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].

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.

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

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

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?”)

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!”)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The End