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Functional Activities Questionnaire
Copyright © The Gerontological Society of America

No difficulty Finds it difficult but manages alone Some assistance needed Fully dependent on others
Dealing with financial matters, paying bills, writing checks
 
 
 
 
Keeping records of taxes, business affairs
 
 
 
 
Shopping for everyday necessities: groceries, clothes, etc
 
 
 
 
Hobbies or playing games
 
 
 
 
Making tea, turning the kettle on and off
 
 
 
 
Cooking a balanced meal
 
 
 
 
Perception of current events
 
 
 
 
Level of attention and understanding: books, television
 
 
 
 
Memory: remembering appointments and medications
 
 
 
 
Getting about: driving or taking public transport