline intact 2 - Mild impairment 3 - Moderate impairment 4 - Moderate or severe impairment 5 - Severe impairment 6 - Very severe impairment Calculate 📖 Interpretation Guide cADL Score Interpretation: 0 (Not triggered): No ADL CAP triggered 1 (Triggered - prevent decline): Prevent decline in ADL functioning 2 (Triggered - facilitate improvement): Facilitate improvement in ADL functioning Parameter Descriptions iC3a: Easily distracted [0-2] iC3c: Mental function varies [0-2] iC4: Acute change in mental status [0,1] iC5: Changing decision making [0-2,8] iG8a2: ADL Decline [0-2,8] iI1a: Hip fracture [0-3] iI1q: Pneumonia [0-3] iJ1g: Falls in the last 30 days [0-2] iJ1h: Falls 31 to 90 days [0-2] iJ6b: Experiencing a flare up [0,1] iJ6c: Less than six months to live [0,1] iN3ea: Physical therapy [0-7] iN5a: Admit to hospital [0-90] iR2: Overall change in care needs [0-2] sADLH: ADL Hierarchy [0-6] sCPS: Cognitive performance scale [0-6]