This data element, along with Person—activity and participation life area, disability flag code N, enables an assessment of a person's level of difficulty and need for assistance in life areas, leading to classification of level of activity limitation.

In the context of health, an activity is the execution of a task or action by an individual. An activity limitation is a difficulty an individual may have in executing an activity. Activity limitation varies with the environment, and is assessed in relation to a particular environment; the absence or presence of assistance, including aids, equipment and/or medications, is an aspect of the environment.

This data element is designed for the whole mainstream population and should be used to collect information from the respondent, or a proxy/carer answering on their behalf. The responses are phrased in response to the question 'For each of the following activities, do you need help/supervision, have difficulty, or use aids/equipment/medications? (choose one answer for each row)'.

Where a life area includes a range of examples, (for example, ‘Self-care’ lists showering or bathing, dressing or undressing, toileting, eating food), if a person requires assistance in more than one of these areas, record the highest level of assistance needed.

Where need for assistance varies markedly over time (for example, episodic psychiatric conditions), record the average level of assistance needed.

Animals used for personal mobility (for example, guide dogs and companion animals) are considered to be aids and/or equipment. Also included in this category are prosthetic and orthotic devices, wheelchairs, transfer devices, etc.

For the ‘Communication’ life area, a person’s level of difficulty is assessed in terms of whether they can understand, or be understood, in their native language or preferred method of communication. This can include both written and verbal communication and it does not refer to situations where the respondent can’t read or write because they did not have an opportunity to access education. Interpreters for language are considered to provide personal assistance, and are not considered aids and/or equipment.

Note that this is seeking to identify if, due to a long-term health condition or disability, a person cannot undertake everyday activities that other people in a similar age group would normally be able to carry out.