The person will assist with rolling to ease placement of bedpan and holding their arm over the bed rail for perineal care.

Full assistance is required for cleaning perineal area, changing incontinence pads and managing clothing.

Carers need to schedule toileting 30 minutes after meals and every 2 hours.

ACL 1.6

A sponge bath maybe given and hair is washed in bed.

ACL 1.8

Carers may provide physical guidance and verbal directives to hold up body parts, hold arm over the bed rail and roll body to cooperate with bathing.

When a tilt-in-space shower / commode chair with head support is used, the person will also cooperate by holding still.

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

ACL 1.6

The person will assist with dressing by rolling, holding their arm over bed rail, and following the direction to "hold still."

ACL 1.8

Carers may provide physical guidance to roll from side to side, initiate "bridging" to hold up buttocks for a few seconds to cooperate with donning lower extremity garments.

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 swallowing pureed food, holding a trunk position or lifting a body part if the carer waits 20 seconds.

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.

They may respond to simple instructions like "hold still" now.

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.

A person's sense of smell may diminish as their cognition drops. The smell will have to be very strong in order to gain their attention. Mustard, garlic, lemon, perfumes and various herbs and spices produce strong distinct smells.

Primary contrasting colours are noticed in ACL1 High when their vision is intact. A PDF of a yellow smiley face is available here: https://acdmweb.com/downloads.

Busier pictures maybe ignored as the information is not processed.

A person's sense of touch may vary and may be affected by their medical diagnosis. If they have had a cerebral vascular accident or an acquired brain injury, their sensation maybe affected. One side maybe more affected than the other. Approach the person from their better side first and then alternate to their affected side. Note their response. Did the person's facial expression change as a result of the sensation. Do they appear more relaxed after the sensation?

Different textures produce various touch sensations like smooth, rough, slippery, furry, fluffy, bumpy, squishy, etc.