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Ron, 72 y.o. male, Dementia. By Alex Sharp & Stephanie Wood…

- - - - Lack of noticing/responding to commands
      - Does not attend to task at hand
      - Lack of self-awareness
      - Short attention span
    - - No initiation in conversations
      - No response in conversations
  - - - Cultural
        
        disrupted client identity and activity choices
      - Personal
        
        unemployed male
      - Temporal
        
        Elderly adult
    - - Lives in mobile home with sister & her young granchildren
  - - - Wandering at night, leaving the home
      - Repetitive Actions with objects
      - Respond to tactile cues to perform manual actions
    - - Inconsistent
    - - Brother
      - Uncle; Great Uncle
- - - - Easily distracted
      - Difficulty attending
      - Decreased information-processing speed
    - - Less concise
      - Economy of utterances
      - Repetitious/perseverative language
      - Word-finding difficulties signaled by long latencies, paraphasias, and word substitutions
      - Bilingual individuals see errors in selecting and maintaining appropriate language during conversation
      - Tangential language
      - Circumlocution
      - Grammatical errors
      - Use of jargon and loss of meaningful speech
      - Impaired ability to compose meaningful written language
      - Difficulty following and maintaining conversation
      - Language comprehension deficits
      - Difficulty following multi step commands
      - Reading comprehension difficulties with complex materials
    - - Difficulty setting goals and planning
      - Poor judgement and impaired reasoning/problem-solving skills
      - Difficulty multitasking and handling complex tasks
      - Difficulty responding to feedback
      - Poor self-monitoring and ability to correct own erros
      - Lack of inhabition
      - Lack of mental flexibility
    - - Difficulty completing previously familiar activities of navigating in familiar environments
      - Inability to recognize familiar people, common objects, sounds, and so forth
      - Inability to find objects in direct view, independent of visual acuity
      - Other visuo-perceptual difficulties, such as trouble with depth perception and sensitivity to light
    - - Episodic memory deficits
      - Short-term/working memory deficits
      - difficulty recalling names of family and friends
      - difficulty acquiring and remembering new information
    - - Anger and aggression
      - Anxiety or agitation
      - Forgetfulness and confusion
      - Repetitive actions
      - New suspicions
      - Wandering and getting lost
      - Trouble sleeping
      - Mood fluctuations
      - Negative reasion to questioning
      - loss of initiative and motivation
- - - - Establishing ADL and IADL routine to promote engagement in occupational activities
    - - Decreasing aggression & wandering thus improving safety for both Ron and his family members
    - - Adapt tasks for Ron to achieve success in occupations and promote agency
    - - Rearrange furniture to allow easier maneuvering around his environment
      - Applying a multitude of home modifications to ensure optimal occupational performance and safety for Ron within his home
- - - - Ron's context will need to be adapted, manipulated, and structured to meet his performance
      - Task demands will also need to be adapted
    - - Prevention of his maladaptive performance through modifying the home environment to ensure safety
    - - Creating a scheduled routine through an assistive device to help Ron stay structured and focused on tasks
      - Making a Identification bracelet that does not come off
    - - This frame of reference examines the interdependent relationship between “the person and the physical environment, it expands the concept of context-environment to include physical, temporal, social, and cultural elements” (Dunn, Brown, McGuigan, 1994). Our case involves a large component of the dynamic between the caregiver and our client. We also recognize Ron's home environment playing a huge influence on his behaviors. Interventions such as home modifications and employing visual cues within the home show a high correlation to the focus of the Ecology of human performance.
- - - - Visual Aids placed on walls in home
      - Wearing a Watch that sends out Verbal reminders throughout the day
  - - - Identifying antecedents to behavior and the consequences
      - Register Ron to a Safe Return Program if he does wander off
    - - Environment in home needs to be predictable and constant
    - - Leaving the TV or Radio on can cause confusion to Ron
      - A tidy home will instill the best occupational performance for Ron
      - Less clutter in the home is important for Ron's safety and stress levels
      - Floors free from patterns or designs
      - Being mindful of the room temperature, Individuals with dementia can not always report how they feel
    - - Do not rush Ron, give him enough time to respond
      - Give 1 to 2 step simple commands
      - Avoid negativity, Always encourage
      - Be aware of facial expressions, give eye contact but do not stare at Ron (can increase anxiety and agitation)
      - Individuals with dementia are sensitive to body language and unexpressed feelings (can increase anxiety and agitation)
    - - Mealtime
        
        Putting plate on a different colored placemat
        
        Serving one food/meal at a time
        
        To decrease distraction, agitation &/or anxiety, have Ron seated last at the table
        
        Offering Ron something small to eat to help him easily transition to eating at dinner. It also helps to give him something to do while waiting
      - Toilet & Toileting Hygiene
    - - Reenergize yourself with activities you enjoy or go to a spa
      - Resources for