1. HEAD Presented by HomeCare Rehab and Nursing LLC

2. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HEAD “HEAD” = thinking, brain Level 4 of the Allen Cognitive Scale. Early Stage Dementia Medicare “Min Assist” Goal-directed in function and may have some limited ability for new learning Copyright © 2003

3. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HEAD Why? –Loss of inhibitions (frontal lobe). –Unable to self-monitor. –No insight into deficits (nothing is wrong with them)…problem is with the world. –Loss of independence and dignity, loss of role in life. –Words are the best fighting tool they have. Copyright © 2003

4. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HEAD Cognitive skills/Communication: Understands beginning, middle, and end of an activity. Can seek help but may not remember emergency procedures. Rigid, likes routine. Self-centered communication, confabulates, high verbal output. Recognizes highly visible striking cues in the environment. Limited reading comprehension. New learning possible with maximum repetition if highly valued. Believe that nothing is wrong with them. Well, maybe you say it’s wrong but that’s just the way I like it. My way is the best way. Copyright © 2003

5. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HEAD Precautions: Unable to understand precautions, complications, hazards. Written language is not reliable. Signs are not really effective. Copyright © 2003

6. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HEAD Feeding: May eat too fast or too slow. Annoyed with others eating near them. Complains about food. Grooming: May neglect unseen surfaces (back of head). Sequencing errors. If you tell me to go brush my teeth I will stay on task. I just may forget to use toothpaste or rinse out my mouth. Copyright © 2003

7. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HEAD Dressing/Bathing: Performs familiar self care with decreased attention to unseen surfaces. Follows routine. Remembers what they are doing throughout task. Clothing selection may be based on striking features (brightest shirt in the closet). Quality may not be good. I am really drawn to bold, striking visual input. Did you ever notice that I choose bright clothing and wear too much make- up? Copyright © 2003

8. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HEAD Toileting: May neglect parts of the task. May require verbal reminders to initiate task. Completes the task although quality may not be good. This is a huge loss of dignity for me- and a very overwhelming task at times. Copyright © 2003

9. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HEAD Functional Mobility: Able to navigate using familiar landmarks. Transfer skills depend on familiarity of environment. Carries walker if distracted, but will correct with cues. Notices barriers above and below knee. Trunk becoming more rigid. I can remember new things with tons of patience and practice!