Trends in aging: Alzheimer's and Dementia: Ruby Stage (Part I)

By Wendy McHaney
April 11, 2014 at midnight
Updated April 10, 2014 at 11:11 p.m.

Wendy McHaney

Wendy McHaney

Today's column continues through the Senior Gems approach to care, based on the Allen Cognitive Disability Theory. My previous columns discussed the first four stages - sapphire, diamond, emerald and amber.

This next series of columns will explore mid- to late-stage dementia, also known as the ruby stage.

A ruby was chosen to represent this stage because of the color red. In the stoplight sequence, red means stop. At this stage, fine motor in the mouth, eyes, fingers and feet stop. The following are some basic characteristics of a ruby:

•  More frequent falls because of the loss of fine motor skills.

•  Weight loss and skin problems because of difficulties eating.

•  Struggle with going from walking to sitting.

•  Vision has become monocular.

•  No longer get into things but like to carry things.

•  Sleep/wake cycle is destroyed.

•  May seem as though they are lost in the world.

At this stage of dementia, communication can be very difficult. It is difficult for a ruby to understand or comprehend what you are saying, and since they are losing fine motor skills in their mouth, their speech is difficult to understand.

However, because of the right side of the brain being preserved, social chitchat, rhythm and music will be very easy to understand. In communicating with a ruby, it is best to:•  Slow down your words and directions.

Not talk too loudly. Their hearing has not been affected by the disease, and talking loudly will make them want to turn away from you.•  Show and demonstrate.

•  Avoid a confrontational posture. Being at their side rather than in front of them will help a ruby feel at ease. Standing directly in front of them may feel confrontational since their vision has become monocular and they may feel trapped.

•  Use visual, verbal and touch cues. Use visual and verbal cues first to allow them to see and hear you and make a connection. Once the connection is made, then touch to establish a physical connection or help with a task.

Senior Helpers is presenting free workshops and support groups at Copperfield Village, 501 E. Larkspur Drive, every other Thursday morning from 10:15 a.m. to 11:15 a.m.

Call 361-894-8901 for more information about these workshops. Previous columns on the stages of dementia as well as other trends in aging can be found at

Sources: SH Franchising Senior Gems training materials

Wendy McHaney is a certified senior adviser and the owner and director of operations of Senior Helpers. For more information about Senior Helpers, visit



Powered By AffectDigitalMedia