Stamps can come in all shapes and sizes. There are many clear stamps on the market too which may be found in craft shops. Larger easy to grip stamp handles also helps those who are functioning in ACL 3.0.

Walking and other movement information still attracts the person's attention. The person will enjoy walking freely and following a path. Make sure that there are sturdy chairs for them to sit on to have a rest and that the path is protected from harsh weather.

Functioning in ACL 3.0, the person will enjoy having a trolley or cart to push. Make sure the item is sturdy.

Objects the right size for grasping takes time to locate but is definitely worth the effort. As an example try unwanted used shampoo bottles which are gender appropriate may attract the person's attention. What other objects can you find?

Also try tools with a good handle that the person can grasp with a gross palmer grip.

Ribbon wands with a nice thick handle which may be flicked around may also be used with supervision.

Creating affirmative activities may seem difficult for people functioning at ACL 3.0 as it may seem that there is so little they can do. But once you realize and accept what they can't do and focus on what they can do, you soon realize you can create activities to fill their days with joy.

Because the person is usually incontinent in this mode, continence care with regular toileting routines is important for the person and other people's comfort.

When a person can pick up and let go of objects, the objects which are available need to be safe and appropriate for the person to grasp and release. Objects which require a gross grasp work best. Finding a gross grasp handle object takes time and effort but is well worth it.

The fact that we know so much about self-care and mobility and so little about activities is embarrassing. Our ignorance has contributed to over sedation in nursing homes.

There are usually a few staff members who are accustomed to thinking about these people as if they were mannequins. The idea that these people can enjoy a quality of life may be silently dismissed as ridiculous. Within ACL 3.0, people do not have wide smiles and joyous expressions of enthusiasm. Their demonstrations of pleasure are subtle, and it will probably take months for some jaded staff members to catch on. The first things to point out are decreases in troublesome behaviors, sleeping through the night, and only sleeping during nap times.

Activities that can be done while seated make it easier for visitors to engage them in doing activities when they come to visit. Visitors are a neglected resource with unknown potential. The development of visitor's books and records of participation are a top priority because we need to find out what can realistically be done by supporting their efforts. As far as I can tell, the only people watching all of the televisions in the nursing homes are the visitors, which seem like a waste of important resources.