Intent:
To identify a recent change (as compared to 90 days ago — or since the last assessment if less than 90 days) in the person’s level of participation in social, religious, occupational or other preferred activities. If the level of participation has declined, determine if the person is distressed by it.
Definition:
The level of participation refers to the quantity (how many) of different types of social activities; the intensity (e.g., how frequently contact occurs); and the quality of the activity (e.g., how deeply the person is involved). Remote participation is equally important and significant for the person’s role fulfillment and self-esteem (e.g., a person who cannot move outside her or his home may still participates or be associated with some kind of religious, political, or social activity). Distress occurs when the person’s mood is adversely affected by a recent change in the level of participation (e.g., as evidenced by sadness, loss of motivation or self-esteem, anxiety, depression, etc.).
Process:
Talk with the person to determine whether a change has occurred and to determine his or her subjective response to any changes. If possible, speak with the family or other informal contacts (e.g., neighbors) to get their opinions on whether the person’s activity levels have changed and, if so, how she or he responded to those changes.
Coding:
No Decline (e.g., there was no change or there was an increase in the person’s level of participation in social activities)
Decline, not distressed – if the person experienced a decline in his or her level of participation in social activities without a corresponding increase in the person’s distress
Decline, distressed -- if both decline and distress are observed or reported