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☐ Rank 2 – Judgment mildly impaired: Shows lack of ability to plan for self; has difficulty deciding between
alternatives, but is amenable to advice; social judgment is poor.
• Social Worker Observation: Observe if the home is in disrepair (leaking faucets, broken appliances,
inadequate lighting, etc.); if debris has been allowed to accumulate in walk-way areas; if food in the home is
of poor nutritional value; if the recipient cannot recognize there are alternatives or unable to select between
them and cannot plan or foresee consequences of decisions. Observe if the recipient is not capable of
making decisions without advice from another, is able to understand options when explained, makes
correct choices; knows enough to turn stove and heat on and off.
• Example: Recipient wastes money on useless items while allowing needed repairs to go unattended. The
recipient “makes do” with the condition of home even if it is inconvenient for the recipient. The recipient
appears to be a “collector,” has difficulty throwing anything out even though access through home is limited.
The recipient can’t decide which provider s/he wants. The grocery list to provider contains mostly junk
food. The recipient stopped homebound meals when s/he decided they weren’t tasty rather than add salt.
S/he refuses to use walker or cane.
• Questions social worker may ask: Who would you call in case of emergency? If someone you did not
know came to your door at night, what would you do? What are you able to do for yourself? Do you need
anyone to help you? Who would you depend on to assist you if you needed a household repair done such
as if your heater did not work?
☐ Rank 5 – Judgment severely impaired: Recipient fails to make decisions or makes decisions without
regard to safety or well-being.
• Social Worker Observation: Observe if safety hazards are evident: clothing has burn holes; faulty wiring,
leaking gas, burned cookware, etc. Observe if utilities may be shut off; food supply is inadequate or
inedible. If the recipient is a pet owner, observe if there are animal feces in home. Observe if the recipient
is obviously unaware of dangerous situations, not self-directing, mentally unable to engage in activities of