1. Ways of Helping and Disease Progression
Module 16
Ways of Helping and Disease Progression
Geriatric Aide Curriculum
NC Division of Health Service Regulation
For use in conjunction with: The Eastern North Carolina Chapter of the Alzheimer’s Association. (2003). Module 3 of Accepting the Challenge: Providing the best care for people with dementia, [Videotape].

2. Ways Of Helping For Dementia Caregivers Objectives
Discuss three ways of helping persons with dementia: visual cues, verbal cues, and tactile (touching) cues.
Recognize the 5 progressive levels of dementia.

3. Ways of Helping: Visual Cues
Make eye contact and smile
Use simple written schedules and notes as reminders early in disease
Label areas and items with simple words to prompt
Use pictures to remind about what is hidden

4. Ways of Helping: Visual Cues (continued)
Put things in view one at a time if they are to be used
Use props to focus or provide choices
Use gestures and pointing
Show what you want and mean by doing it yourself

5. Ways Of Helping: Verbal Cues
Use person’s preferred name
Keep information short and simple (“Here’s your tea.”)
Say what’s going on (“It’s time for lunch.”)
Offer simple choices (“Do you want tea or coffee?”)

6. Ways Of Helping: Verbal Cues (continued)
Ask for help (“Could you help me, please?”)
Ask to try (“Would you like to give it a try?”)
Break requests into smaller steps (“Stand up.”)
Always give positive feedback and praise (“Yes! Good!”)

7. Ways Of Helping: Tactile (Touching Cues)
Shake hands to start
Offer a hug or hand holding if distressed
Touch for attention during tasks
Guide movement – lead through once

8. Ways Of Helping: Tactile (Touching Cues)
Do the hard parts – have person do the easier ones
Hand under hand assistance
Doing for…

9. Progression of Dementia Levels Of Cognitive Loss
Level 5: Early loss, running on routine, repeating stories
Level 4: Moderate loss, just get it done, wanting a purpose and a mission
Level 3: Middle loss, see it, touch it, take it, taste it, hunting and gathering

10. Progression of Dementia Levels Of Cognitive Loss
Level 2: Severe loss, gross automatic action, constant GO or down and out
Level 1: Profound loss, stuck in glue, immobile and reflexive

11. Progression of Dementia Level 5: Early Loss
Some word problems and loss of reasoning skills
Easily frustrated by changes in plans or routines
Seeks reassurance but resents takeover

12. Progression of Dementia Level 5: Early Loss (continued)
Does fairly well with personal care and activities
Tends to under- or overestimate skills

13. Progression of Dementia Level 4: Moderate Loss
Gets tasks done but quality poor
Leaves out steps or makes errors and won’t go back and fix it
Can help with lots of things with guidance
Likes models and samples – uses others’ actions to know what to do

14. Progression of Dementia Level 4: Moderate Loss (continued)
Asks “what/where/when” lots
Can do personal care tasks with supervision and prompts
Still very social but content is limited and confusing at times

15. Progression of Dementia Level 3: Middle Loss
Handles almost anything that is visible
Does not recognize others’ ownership
Can still walk around and go places
Language is poor and understanding of another’s language is very limited
Responds to tone of voice, body language, and facial expressions

16. Progression of Dementia Level 3: Middle Loss (continued)
Loses the ability to use tools and utensils during this level
Does things because they feel, look, taste good – refuses if they don’t

17. Progression of Dementia Level 3: Middle Loss (continued)
Stops doing something when it’s not interesting anymore
Can imitate some – but not always aware of the other person as a person

18. Progression of Dementia Level 2: Severe Loss
Paces, walks, rocks, swings, hums, claps, pats, rubs…
Ignores people and small objects
Doesn’t stay long in any one place
Not interested in food
Can grossly imitate big movements
Generally enjoys rhythm and motion – music and dance

19. Progression of Dementia Level 1: Profound Loss
Generally bed or wheelchair bound – can’t move much on own
Often contracted with “high-tone” muscles

20. Progression of Dementia Level 1: Profound Loss (continued)
Poor swallowing and eating
Still aware of movement and touch
Often sensitive to voice and noise
Difficulty with temperature regulation
Limited responsiveness at times

21. The End