According to statistics, in the USA there are more than 6 million people with cognitive impairment caused by dementia. The situation in other countries is approximately the same. To take appropriate care of such people it is necessary to know their cognitive and performance abilities. A special tool was designed for these purposes. It is the Allen Cognitive Level Screen (ACLS) named after its creator Claudia Allen.
She described six cognitive levels. The results of the screen help to identify the person’s limitations and potential and are of great help to people who provide care.
This caregiver guide includes instructions for nutrition, medication management and safety within each Allen cognitive level.
Occupational Therapy for Allen’s Cognitive Levels
Such individuals need a consistent routine and a close supervision around the clock. They tend to resist care so those who provide assistance should be patient and give more time for everything.
- see that dietary restrictions are observed;
- ensure the proper intake of medications;
- position the person in the way to ensure safe swallowing;
- make sure that the texture of the food is appropriate for the person;
- if necessary, feed the person;
- see to the temperature of foods and drinks;
- assist in hygiene, dressing, walking and remind of the use of toilet;
- ensure a safe environment by barricading open stairwells, using locks, removing objects on the floor and unsteady furniture;
- suggest doing motion exercises at least once a day;
- provide enjoyable experiences ‒ favorite music, singing, walking, sensory engagement, etc.
To ensure successful communication clear statements should be used.
Such patients also need a consistent routine and supervision around the clock. Caregivers’ responsibilities are the same. The only difference is that they let the client actively participate in everything and encourage performing different activities about the house, such as polishing, folding and the like.
Patients whose cognitive levels are from 3.6 to 3.8 need practically the same care. Yet, they are able to perform more activities themselves, so they may need just to be reminded of the necessity to keep hygiene or to take medications. Verbal prompts concerning the sequence of steps are often required.
People whose test results in the Allen Cognitive Level Screen are within this range can perform familiar household tasks but require constant reminders and education.
They usually underestimate potential hazards in everyday life, and it is desirable to make their environment safer. Appliances with automatic shut-off, med-alert equipment, hot water thermostats, grab bars may be helpful. Caregivers need to practise safety routines and periodically check safety rules. It is not recommended to give instructions over the phone.
People can live alone but they need daily supervision. It may include determining the need to take medications and monitoring their effects, meal planning, cooking, and money management. In new environments they always need help.
Problems may arise because of their impulsivity, so be ready to provide assistance, if necessary.
Learning strategies include detailed instructions, repetition and trial, often through error.
If the person lives alone, weekly supervision is quite enough, provided the environment is safe and the routine is well established. If necessary, help them realize the importance of a healthy diet, taking medications, incorporating exercise and techniques into the daily routine, using daily planners, checklists and things like that.
These recommendations are sure to facilitate the ability of people with different cognitive levels to function.