BATH (Required*)
    Bath/Shower, Sponge/Bed Bath, Shampoo, Shave, Oral/Denture Care, Dressing PerformedRefused
    BLADDER (Required*)
    Catheter, Toilet/Commode, Bedpan/Urinal, Brief/Pad, Incontinent, Peri Care PerformedRefused
    AMBULATION (Required*)
    Distance, Frequency, Transfers, Bedbound, Cane/Crutches, Walker/Wheelchair PerformedRefused
    RANGE OF MOTION (Required*)
    Assist with Movement, Apply Limb Prothesis, Braces, TEDS/Ace Wraps PerformedRefused

    SKIN (Required*)
    Lotion, Nail Care, Turn & Position, Foot Soak, Dressing Change, Glasses, Hearing Aide PerformedRefused
    MEALS (Required*)
    Restrict/Push Fluids, Feed Client, Meal Prep, Supplement Given, Weight PerformedRefused
    HOUSEHOLD (Required*)
    Vacuum, Laundry, Kitchen/Dishes, Bathrooms, Garbage, Make Bed/Linens PerformedRefused
    IADL (Required*)
    Shopping, Transportation, Appointments, Social Interaction, Companionship PerformedRefused

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