Attendance Allowance (AA) guide

This guide is intended to inform and assist you to complete the Attendance Allowance (AA) form, including information to help with each section of the form, as well as guidance on keeping a diary to support your application. We recommend that you take some time to read this guide before completing your form.

If your condition varies from day to day, we suggest you keep a diary focusing on the activities considered for AA. By doing so over time you will get a clearer picture of how you manage your daily living needs.

If you find it difficult to keep a diary, you could ask a relative, carer or friend to help you. Explain in the AA form that your diary has been completed with their help.

When you attach the diary to the AA form, include your name, address and National Insurance number at the top of every page. Longer term diaries can be useful in explaining more sporadic problems that can result from your condition.

Remember it's the help you need, not the help you get.

The help needed but not exclusively to be considered for AA includes:

• washing and bathing
• dressing and undressing
• getting in or out of bed
• going to the toilet
• at mealtimes
• moving about indoors
• taking medication or having treatment
• keeping an eye on you
• communicating to people what you need or making yourself understood

If you struggle to get up, wash and dress yourself without help, say so. If you struggle everyday of the week, say so. If you have a couple of good days, say 4 to 5 days.

Time yourself or get someone else to time you. If you have to stop and rest, say so and give the reason. Is it because of pain, discomfort, dizziness or problems with balance?

Think carefully about the length of time it takes you to get out of bed, and if possible time it from the time you wake up. Remember to say how long you have to rest before you can continue.

Think about all the different tasks involved in getting in and out of bed:

• are you breathless when you wake up
• do you have to take your time because your muscles or joints are painful
• do you use any equipment, furniture or the wall to help lever or push yourself up? You may have to use a walking frame for support in order to get to your feet due to the arthritis in your legs
• do you need someone to help you sit up or get your legs out of bed? Your mobility is very poor and if you need someone to help you off the bed and onto your feet
• do you need someone or something to support you when you stand up from the bed, for example because of pain, muscle weakness or problems of balance? Say why
• do you have to go back to bed during the day because of pain, fatigue, exhaustion? Say why and how often
• do you need to be encouraged or prompted to get out of bed? If so say how and why
• do you hear voices telling you not to get up? If so what do they say
• if because of the severity of your illness you are unable to get out of bed at all, say so

Some people understandably find it embarrassing to be honest about their personal needs, but it is important to be clear about the help you need.

Think about the following when filling in the form:

• do you have difficulty getting to the toilet? Perhaps you have to go upstairs or downstairs and you need help or you use a urine bottle or commode and need help cleaning or emptying
• do you need help from someone else to help you to the toilet
• are you incontinent or are you unable to move quickly if you need to use the toilet urgently
• do you need help to change your clothes if you are unable to reach the toilet in time
• do you have a condition such as irritable bowel syndrome that means you must make frequent visits to the toilet
• do you have problems getting on or off the toilet, for example because of pain or stiffness
• do you have a grab rail or use something else to get on or off the toilet
• do you use any equipment like a raised seat rail, or the wall or the sink, to help lever yourself up
• do you have problems adjusting your clothing before or after using the toilet
• do you have difficulty pulling clothing up or down
• does your disability make it difficult for you to wipe yourself or wash your hands afterwards
• if you are a woman, do you need help with sanitary protection
• do you get dizzy or have breathing problems due to the effort of going to the toilet

You should answer the question about having a bath or shower even if you never have one, as you may need one but have difficulty managing. If you need a bath every day say so.

Think about the following when filling in the form:

• are you unable to wash yourself properly without help, for example, because of muscle and joint pains or fatigue
• are you tired or breathless after washing or bathing
• do you have difficulty handling soap, squeezing a toothpaste tube, lifting your arms in order to wash round your neck, or using a towel to dry yourself
• do you need help to wash or dry any area of your body, such as your back or feet
• are you only able to wash your hair with help
• do you need help to comb your hair
• do you need help to cut your finger or toe nails
• if you shower because you cannot use the bath but would prefer a bath, say so
• can you use a shower without help? If not, explain why and what help you need
• if you have a walk-in shower because you cannot use a conventional one, say so
• are you in danger of slipping because of muscle weakness, giddiness or problems with balance
• what help do you need getting in or out of the bath or shower
• do you need to hold onto somebody or something for support or do you have aids or adaptions
• do you use aids or adaptions
• have you fallen or slipped in the bath or shower
• do you need somebody to be present in case you get into difficulties? Say why
• do you get dizzy or have breathing problems due to the heat or steam
• if you have a bath or shower and you would like to use them but are unable to do so, say why
• are you frightened of falling when you bathe or shower? Why are you frightened, have you previously fallen or had dizzy spells
• do you need to be reminded to have a wash, bath or shower? Say what you need to be reminded of
• do you hear voices telling you not to wash, bath or shower and what do the voices say
• do you need to be motivated or prompted to wash, bath or shower and what motivation or prompting do you need

