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To explore factors associated with the need for assistance in dressing, cleaning and personal hygiene by adult intensive care unit (ICU) patients and the type of assistance provided. Cross-sectional survey. All 1,011 ICUs in the United States. All adult (10 or older) ICU patients on a given study day, from September 18, 1998, to February 22, 1999. None. We received complete responses from 1,219 of 1,237 adult ICUs, with a 97% response rate for the 16,558 study days. Of those ICU patients on an eligible study day, 57% (n = 5,462) were classified as self-dressing, 14% (n = 1,404) as dressing-assisted, 28% (n = 2,766) as cleaning, and 11% (n = 1,026) as bathing. Compared with self-dressing patients, patients assisted at dressing and cleaning were younger, had lower levels of comorbidity, consumed greater quantities of intravenous (IV) fluids, and were more frequently mechanically ventilated. Further, we estimated that for every 5% increase in illness severity (measured by logistic regression) there was a 7.7% (95% confidence interval [CI], 1.6 to 31.1%) increase in the odds of being assisted in dressing, 6.9% (95% CI, 1.2 to 18.7%) increase in the odds of being assisted in cleaning, and 5.4% (95% CI, 0.9 to 18.3%) increase in the odds of being assisted at bathing. Compared with patients at low risk for needs assistance, patients at intermediate risk had 2.2 (95% CI, 1.7 to 3.0) times the odds of being assisted 0b46394aab