Reduce the risk of falls by using bed rails. Bed rails should be left up during care to prevent accidentally rolling out of bed during care giving. If an extremity starts to slide off the bed, the effects of gravity may not be perceived or corrected. The rail protects them from sliding off the bed.

This is not a restraint because the person is unable to sit up to get out of bed independently. The rails offer protection during unexpected startle reactions.

Hair & Nail Care

Prevent ingrown or broken nails by cutting and smoothing nails.

Prevent hair matting by a short hair cut or by brushing and braiding hair.

ACL 1.0 - 1.2

Tube feeding is usually required.

ACL 1.4

The person's ability to track happens at about the same time that swallowing does in ACL 1.4. Tracking and sitting up for at least 15 minutes can be used as the prerequisites for swallowing. The person is able to follow a sensory cue as it changes location. Visual and auditory tracking is accompanied by swallowing and sitting in a chair with total support of their head and trunk.

Use of incontinence pads is required with full assistance with perineal care.

ACL 1.0

Total nursing care is required. Scheduled changes in incontinence pads is required.

ACL 1.2 - 1.4

A tilt-in space shower commode chair may be used. Assistance will be required with head support.

ACL 1.0

May be given a sponge bath, hair may be washed in bed or a shower bed may be used.

ACL 1.2 - 1.4

A tilt-in-space chair may be pushed into a shower, but constant checking for head support is required.

To preserve their dignity for daytime wear and for carer ease, modify the person's customary clothing to open/fasten down the back.

The person is dependent on others for all of their self-care activities.

Carers will need to assist with all activities of daily living and ensure that an adequate level of care is provided.

The person may cooperate with the carer.

Things that produce sounds vary. Everyday objects can produce a sound. It can vary in volume and pitch. If the person has a favourite instrument see if a relative will bring it in if it is portable. Find recordings of their favourite familiar music. Keep beats and rhythms simple. Other sounds that capture attention are things like bike bells.

Taste preference is also very individualised. You may have siblings with very similar backgrounds who have very different food preferences. This preference can also occur in people with a cognitive disability. Give them a variety of tastes to awaken their senses. Of course, adhere to swallowing precautions. Some strong taste experiences are salty, sour, sweet and bitter.