1. HEART Presented by HomeCare Rehab LLC

2. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT WRITTEN PERMISSION FROM THE AUTHOR HEART “HEART” = feeling, living Level 1 and 2 of the Allen Cognitive Scale. Late and End Stage Dementia Medicare “Max Assist/ Dependent” Respond to internal and external stimuli through any of the five senses Copyright © 2002

3. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT WRITTEN PERMISSION FROM THE AUTHOR HEART Allen Level 1: Mostly bedbound Can move limbs and head Total assistance for self care and mobility. Allen Level 2: Can overcome gravity Can sit, stand and/or walk (mobility) Have a sense of balance, although not good Copyright © 2002

4. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT WRITTEN PERMISSION FROM THE AUTHOR HEART Precautions: Contractures Skin Breakdown Falls Aspiration Because I can’t move or communicate well, I’m really at risk for contractures, falls, and skin breakdown. YOU can prevent this from happening to me! Copyright © 2002

5. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT WRITTEN PERMISSION FROM THE AUTHOR HEART Cognitive Skills/ Communication: Speech mostly unintelligible, mumbles incoherently Unable to follow most verbal commands Poor attention span, distracted by moving objects A funny trick I know: I may only be able to say one or two words, but I can sing a whole song without any errors. Copyright © 2002

6. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT WRITTEN PERMISSION FROM THE AUTHOR HEART Feeding: May be able to feed self with limited or extensive assistance More successful with finger foods Can sip from a cup held to lips until very end stages- don’t introduce a straw too early! I can only see things less than 12 inches from my face. Bring the world to me! Copyright © 2002

7. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT WRITTEN PERMISSION FROM THE AUTHOR HEART Dressing/Bathing/ Grooming: Has no idea what to do with objects Assists caregivers by holding positions, moving limbs, and standing I have a major fear of falling. I may resist, hit, or kick but it’s only to protect myself from injury. I’m not just being difficult. Copyright © 2002

8. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT WRITTEN PERMISSION FROM THE AUTHOR HEART Toileting: Needs assistance with managing clothing, perineal hygiene, and positioning on toilet Frequently incontinent Inappropriate toileting locations- sometimes the same place over and over. Can assist caregiver by holding onto grab bar. You may know me by my “death grip”. I have a hard time releasing things from my hands. Copyright © 2002

9. NO PART OF THIS MATERIAL MAY BE REPRODUCED WITHOUT WRITTEN PERMISSION FROM THE AUTHOR HEART Functional Mobility: Higher level “hearts” walk aimlessly, pace, rock, and march. Lower level “hearts” can only respond with a grimace or glance. Seek stability and comfort Enjoy gross motor activities- without a sense of purpose. I can turn my head to track a moving object even at the last stages of my disease. Give me moving stuff to look at! Copyright © 2002