1. Dementia Slideshow Pictures
2. Alzheimer's Disease Slideshow Pictures
3. Take the Alzheimer's Quiz

Medical Author:

Norberto Alvarez, MD

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Bathing

1. Can independently carry out an appropriate bathing routine (disrobing, washing, drying, and dressing)
2. Can carry out an appropriate bathing routine with occasional reminders to do a step or wash more thoroughly
3. Needs verbal prompts to initiate and/or complete some steps in the bathing process (because of low-level confusion and/or fear), continuous staff supervision at shower time not necessary, may use toiletries inappropriately
4. Requires continuous staff supervision at shower time to ensure complete bathing and safety (for example, problems due to confusion and/or fear), hand-over-hand assistance may be necessary at times, alternatives to showering or a specialized program may be recommended because of fear of showering, safe use of hot and cold water needs monitoring
5. Primarily passive during bathing, requires some form of assistance for all steps, may be able to stand and move a body part when given a verbal or touch cue, fear of water may be present
6. Physically and cognitively unable to participate actively in bathing process, may respond to stimulation during bathing with vocalizations or changes in facial expressions

Dressing (skills and appropriate dress)

1. Dresses independently or with physical assistance due to handicap, can choose appropriate clothing (for weather or activity of the day) and cares for own clothing (for example, places dirty clothes in hamper, hangs clothing, stores properly)
2. Occasionally needs reminders to dress appropriately ("It's cold out today") and to care for clothes ("Remember where your dirty socks go?")
3. Dresses with minimal assistance or verbal prompts
4. Dresses inappropriately for weather (layers clothing and/or puts clothing on inappropriately), may undress at an inappropriate time and/or place, may benefit from adaptive clothing to retain dressing skills; makes no attempt to care for own clothing
5. Needs assistance in dressing (50% or more of task) and may be resistive; may assist when compliant (for example, puts arm through sleeve)
6. Lies passively during dressing; does not respond to dressing or undressing

Personal/oral hygiene (hair brushing, teeth brushing, sanitary pad, shaving)

1. Able to perform all personal hygiene tasks
2. Able to perform all personal hygiene tasks within regular routines, may show difficulty in performing tasks if routine is changed (for example, hospitalized, moved)
3. Able to perform all personal hygiene tasks but requires occasional reminders from staff to complete the task
4. Able to perform personal hygiene tasks but requires frequent reminders from staff to complete the task, may need staff guidance (verbal and point cues) in some parts of some tasks (for example, may forget steps), may still be proficient in one area and lose ability in another area
5. Requires staff supervision (verbal and point cues) to complete some personal hygiene tasks and staff assistance (light, moderate physical cues) to complete others
6. May still be able to perform some steps of some personal hygiene tasks with staff assistance but depends on staff to meet other personal hygiene needs
7. Depends on staff to meet all personal hygiene needs

Environmental awareness

1. Aware (cognizant) and responsive, in a relevant way, to familiar and unfamiliar people and other environmental stimuli
2. Generally responsive to familiar and unfamiliar people and situations but seems self-absorbed and/or confused most of the time
3. Cognizant and responsive in a relevant way to familiar people and situations but shows a delayed or inappropriate response to unfamiliar people and situations
4. Cognizant and responsive to stimuli, but response is often inappropriate, even in familiar situations
5. Mostly awake but seems self-involved, showing little or inconsistent response to the environment
6. Sometimes awake but shows little interest in surroundings, sleeps at other times
7. Sleeps most of the day, needs to be aroused repeatedly to maintain interaction

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