1. HANDS Middle Stage Dementia Presented by HomeCare Rehab and Nursing LLC

2. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HANDS “HANDS”= reaching, grabbing, holding objects Level 3 of the Allen Cognitive Scale Middle Stage Dementia Medicare “Mod Assist” Not goal directed, cannot be expected to complete a task without assistance Copyright © 2002

3. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HANDS Behaviors: Pacing, repetitive actions Agitated, worried, trembling hands Unpredictable with social interactions Confused, acts randomly Have you seen my mother? Has anyone seen my mother ? Copyright © 2002

4. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HANDS Precautions: At risk for falls Unable to understand precautions, complications, or hazards Does not recognize need for help At risk for accidents- poison, sharp objects, elopement I love to use my hands...and touch everything! I tend to get into things I shouldn’t and carry them around with me. Copyright © 2002

5. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HANDS Cognitive skills/ communication: Able to name objects Decreased sense of task completion Needs verbal cues to sequence steps of an activity Responds best to demonstrated instructions Word finding problems Loses the thread of a story Jargons, incoherent sentences I have to get out of here. I’m late for work and the train is on that other thing over the @#%*! out that window day @#%*! right here in Chantilly. Copyright © 2002

6. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HANDS Functional Mobility: Limited head/neck/trunk movement during walking Does not scan environment Has trouble stopping, may trip May be impulsive Frequent fallers I hate confinement and may try to get out! I want to walk walk walk! Copyright © 2002

7. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HANDS Self-care skills: May initiate action with familiar object- but not sustain to completion Resistant to care Layers clothes until all items used up, unable to orient clothing or sequence task Needs supervision or assistance with toileting I am sometimes very resistant to care. Don’t you sneak up on me or just might get slugged! Copyright © 2002

8. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT PERMISSION FROM THE AUTHOR HANDS Feeding: May reach for food from other place settings or centerpiece Unable to complete meal without redirection and set-up Plays with food and utensils You may notice that I play with my food or grab other’s food from their plates. I’m easily distracted and overstimulated. Copyright © 2002