Improved communication skills within ACL 4 High are apt to increase their vulnerability to con artists. Someone may need to protect them when large sums of money are involved; legal actions for conservatorship / guardianship are often necessary. Questionable family members and family conflicts are a frequent source for financial risks.

Within ACL 4 High, they can use rote learning to learn new ways to purchase items. 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 High, scanning the environment gets them into the shops and looking for desirable items at eye level. High and low items are apt to be missed.

Within ACL 4 High, they may be able to learn safety precautions to protect against theft. They are apt to turn items over to locate a price tag and size.

Varying their usual shopping routine, including visiting a new store or substituting a different brand for an unavailable product occurs spontaneously within ACL 4 High. The secondary effects will probably not be given a thought, even when pointed out.

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.

Within ACL 4 High, the person may be able to load daily pill boxes / dispensers. In ACL 4 High, the person has a better ability to take their medication at the right time using a daily pill box or other prepackaged device.

Liquids will probably not be accurately measured unless poured by someone else.

With psychotropic medications, better distinctions are needed between cannot and will not take their medicines. The mechanics of loading pill boxes may account for more non-compliance than is currently recognized by most doctors.

Within ACL 4 High, 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 High, 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 High, the need for house cleaning may be acknowledged and sporadic attention may be addressed to certain preferred areas.

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

Within ACL 4 High, rote learning provides for more variety in simple hot meal preparation, i.e. a can of soup or TV dinners.

Meal Preparation with Assistance

Within ACL 4.6, the person might be provided with the opportunity to prepare well-learned dishes. A demonstration along with rote learning is required for the person to learn new tasks. Caregivers will need 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.

In ACL 4 High, the person is more able to follow the steps required to complete household management tasks. They are able to scan the environment looking for supplies required to complete their household management tasks. They have more ability to apply more pressure to different objects though this maybe hitting it harder or longer which may result in breakage. The ability to read simple instructions and follow a checklist also improves their independence. They do however have difficulty understanding verbal and written instructions in unfamiliar activities.