You may not have anyone to help you but you still manage to dress or undress yourself, although this may take some considerable time. If this is your situation put it on the form.

Think very carefully about how long it takes you to dress without help. Say how long you have to rest between each procedure or how because of fatigue you have to rest once you are dressed.

Think about the following when filling in the form:

• do you have difficulty putting certain items of clothing on? What is the problem and with what clothing
• are you unable to bend over, reach behind your back or put your hands above your head? Does this make it difficult to put on certain items of clothing
• can you pull a jumper over your head
• can you bend over to put on socks or tights and then pull them up
• do you have difficulty with detailed tasks like buttons, zips or shoelaces, and how do you overcome the difficulty
• are you restricted to wearing front fastening clothing or Velcro attachments because you have difficulty managing back fastenings
• do you need to support yourself by leaning against the wall or furniture while dressing
• do you need to get dressed or undressed more than once a day, due to things like incontinence, spillages or sweating
• do you need to be reminded to get dressed or undressed
• do you have a disability such as a sight impairment and need help to choose suitable clothing to wear
• do you need to be told if your clothes are appropriate for the weather
• do you need motivating or prompting to get dressed and detail why
• do you need help in locating your clothing
• do you need assistance in choosing
• do you need to be told that your clothes match
• do you need to be told how to put your clothes on

Think about the following when filling in the form:

• are you unable to walk at all
• do you use a wheelchair
• do you need help getting in or out from your wheelchair
• do you use a walking frame
• do you need help to use your walking frame
• do you have difficulties walking
• do you experience pain that stops you from supporting your own weight or moving your legs
• do you tire, fatigue or get out of breath easily
• do you suffer from vertigo and need somebody to steady you
• do you have balance problems
• do you feel faint for any length of time
• do you use furniture, doors or walls to hold on to when moving about indoors
• do you need assistance from another person to help you by supporting your weight
• can you only climb the stairs by putting both feet on each step rather than on alternate steps
• can you get up if you fall
• have you fallen or tripped in the house
• have you hurt yourself following a fall
• do you have a fear of falling in the house? If so, say why

Think about the following when filling in the form:

• do you have to walk very slowly and hold onto things
• do you tend to shuffle when you walk, which can cause you to stumble frequently
• do you have poor circulation which often results in numbness in your legs, causing you to fall
• do you suffer from high blood pressure, which causes dizzy spells resulting in falls
• if you have poor eyesight do you knock into things and does this also affect your balance, causing you to stumble or fall
• when you fall, you don't have enough strength to pick yourself up and need to call for help
• do you suffer from dizziness and or nausea causing you to fall or stumble

Think about the following when filling in the form:

• do you have the full use of your hands
• do you have a disability that makes it difficult for you to grip or do you have a sight impairment
• are you able to use a knife and fork at the same time or do you have difficulty when trying to cut up food, for example due to painful joints like arthritis
• do you have difficulty locating food on your plate
• does somebody help at meal times or do you have adapted cutlery
• do you sometimes spill food or drink when trying to put it into your mouth, because of difficulty lifting your arms or a disability
• if you spill food or drink, do you need help to change your clothes
• do you need to be told that you have left food on your face or clothes and do you need support with this
• do you have difficulty in chewing and swallowing food or do you need help with a feeding tube or similar aid
• do you need prompting or encouraging to eat or drink and why? Go into as much detail as possible
• do you have short-term memory loss and forget whether you have eaten and need supervision
• do you need supervising when you eat or are you at risk of choking when eating or drinking

Think about the following when filling in the form:

