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!!!
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