ACE Assessment Tool

Score Guide

Meals/Drinking

0Full assistance

1Minimal assist eg cut food
2Independent

Out of bed/chair

0Assist 2 people
1Assist 1 person
2Independent
Walking/mobility
0Assist 2 people
1Assist 1 person
2Independent, with/without aids
Personal Hygiene/ Dressing
0Full assistance
1Partial assist
2Supervision
3Independent
Grooming
0Full assistance
1Partial assist
2Supervision
3Independent
Continence
0Incontinent / needs assistance
1Incontinent/ no assistance needed
2Continent /

Patient ID Label here

/ Home / social situation / Carer / services please refer to Risk Assessment Tool / Note: If completing the form for the first time
Please refer to the back for a detailed description of the scores
Activities of Daily Living
( Nursing Staff ) / Home Score / Date

Day Score

/ Date
Day Score / Date
Day Score / Date
Day Score /

Date

Day Score
Eating meals / Drinking
Getting out of bed / chair
Walking / mobility
Personal Hygiene / Dressing
Grooming
Continence Management
Please Note Score Guide at side of form. Please record, total score and initial. /

Total Score

/

Total Score

/ Total Score / Total Score /

Total Score

/ Total Score
Medical and Allied Health Staff
please specify & initial
Seen by Geriatrician
Social Work and Dietician
OT and Speech pathologist
Physio involvement /Mobility Assessment
Mobility Enhancement Team Utilised
NB Geriatrician, Social Worker, Physiotherapist, Occupational Therapist, Speech Pathologist and Mobility Enhancement Team please sign this form when assessing the patient (Adapted from the WestinHospital Ace Care Plan)
Meals and Drinking
0 Full Assistance / 1 Minimal Assistance / 2 Independent
Nurse assists with all feeding and fluids / Assistance with cutting up, placement of food and utensils etc eg Place table low / Manages meals and drinking with or without aids such as a padded spoon
Getting out of bed / chair
0 Assist with 2 people / 1 Assist one person / 2 Independent
Two people assist with or without aids eg hoist / One person assist with or without aids eg frame / No assistance required but patient may use aids
Walking / mobility
0 Assist with 2 people / 1 Assist one person / 2 Independent
Two people assist with or without aids eg Frame / One person assist with or without aids eg frame / No assistance required maybe with or without aids
Personal Hygiene / Dressing
0 Full assistance / 1 Partial assistance / 2 Supervision / 3 Independent
Patient requires 75% or more assistance / Patient requires 25 to 75% assistance / Patient requires 0 to 25% assistance variable / Pt can manage once set up
Grooming
0 Full assistance / 1 Partial assistance / 2 Supervision / 3 Independent
Full assistance with shave, teeth and hair / Needs assistance to complete some of the tasks eg teeth, shave or hair / Observation that the patient can safely carry out the tasks / Can safely complete the tasks, may need prior set up
Continence
0 Incontinent needs full assistance / 1 Incontinent partial assistance / 2 Continent
Patient requires full assistance may include pads, catheters, colostomies, ileostomies etc / Requiring some assistance to manage pads or other devices such as catheters and colostomies, ileostomies etc / Continent, no assistance required
Self managing pads or other devices such as catheters and colostomies,
ileostomies etc