Caregiving Gems - Duke University

Caregiving Gems - Duke University

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 Whos 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 dont 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, DONT 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 Cant 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 Cant 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

Cant 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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