Excess disability during morning care in nursing home residents with dementia

Excess disability was examined in 17 nursing home residents with dementia b y comparing their performance of morning care tasks under two activities of daily living (ADL) caregiving approaches-a dependence-supportive one under usual care and an independence-supportive one under functional rehabilitat ion. The results suggest that excess disability in severely cognitively imp aired and functionally disabled residents can be reduced by increasing oppo rtunities for independent activity, and substituting nondirective and direc tive verbal assists for physical assists. Further, the findings indicate th at increased independence in ADL can be achieved without increasing disrupt ive behaviors and can foster appropriate requests for task-related help dur ing caregiving. Functional rehabilitation, however, requires more time than usual care.