• do you ever forget to take your medication and do you have any aids or adaptions you use
• do you need someone to remind you to take your medicine at the right time or have problems with short term memory
• what happens if you forget your medication
• do you need help with physiotherapy at home
• do you require help with dialysis treatment at home and what help do you require
• do you require assistance with oxygen at home
• do you need help to open containers or help to take your medication
• do you have to use special containers for your medication and do you have any aids or adaptions you use
• do you need help to ensure that you only take the prescribed amount each day
• do you attend clinics for outpatient treatment and how often
• do you attend a day centre and how often
• do you have counselling or therapy of any sort
• do you need somebody to monitor your mental state or health? Go into as much detail as possible about why you need assistance
• do you need to be supervised with medical treatment or do you need help or supervision monitoring blood sugar levels
• go into as much detail as possible about why you need supervision

Think about all the times that you need somebody to help you communicate. Remember this can include reading mail, replying to letters, using the telephone or using sign language.

Think about the following when filling in the form:

• do you have problems with concentration which make it difficult for you to read? This can be anything from reading a book to a gas bill
• do you need someone to read letters or correspondence for you
• do you have sight or hearing problems? Do you need somebody to sign for you
• do you need someone to speak for you because you are not always able to express yourself clearly
• if you have short term memory loss, you find it difficult to hold a conversation because you forget the topic of conversation and start talking about something else
• do you need someone to verbally guide you when you are walking
• do you need help to go to the doctors, chemists, church, visit friends or relatives, pay bills or social events. Think about where you go or would go if you had the help you need
• do you have difficulties answering the telephone
• do you have difficulties letter writing
• does somebody have to attract your attention by touch or waving to speak to you

Do you need help in taking part in social events, religious activities or hobbies? It's the help needed, not the help that you receive, which is important. Explain about the kinds of help that you need when doing these activities.

This may include:

• coping with transport
• guidance when walking in unfamiliar places
• help to locate and use tools or items that you need to do a hobby
• help to read notices, instructions and other information
• help with handling money and buying tickets, drinks or other items
• having your surroundings described to you and being told who else is there
• help to recognise friends or acquaintances, or to recognise who is talking in a group

• do you need someone to verbally guide you when you are walking

Do you need help to go to:

• the doctors
• the chemist
• religious services and events
• visit friends or relatives
• social events such as bingo, playing cards, birthdays and weddings or going to the theatre

• if you have a sight impairment, do you need help with exercising such as at a gym or with things like completing crossword puzzles

Think about the following when filling in the form:

• do you get confused? This may be due to your illness or the medication you are taking
• do you forget where you are going or forget what you are going for
• do you cause harm to yourself
• do you cause harm to others
• do you damage furniture or damage other items
• do you get frightened around other people
• do you need reassurance from other people
• do you get any warning about your illness
• do you need help or supervision when you are outdoors
• do you have any road sense
• do you realise when there is danger
• do you need others to help you get from one place to another
• do you need someone to take your weight when walking
• can you manage stairs, lifts and kerbs safely on your own
• do you realise when your condition is getting worse

Give an estimate of how long somebody has to keep an eye on you. Use examples of past experiences.

Think about the following when filling in the form:

• do you need help to get settling at night when the household closes down at the end of the day
• do you need help to lie in one position, for example propped up by pillows to avoid choking
• do you need help to turn over
• if the bedclothes come off, do you need help to get them back onto the bed? You may not be able to pull or lift the covers because of pain in muscles and joints, or weakness or difficulty in gripping
• do you need help changing sheets or nightwear? This could be through sweating or incontinence
• do you need help getting to the toilet
• do you need help using the toilet
• do you need to be encouraging or reminded about toileting
• do you need help using a bedpan or bottle
• due to your mobility and balance problems do you have a commode by your bed at night? Say if are not able to empty or clean this because of your condition
• do you need help getting to and taking the tablets or medication
• do you need to be encouraged or reminded about medication
• due to mental health, learning disability, sight, hearing or speech difficulty, do you need another person to be awake to watch over you
• do you need help to prevent danger to yourself
• are you aware of common dangers
• are you at risk of harming yourself
• do you wander around the house
• do you get confused or disorientated
• do you hear voices

Think about the following when filling in the form:

• do you hear voices that tell you to do things
• do you see things? If so what
• do you get anxious, scared or panicky for no apparent reason
• do you get aggressive towards other people
• do you care about your appearance, for example bathing, shaving, washing and getting dressed 
• do you need prompting to get up and out of bed
• do you refuse friends or relatives access to your house because you are frightened
• if you did not have somebody to keep an eye on you could you cope