The additional use of grab bars means that they are able to stand while they are assisted with perineal hygiene and clothing adjustments. They can also learn to press down on the safety frame attached to the toilet to standup.

Reaching out can be encouraged by cueing them to wash their hands.

Because they recognize a need to void, they may start searching for a toilet and mistakes can be made. Camouflaging items that are often mistaken for toilets becomes necessary if a schedule for toileting cannot be established.

A stable shower chair with arm rests or a shower bench with back support may be suggested when the floor is not slippery. If the floors are extremely slippery, recommend the use of a mobile shower commode chair or wipe the floor dry.

ACL 2.8

If the person grabs onto a caregiver's arm during bathing, offering an empty shampoo bottle may be an acceptable alternative. The size needs to fit into the palm of their hand and a cylinder shape is the easiest to grasp. Of course, bright or contrasting colors always work the best.

Assistance with dressing includes placing the garments beside them and cueing to the openings for their hands and feet. They will need assistance to open buttons, zippers and Velcro or magnetic fasteners.

Uncomfortable clothing may be removed. Protect the person's dignity with clothes that fasten in the back or at the side. Another possibility is a jump suit, which requires assistance to remove.

The person requires assistance and constant supervision to complete their self-care activities.

Within ACL 2 High, the person needs assistance with eating, drinking, toileting, bathing, and dressing. Caregivers are required to plan, guide and assist with all activities of daily living.

For people functioning in ACL 2.8, safe objects will need to be provided during self-care activities as a form of distraction.

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

Simple few word commands are understood like "come here", "eat" and "shower".

Taste preference is also very individualized. 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 colors are noticed in ACL 2 High when their vision is intact. There should only be one subject with a bland or blurry background.

Busier pictures maybe ignored as the information is not processed.

Familiar furniture are vaguely recognized and items can be mistaken. When there is too much information present, confusion or ignoring the visual cues may occur.

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.