ONA Item Essential Elements

Item Set Up During the Activity Clean-up (Includes reminders/cues before (Includes reminders/cues during (Includes reminders/cues after the activity) the activity) the activity) 3a Upper Body Dressing:  Select appropriate  Lift arms  Put clothing away The ability to put on and clothing for the  Put clothing on after undressing remove shirt or pajama setting or  Button, snap and zip top. Includes buttoning, if environment. applicable.  Get clothes out of drawers and closets

3b Lower Body Dressing:  Select appropriate  Raise legs  Put clothing away The ability to dress and clothing for the  Pull up clothing after undressing undress below the waist, setting or  Button, snap and zip including fasteners. Does environment. not include footwear.  Get clothes out of drawers and closets

3c Putting on/taking off  Select appropriate  Bend down to put  Put footwear away footwear: The ability to put footwear for the footwear on after taking off on and take off socks and setting or  Put footwear on shoes or other footwear environment.  Tie, buckle or fasten that are appropriate for  Get footwear out of footwear safe mobility. closets or off of floor

4a Sit to stand: The ability  Get assistive devices  Use legs to bear  Put assistive devices to safely come to a in place such as a weight away after use standing position from walker or cane  Use arms to bear sitting in a chair or on the weight side of the bed.  Rise up to a standing position  Pull oneself up using an adaptive device

4b Chair/bed to chair  Get assistive devices  Use legs to bear  Put assistive devices transfer: The ability to in place such as a weight away after use safely transfer to and from walker or cane  Use arms to bear a bed to a chair (or weight wheelchair).  Rise up to a standing position  Pull oneself up using an adaptive device  Sit down in a chair

4c Roll left and right: The  Get sidelyer or other  Position self  Put assistive devices ability to roll from lying on assistive device in  While laying down, away after use back to left and right side, place roll from one side to and return to lying on back. another  Use side rails or devices to roll  Use arms to pull oneself to one side and the other

5b Walks 150 feet: Once  Get assistive devices  Bear weight to walk  Put assistive devices standing, the ability to walk in place such as a  Consider mobility away after use at least 150 feet in a walker or cane with adaptive devices corridor or similar space. in place such as walkers and rails if currently used to ambulate.

5c Step onto/off of a curb:  Get assistive devices  Bear weight to go up  Put assistive devices The ability to step on/off a in place such as a and down a curb or away after use curb or up/down one step. walker or cane step  Consider the ability to go up and down a step or curb with adaptive devices in place such as canes, walkers, etc.

5d 12 steps: The ability to  Get assistive devices  Bear weight to go up  Put assistive devices go up and down 12 steps in place such as a and down stairs away after use with or without a rail. specialized rail  Bear weight with arms to use rails to go up and down stairs

5f Wheels 150 feet: Once  Get wheelchair into  Use arms to propel  Plug in wheelchair to seated in position for use manual wheelchair charge wheelchair/scooter, the  Get wheelchair off of  Use controller to ability to wheel at least 150 a ramp or out of a propel electric feet in a corridor or similar vehicle wheelchair space.  Maneuver wheelchair/scooter around corners  Maneuver around obstacles

6b Eating: The ability to  Set up plate, drink  Cut-up food during  Capture cleaning up use suitable utensils to and/or utensils on meal. (If food is cut after eating in Item bring food to the mouth the table for effective up before meal is 12 - Housework and swallow food once the use presented at the meal is presented on a table, capture food table/tray. This includes cut-up in meal prep). modified food consistency.  Bring food and drink to the mouth to eat and drink  Eat in a safe manner (Choke risk may be present if food is eaten too rapidly).

6c Tube feeding: The  Set up supplies for  Pour nutrition into  clean g-tube site and ability to manage all feeding bag or syringe supplies equipment/supplies  Watch for residuals related to obtaining  Flush tubing nutrition.  Ensure proper operation throughout feeding

7a Toilet hygiene: The  Identify the need to  Adjust clothing  Dispose of ability to maintain perineal eliminate before and after use elimination supplies hygiene, adjust clothes  Wipe after toileting such as: attends, before and after using  Flush the toilet wipes and catheter toilet, commode, bedpan,  Empty bedpan or items. urinal. commode  Change and clean up  Capture cleaning the after incontinence toilet in Item 12 –  Use of catheter, Housework colostomy, urostomy

7b Toilet transfer: The  Set up rails or  Bear weight to get on  Remove rails or bars ability to safely get on and handles to assist with and off of a toilet. after use off a toilet or commode. transfer  Consider use of adaptive devices to transfer if already in place

8a Shower/bathe self: The  Transfer into the  Adjust water  Transfer out of the ability to bathe self in shower temperature shower or tub shower or tub, including  Set up supplies  Use soap, shampoos washing, rinsing, and to clean the body drying self. Includes  Rinse off the body transferring in/out of  Dry off tub/shower. 9a Oral Hygiene: The  Set up toothpaste  Apply toothpaste to  Put toothpaste and ability to use suitable items and toothbrush toothbrush toothbrush away to clean teeth. [Dentures (if  Brush teeth applicable): The ability to  Rinse remove and replace  Floss dentures from and to the  Clean and soak mouth, and manage dentures equipment for soaking and  Oral care for gums rinsing them.]

