Daily Care: Moderate Stages of Alzheimer’s Disease

We can support the people we know living with dementia by keeping them mentally stimulated and providing ability-based care and support. At NursePartners, we recognize the GEMS™ model as an effective method for providing a plan of care for individuals living with Alzheimer’s disease or another form of dementia.  Click here for an introductory overview of the classification system and to understand the stages of the journey.

By appreciating what is changing and what is still possible, we can provide care that is more effective and less challenging.

 

Stage 2 – Moderate/Middle (lasts 2-10 yrs) – Emeralds and Ambers

At NursePartners, we use the “Emerald” or “Amber” classification for clients with moderately developed dementias.  We prefer this terminology because we know that all clients are operate at their best with the right approach to care.

A client normally persists in the Emerald and Amber stages the longest out of the other GEM levels. During this time, damage to the brain can make it difficult to express thoughts and perform routine tasks. It is important to allow your loved one to be involved in their day-to-day routine. Provide meaning through relevant activities that were part of their past because this will provide them with a sense of self-worth and add to their quality of life.

There will be acute changes to their self-awareness and senses.  We need to be able to distinguish daily changes and overall trends.  By having an established relationship with the client, we are also able to tell the difference between a client’s personality quirks and further developments of the disease.

 

About Emeralds and Ambers

 

Emeralds

Emeralds may get lost in time, thinking that are in another place or assuming a former role. They have problems with communication and comprehension, often asking questions that begin with “who”, “what”, “where”, and “when”.  At this GEM level, clients are making small mistakes with their personal care, but may not recognize it.  Some examples of this might be fastening buttons in the wrong holes, putting shoes on the wrong feet, or not changing clothing or brushing hair before leaving the home.  It is not important that we “correct every mistake”, but make changes subtly by using the right approach.  Sometimes this requires relating to the “mistake”, by discussing how we do this ourselves.  We could also pull out another piece of clothing and convince the client how good they look in that particular piece.

Emeralds are most comfortable when doing familiar tasks. They like to engage and help others, as well as feeling like they have a purpose. At a family functions, engage them by asking to help set the table and then clean it up. Choose favorite activities or hobbies of the past, but do not impose time limits for completing each task

Activities at home

Activities around the house can help Emeralds feel involved and provide a sense of normality. Activities such as setting the table, watering plants, and cooking can reflect past hobbies and interests, and can be a good way of retaining skills. Helping in the kitchen can also bring people together, as many experiences revolve around meals: holidays, birthdays, church potlucks, summer barbecues, weddings. Some activities for Emeralds include:

  • Cooking: salads, ice cream, Jell-O, pudding, no-bake cookies and pies, etc.
  • Copying recipes from magazines onto cards
  • Making a grocery list of items needed for recipes
  • Setting the table: Folding or rolling silverware into napkins

 

Ambers

Ambers like to live in moments of time, and are focused on sensation – manipulating, gathering and touching.  They are focused on wants and needs, and sometimes are exploratory without safety awareness. Their communication is limited with difficulty understanding and expressing needs, so activities selected need be familiar and sensory stimulating. Ambers may enjoy sing-alongs or being in visually stimulating outdoor locations.

Family members find it hard to find new ways “to say hello”.  We need to remember that there are other ways to communicate beyond verbally.  This is the time to start using those our methods.

Some activities for Ambers include:

  • Sorting nails, screws, and other hardware.
  • Organizing nail polish and lipsticks by color and shape.
  • Grouping coins, according to date, value or place of origin.
  • Rearranging the order of the silverware drawer by forks, spoons and knives.
  • Categorizing playing cards into decks or suits that match.

Planning the Day

  • Make a schedule and follow it: be structured but allow flexibility.
  • Offer a variety of activities everyday: leisure, work, rest, and self-care.
  • Create a flow for the day: build up and then slow down.
  • Build a foundation of familiar and favorite activities.

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NursePartners is committed to providing uncompromised care to those living with a diagnosis of dementia. Our carepartners are trained in the Positive Approach to Alzheimer’s and Dementia Care (GEMS™) and work with families to enable safety, comfort, and happiness through home-care services.

If your loved one need home care assistance or relief, our team would love to help.  Contact us today.

 

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