Comprehension of Concrete Actions

For a 99-year-old, 'Comprehension of Concrete Actions' primarily shifts from initial learning to maintenance, re-acquisition (post-stroke or injury), or adaptation to progressive cognitive changes (e.g., dementia). The goal is to support functional independence, effective communication, and engagement with daily life activities.

Our selection of the 'Constant Therapy' application is guided by three core principles for this age group and topic:

1. Functional Relevance & ADL Integration: At 99, understanding concrete actions is most critical when it directly impacts Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Constant Therapy offers customizable exercises that simulate real-world scenarios, such as following steps for preparing a meal, dressing, or participating in a conversation, directly addressing the practical application of action comprehension.
2. Multi-Modal Support & Redundancy: Given potential age-related sensory (hearing, vision) and cognitive (attention, memory) changes, tools must provide information through multiple channels. Constant Therapy excels here by integrating visual cues (images, text), auditory instructions, and interactive prompts (touch, drag-and-drop), providing redundant pathways to comprehension and allowing for compensation if one modality is impaired.
3. Cognitive Scaffolding & Errorless Learning: To prevent frustration and maximize success, tasks need to be broken down, progressively challenging, and offer immediate, supportive feedback. Constant Therapy's adaptive algorithms automatically adjust the difficulty of exercises based on performance, offering scaffolding that is precisely tailored to the individual's current capabilities. This minimizes errors and builds confidence, which is vital for maintaining engagement in cognitive rehabilitation.

Implementation Protocol for a 99-year-old:

• Initial Assessment: A speech-language pathologist (SLP) or occupational therapist (OT) should conduct an initial assessment to identify specific deficits in action comprehension and set personalized goals. This informs the customization of the app's exercises.
• Device Setup: Ensure the tablet is set up with a simple, clear interface, large text settings, and optimal screen brightness/contrast. Good quality noise-cancelling headphones are crucial for auditory clarity.
• Supervised Introduction: Begin sessions with a caregiver, family member, or therapist present. Introduce exercises gradually, starting with simpler tasks and clear, consistent verbal instructions.
• Short, Frequent Sessions: Optimal engagement for older adults is typically achieved through short (15-30 minute) but frequent sessions (daily or several times a week) to prevent fatigue and reinforce learning.
• Contextualization: Connect the in-app exercises to real-world actions. For example, if practicing sequencing steps for making coffee in the app, follow up with a supervised attempt to make actual coffee.
• Feedback & Reinforcement: Provide positive reinforcement for successful completion. The app provides immediate feedback, but verbal encouragement from a helper enhances motivation.
• Regular Review & Adjustment: The SLP/OT should regularly review progress data from the app and adjust exercise parameters as needed to ensure continued challenge without excessive frustration. The caregiver should monitor for signs of fatigue or disengagement and adjust session length accordingly.
• Accessibility Aids: Utilize an ergonomic stand for the tablet and a stylus if manual dexterity is an issue.