Within ACL 4 High, the person is rarely aware of having a memory problem. Without awareness, the idea of needing memory aids seems silly to them unless they have been taught to use them. Using aids for people with an obsolete identity may not make sense to them.

Some examples of aids are:

Standby assistance during exercises is required when the person has had a medical problem that has secondary consequences, e.g. hip and knee replacements, unhealed fractures, etc. They are not apt to comprehend the consequences, nor are they apt to follow precautions.

ACL 4.6

The person learns an exercise routine.

Splints can be taken on and off, but assistance tends to be needed for smaller adjustments.

The person may appreciate you incorporating your desired outcomes for joint mobility and strength into interesting functional activities.

Retraining on how to correctly use walking aids requires rote learning. Consistent training is required over a period of around a month. Regular reinforcement is required especially if there is a recommencement of the task after a break.

Non-Weight-Bearing Adherence

Within ACL 4 High, many people realize that their normal activity performance is impaired by a physical disability. They will usually cooperate with alternatives to walking.

Their learning of a transfer sequence with safety precautions is slow and by rote.

Much of occupational therapy's value has been dependent on knowledge about adaptive equipment that is readily available to the general public now. The general public does not know when the purchase of a piece of equipment is valuable or a waste of money. The following guidelines suggest when the use of a piece of equipment should be explored.

Adapted Bathing

A demonstration along with numerous repetitions is required to learn a safe transfer technique.

The impairments associated with a physical disability are regarded as an addition to a cognitive disability.

Driving is a contested issue in ACL 4 High. Driving has followed the example of psychometrics and broken the activity into a variety of mental processes. Thinking about the brain as a total unit guiding the activity would bring processes into the same three mental processes of captured attention, information processing speed and sustained attention. Captured attention seems to be dominated by visual perception with the most hazardous and routinely difficult element in ACL 4 High being making turns across the flow of traffic.

The person may use rote learning to learn a new public transport route. They will require someone to provide several demonstrations and accompany them on a new route. Once they are familiar with the route they can independently use this system of travel until something unexpected occurs. A back up way of acquiring assistance such as using a smart phone (well charged) is required, otherwise they will become confused and anxious.

Being able to hold an image in their working memory results in the person scanning the environment to assist with their orientation. They will scan the environment to avoid stepping in front of traffic and other busy pedestrians.

While ambulatory, someone will need to cue them to alter pace and redirect their attention when they become distracted. Most people must be accompanied to prevent getting lost outside of the immediate neighborhood.

If they get lost, they rarely know how to retrace their steps to reorient themselves.

Transportation is a generic category for moving about in the community.

When the person is left alone, access to a telephone is important. Land lines in some geographical areas are connected with emergency services with the address of the caller posted on each service's screen. Dialing 911, 000 or 999 will bring help if the person can reach the phone.

Portable alarm buttons that people can wear and notify services if the person is unconscious are currently available but expensive. Portable buttons that require being conscious to push the button are not as expensive.