Within ACL 4 Low, many people can state the amounts for a few highly important and large amounts, e.g. monthly disability check, rent. Those amounts are often the only amounts that they can tell anyone. They may not know the prices of most of the goods and services that they receive. In these circumstances, caregivers usually must assist with managing finances and provide a daily allowance. Assistance is usually required to manage on-going, long-term, and unusual monetary transactions.

Within ACL 4 Low, the person often enjoys the opportunities to make small routine purchases in familiar shops or to cooperate with assistance for other purchases. They are apt to walk a short distance to familiar shop locations, note price of articles, hand over cash and look at their change.

The following suggestions have better credibility when the behavior is observed in the neighborhood where the person lives and carries out their financial transactions. Simulated environments are apt to be unfair because they over and under-estimate real-life environments. Legal decisions tend to place greater value on real-life observations.

The person recognizes medications by color, shape, size and number in the same sequence as seen in craft projects, but the colors are often muted in medications. One feature is remembered for ACL 4.0 and 4.2; two features are remembered for ACL 4.4; The person is often regarded as being non-compliant with their medication taking within ACL 4 Low. When information is not stored within their working memory, poor medication compliance can be seen as a biological limitation and not an unwillingness to be compliant with their medication.

Within ACL 4 Low, the following home safety features can be recommended:

• Prevent climbing to reach light bulbs, high cupboards, wash windows, etc.
• Prevent carrying items up and down stairs; recommend using a hand rail to minimize falls because balance may be wobbly.
• Install and maintain smoke detectors.

Within ACL 4 Low, attempts at house cleaning are usually restricted to a narrow pathway and the rest of the house is ignored. Without a housekeeper, the place is apt to become a health hazard in a couple of months. When the dirt is pointed to, the person will probably not be able to see the problem and say that they like it that way within ACL 4 Low.

Quick cleaning for basic hygienic safety may require assistance to select necessary tasks.

The person may be able to follow an established routine for obtaining food at usual times of the day (goes to dining room, familiar restaurant, grocery store, missions).

Within ACL 4 Low, the person is safest with cold meal preparation.

Meal Preparation with Assistance

Within ACL 4.4, the person might be provided with the opportunity to prepare well-learned dishes with assistance from caregivers to avoid harmful effects and solve new problems related to food preparation, storage and clean-up.

Given the opportunity, laundry can be sent out, hand washed, or done at home in a machine and the quality varies. These are common expectations that should be validated with observations.

Washing

A clothes hamper beside where they change clothes may help with the dirty clothes. If the clean clothes are to be put away, someone else will probably have to do it within ACL 4 Low. Re-wearing dirty clothes may occur when the person is not assisted in ACL 4 Low.

Household management tasks usually require daily assistance. Objects will need to be stored within sight of their work area.

The ability to transfer off various surfaces at will reduces the risk of pressure sores.

Caregivers will still need to check for pressure sores due to poor fitting shoes and other poor fitting items.

If the person has reduced sensation, caregivers will need to provide appropriate pressure care as the person is unaware of the secondary consequences of poor pressure care.