Caregiving Gems Teepa Snow, MS, OTR/L, FAOTA

Gem Stone Approach to Cognitive Levels

Rationale 3 systems – all use numbers Each has value – together confusing People are not numbers Until we begin to the see the beauty and value in what the person is at this point in time – we will never care for them as we should Gems are precious and unique – common language and characteristics

Based on Allen Cognitive Levels – – Cognitive Disability Theory – OT based Creates a common language & approach to providing – – Environmental support – Caregiver support & cueing strategies – Setting expectations regarding retained abilities and lost skills – Promotes graded task modification for success

Now for the GEMS… Sapphires Diamonds Emeralds Ambers Rubies Pearls

Sapphires Us on a good day… Clear & True to Themselves May feel ‘blue’ over changes Some are ‘stars’ and some are not They can CHOOSE

Sapphires Can connect ABCs – make contracts May have other health issues that affect behaviors Recognize life experiences, achievements & values in ABCs Can follow written info & hold onto it Will still need us to work with them Can typically CHOOSE their behaviors

Diamonds Still Clear Sharp - Can Cut Hard - Rigid - Inflexible Many Facets Can Really Shine

Diamonds Know Who’s in Charge – Respect Authority Can do OLD habits & routines Become more territorial OR less aware of boundaries Like the familiar – FIGHT CHANGE Can pull it together to make you look bad Know how to push your buttons Want to keep roles the same Tell the same stories ask the same ?s

Emeralds Changing color Not as Clear or Sharp - Vague Good to Go – Need to ‘DO’ Flaws are Hidden Time Traveling

Emeralds Think they are FINE Get emotional quickly Make mistakes – don’t realize it Do over and over OR Skip completely Ask – “What? Where? When?” Like choices Get lost in past life, past places, past roles Need help, DON’T know it or like it!

Ambers Amber Alert Caution! Caught in a moment All about Sensation Explorers

Ambers Get into stuff Fiddle, mess, touch, taste, dig, tear, fold….. Move toward action and noise OR away Sensory tolerance Sensory need Mouth, fingers, feet, genitalia Can’t figure it out… react physically

Rubies Hidden Depths Red Light on Fine Motor Comprehension & Speech Halt Coordination Falters Wake-Sleep Patterns are Gone

Rubies Fine motor stops Hard to stop and hard to get going Limited visual awareness One direction – forward only Can’t figure out details – but do copy us SLOW to change On the go or full stop Use music and rhythm

Pearls Hidden in a Shell Still & Quiet Easily Lost Beautiful - Layered Unable to Move – Hard to Connect Primitive Reflexes on the Outside

Pearls Can’t move Limited awareness of the world around – most of the time Problems swallowing Hard to get connected How we touch and help matters May know familiar from unfamiliar SLOW!!!