10a General Hygiene: The  Set up supplies for  Brush hair  Put supplies away ability to perform other use  Apply deodorant hygiene maintenance tasks,  Keep face clean such as hair brushing,  Keep hands clean shaving, nail care, and  Clean face and hands applying deodorant. Note: after eating Excludes toilet, and oral  Wash hands after hygiene. using the toilet  Nail care  Shaving  Menses

12a Housework: The ability  Set up supplies for  Keep the living room  Put away cleaning to safely and effectively cleaning clean supplies maintain cleanliness of the  Keep the bathroom living environment by clean washing cooking and eating  Keep the bedroom utensils; changing bed clean linens; dusting; cleaning  Keep the inside of the the stove, sinks, toilets, home clean tubs/showers and counter;  Use chemicals and sweeping, vacuuming, and appliances to clean washing floors; and taking out garbage.

13a Make a light meal: The  Set up supplies for  Use stove  Put away ingredients ability to plan and prepare making meals  Use knives and supplies all aspects of a light meal  Use microwave and such as a bowl of cereal or other appliances a sandwich and cold drink,  Read list of or reheat a prepared meal. ingredients  Comple steps of making meals

14a Laundry: Includes all  Set up supplies for  Sort laundry  Put laundry supplies aspects of completing a laundry  Take laundry to away. load of laundry using a washer washer and dryer. Includes  Put laundry in washer sorting, loading and  Put soap in washer unloading, adding laundry  Push buttons on detergent, and folding washer to start it laundry.  Put laundry in dryer  Push buttons on dryer to start it  Take laundry out of dryer  Put laundry away

15a Use public  Provide bus schedule  Plan and arrange the  Not applicable transportation: The ability to individual ride to plan and use public  Reminder to plan a  Embark and transportation. Includes ride disembark from ride boarding, riding, and  Fasten seat belt disembarking from  Drive transportation.  Navigate

16a Money Management:  Set out bank  Manage finances for  Put bank statements The ability to manage statements and bills food, clothing and and bills away finances for basic shelter necessities (food, clothing,  Count money shelter), including counting  Make change money and making change,  Pay bills paying bills/writing checks,  Write checks making budgeting and  Balance a checkbook other financial decisions,  Save and budget for and balancing checkbook. larger purchases

17a Light Shopping: Once  Create a shopping list  Shop from a list  Put items away at store, can locate and  Locate and select select up to five groceries items and personal care items,  Take items from take to check out, and shelves complete purchasing  Take cart to checkout transaction.  Interact with store personnel  Pay for items

47c Medication  Get oral medication  Take the correct oral  Put oral medicine management-oral out of where it is medication as away medication: The ability to kept prescribed prepare and take all  Take the oral prescribed oral medication at the medications reliably and right time safely, including  Take the correct dose administration of the  Put the pill in the correct dosage at the mouth appropriate times/intervals.

47d Medication  Get inhaler/mists out  Use the correct  Put inhaler/mists management- of where it is kept amount of away inhalant/mist medications: (includes nebulizer) inhaler/mist The ability to prepare and  Take dose at the take all prescribed correct time. inhalant/mist medications  Hold mask or inhaler reliably and safely, in the correct including administration of position the correct dosage at the appropriate times/intervals.

47e Medication  Get injectable  Use the correct  Put injectable management-injectable medication out of amount of injectable medication away medications: The ability to where it is kept medication prepare and take all  Use the injection at prescribed injectable the right time. medications reliably and  Inject the medication safely, including administration of the correct dosage at the appropriate times/intervals.

47f Medication  Get topical out of  Use the correct  Put topical management-topical where it is kept amount of topical medication away medications: The ability to medication prepare and apply all  Use the topical at the prescribed topical correct time medications reliably and  Apply the topical safely, including medication to the administration of the skin correct dosage at the  Rub the topical appropriate medication into the times/intervals. skin

47g Medication  Get suppository out  Use the correct dose  Put suppository management – of where it is kept  Use the suppository medication away suppository medications: at the right time The ability to prepare and  Insert the apply all prescribed suppository suppository medications reliably and safely, including administration of the correct dosage at the appropriate times/intervals.

47h Medication  Get medication and  Prepare tube for  Put medication and management – supplies out of where medication supplies away medications through tube: it is kept  Flush tube The ability to prepare and  Push medication apply all prescribed through the tube medications that are  Watch for residuals administered through a  Flush with water feeding tube reliably and safely, including administration of the correct dosage at the appropriate times/intervals.