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Progression Dementia: Levels of Cognitive Loss Cheat Sheet by

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Demenetia: Warning Signs

Progre­ssion of the Disease – Levels of Cognitive Loss
♦ It is NOT part of normal aging! It is a disease!
♦ It is more than just forget­fulness - which is part of normal aging
♦ It makes indepe­ndent life impossible

Level 1: Early Loss; Routine; Repeating Stories

Early Loss; Running on Routine; Repeating Stories
Some word problems and loss of reasoning skill
Easily frustrated by changes in plans or routines
Seeks reassu­rance but resents take over
Still does well with personal care and activities
Tends to under or over estimate skills
Seeks out authority figures when upset or frustrated
Points out others’ errors, but doesn’t notice own behavior
May have some awareness – “Just not right” – might blame others or self
Can’t remember ‘new’ rules, locations, plans, discus­sions, facts

Level 2 – Moderate Loss - Just Get It Done!

Moderate Loss - Just Get It Done! – Wanting a Purpose and a Mission
Gets tasks done, but quality is getting to be a problem
Leaves out steps or makes errors and WON’T go back and fix it
Can help with lots of things – needs some guidance as they go
Likes models and samples – uses others’ actions to figure out what to do
Asks “what /where­/when” LOTS
Can do personal care tasks with superv­ision & prompts – often refuses “help”
Still very social BUT content is limited and confusing at times
May try to ‘elope’ /leave to get to a ‘older’ familiar time or situation OR get away from ‘fighting’
Can’t remember what happened AND can mis-re­member it – goes back in time, at times
 

Level 3 – Middle Loss: Hunting & Gathering

See It – Touch It – Take It – Taste It – Hunting & Gather­ing
Touches and handles almost anything that is visible
Does not recognize other’s ownership – takes things, invades space, gets ‘too close’
Can still walk around and go places – ‘gets into things’
Language is poor and compre­hension very limited - does take turns
Responds to tone of voice, body language and facial expression
Loses the ability to use tools and utensils during this level
Does things because they feel good, look good, taste good – refuses if they don’t
Stops doing when it isn’t intere­sting anymore
Can often imitate you some – But not always aware of you as a person

Level 4: Severe Loss – Gross Automatic Action

Severe Loss – Gross Automatic Action – Constant GO or Down & Out
Paces, walks, rocks, swings, hums, claps, pats, rubs….
Frequently ignores people and small objects
Doesn’t stay down long in any one place
Often not interested in/aware of food – signif­icant weight loss expected at this level
Can grossly imitate big movements and actions
Generally enjoys rhythm and motion – music and dance
Doesn’t use individual fingers or tools (more eating with hands)
Either moves toward people and activity (feels like a shadow) or leaves busy, noisy places (ghost)
Chewing and swallowing problems are common – soft, ground, or puree food may be needed
May not talk much at all, unders­tands demons­tration better than gestures or words

Level 5: Profound Loss - Stuck in Glue

Profound Loss - Stuck in Glue – Immobile & Reflex­ive
Generally bed or chair bound – can’t move much on own
Often contracted with ‘high tone’ muscles - primitive reflexes reappear
Poor swallowing and eating
Still aware of movement and touch
Often sensitive to voice and noise - startles easily to sounds, touch, movement…
Difficulty with temper­ature regulation
Limited respon­siv­eness at times
Moves face and lips a lot, may babble or repeatedly moan or yell
Give care in slow, rhythmic movements and use the flats of fingers and open palms
Keep your voice deep, slow, rhythmic and easy as you talk and give care

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