Sample GAS follow up guide
| Goal areas | |||
|---|---|---|---|
| cognition (judgment-safety) | cognition (memory) | function (cooking) | |
| *Initial score. †Final score. | |||
| Much worse than baseline (−2) | Unable to make any judgement or solve problems; Requires 24 hour supervision | No longer recognises daughter | Unable to assist in any meal preparation |
| Somewhat worse than baseline (−1) | Severe impairment in judgement and problem solving; | Repetitious in questioning/ speech >10 times a day; | Attempts to assist in meal preparation 1-2 times per week, but is unable to complete task, even with assistance |
| Unable to operate stove, microwave, or oven (even under supervision) | No longer asks for shopping list and cannot use it, even with prompting | ||
| Baseline status (0) | Impaired judgement with regard to safety concerns; | Repetition in speech, talks non-stop and repeats same thing over and over (>5 times a day); | No longer cooks meals by self; |
| Leaves pots to cook dry on stove; | Difficulty shopping, even with list, constantly rechecks cart to see for items on list; | Assists with meal preparation daily but can only manage one task and requires direction and supervision; | |
| Put styrofoam cup on stove to heat contents; | Does not remember grandchildren when they come over* | Leaves stove burners on for indefinite periods when he attempts to cook alone* | |
| Puts unsafe items in microwave for extensive length of time; | |||
| Family feels he would not recall or react well in emergency such as fire* | |||
| Somewhat better than baseline (+1) | Only slight impairment in judgement; | Less repetitious (<5 times a day)† | Completes 2 or 3 of the tasks involved in meal preparation (daily) with assistance and supervision (for example, peeling and cooking vegetables, making a salad, setting the table, etc) |
| Can operate stove, oven, and microwave with supervision; | |||
| Is able to recall emergency plan for fire† | |||
| Much better than baseline (+2) | Solves small everyday problems; | Able to use and remember items chosen from the list (does not re-check cart for items) | Completes 2 or 3 of the tasks involved in meal preparation (daily) without supervision or assistance† |
| Uses good sound judgement in regards to safety issues, such as stove/oven operation and locking doors; | |||
| Remembers emergency plan for fire | |||