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Adaptations:
Participants who have a Neurocognitive Disorder Alzheimers:
The updated version of the DSM-5 replaced the term dementia with neurocognitive
disorder due to the definition of the word dementia, meaning mad or insane. An
individual who has a neurocognitive disorder displays cognitive deficit. One specific
Neurocognitive disorder, known as Alzheimers, is characterized by plaques forming in the
brain. The plaques destroy brain cells, creating progressive deterioration of higher cognitive
functioning in the areas of memory, problem solving, and thinking. This activity could be
adapted for a participant who has Alzheimers by making it failure free, if one of the topics does
not produce a memory or something the individual can talk about, remind him/her that it is ok
not to share on each topic. Keep the activities simple and decision making to a minimal, this can
frustrate an individual with Alzheimers, as well as keeping the crowds and noise to a minimum.
Provide both verbal and visual instruction, as well as select around the best time of day for the
individuals, when it is seen that they have more energy. It is important to adapt the activity to
establish a routine with this and take turns.
Participants who have had a Traumatic Brain Injury:
A traumatic brain injury is a form of acquired brain injury that occurs from a direct
trauma to the brain and can be classified as mild, moderate, or severe. Individuals are classified
as having a mild traumatic brain injury if they receive a score of 13-15 on the Glasgow Coma
Scale (GCS) and experience headache, fatigue, sleep disturbances, irritability, sensitivity to
noise or light, balance problems, decreased concentration or attention, decreased speed of
thinking, memory problems, nausea, blurry vision, dizziness, depression, anxiety, emotional
mood swings, and/or seizures. A traumatic brain injury is classified as moderate when there is
loss of consciousness, along with persistent confusion and functional impairments in one or more
of the cognitive, physical, emotional, or behavioral domains, along with a GCS score of 8-12
and is classified as severe when there is prolonged unconscious state or coma with a GCS score
less than 8. (Porter, "38. Traumatic Brain Injury.", 2015). This activity would be best to be
utilized with individuals who have had a mild or moderate brain injury.
To adapt this activity to the individual would be to allow for the speed of the activity to
be slower paced. Be sure to provide frequent breaks. The facilitator should be sure to use a
gentle, slow tone when talking to participants and due to communication issues, the facilitator
can provide nonverbal cues to alert the participant when he/she is going off the topic of the
question. Provide individuals with calendars, notes, and phone calls to increase attendance and
participation. Try to refrain from using abstract or general terms when describing something, as
well as provide an example or a relatable activity that the participant may easier identify with. Be
aware of individuals with sensitivity to loud noises, and adapt the balloon popping to piercing a
small hole into the balloon and slowly letting the air out.
Adaptations References:
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