“Lives with spouse in a one story home with 4 steps to enter…”sound familiar?  A key element of a comprehensive evaluation is establishing a clear and objective prior level of function.  As therapists, we utilize this information to help guide our clinical decision making, formulate an individualized plan of care, establish functional goals, support the medical necessity of therapy services, and guide our therapeutic interventions. 

For a person living with Dementia, admission to a rehabilitation facility can bring great fear due to change in environment, change in caregivers and deviation from their normal routine.  Due to fear, pain, confusion, these residents may resist participation in traditional care approaches.  How do we overcome this barrier?  Looking beyond the traditional prior level of function may hold the key. 

Regardless of the stage of Dementia, each individual brings with them a lifetime of experiences, preferences, and ways of being in the world.  Using knowledge of meaningful interests, hobbies, key life events, specific family members, friends, work history, favorite foods, etc., provides the best opportunity to build rapport with a resident and can significantly improve their engagement in care.  If a person places a high level of importance on personal appearance, never leaving the home without makeup and pearls, knowing this information and ensuring these items are attended to daily can make all the difference in boosting confidence and increasing wiliness to get out of their room and go the therapy gym.  If a resident has a special interest in music or mechanics, learning ways to incorporate these elements into your treatment sessions will be more meaningful to the individual better capturing their attention.  Learning what is important to a person can go a long way in in helping reach the desired therapeutic outcomes.

As you complete your initial evaluation, and as part of ongoing treatment, I encourage everyone to explore beyond the facts of the prior level of function and learn about the person’s prior level of life!