Trends in Aging: Exploring final, late stage dementia

By Wendy McHaney
July 11, 2014 at 2:11 a.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 five stages - sapphire, diamond, emerald, amber and ruby.

This next series of columns will explore the final, late stage of dementia, also known as the Pearl stage, with this column focusing on how to provide care for a pearl.

Providing care for a pearl can be difficult since a pearl's muscles are always turned on. A common mistake caregivers can make at this stage is to become so focused on taking care of the shell that we forget what is inside. The following are some tips on caring for a pearl:

• Don't be in a hurry to get a task done. A pearl can get frightened since they don't understand what you are doing, and injuries can occur. Also, give a verbal or visual cue, then allow up to 30 seconds for a response.

• Check for the presence of grasp reflex. If grasp reflex is still present, they will be able to grab your arm while you are trying to provide care and can potentially cause an injury since they no longer have the ability to release their hand. It is often helpful to put something safe in their hand to grasp so they won't grasp you.

•  Hum and sing to get the brain active. This can help a pearl to relax and for their muscles to relax. Their relaxed muscles will give you the ability to lift their arm a little and do what you need to do without hurting them.

• Use only one hand at a time when providing care. Using two hands can be overwhelming since it may cause them to have two sensory experiences at once. Use one hand for the task and one for the connection, like placing a hand on their shoulder

•  Start care from the back of the body. The main muscles are in the back, so there is less of chance for injury when providing care by starting there.

•  Use increased energy if you want them to rouse and be alert and a calm voice if you want them to relax and sleep.

The next column will address making connections with a pearl.

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

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



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