The Family Assessment Form and the Behavior Profile are guides designed to assist you in determining the level of need for your loved one. After you have completed these forms, feel free to send via mail or fax to the attention of Chris Braley, Braley Care Home’s licensed clinical social worker. He will be happy to discuss the results of the assessment tools and any other concerns you may have. The Pre-Admission Resident Assessment Form is required for admission to Braley Care Homes. It must be filled out by the resident’s physician within 60 days prior to the date of admission to the facility.


You can print and mail or fax the forms to our office at:

Braley Care Homes
6192 US 60
Hurricane, WV 25526

Fax: (304) 201-3678

Stages Of Dementia

Learn more about the Stages of Dementia and how Braley Care Homes can help. Braley Care Homes use the Global Deterioration Scale, which has seven stages. The three stages below are a condensed version.

Mild

    • Denial is dominant defense mechanism
    • Reads a passage or a book and retains relatively little material
    • Blame others for stealing lost items
    • Repeat themselves
    • Arrives at wrong time or place
    • Forgets why they went to the store
    • Has multiple late notices for bills
    • Lost interest in hobbies or activities
    • Unwilling to try new things
    • Easily taken advantage of, such as giving large sums of money to strangers

Moderate

    • Five minutes or less of functional short-term memory
    • Becomes lost if away from familiar surrounding
    • Wander around streets, perhaps at night, sometimes becoming lost
    • Neglectful of hygiene and/or eating
    • Forget names of family or friends, or confuse one family member with another
    • See or hear things that are not there
    • Forgetfulness is creating unsafe environment, such as leaving gas unlit or food on a stove
    • Can’t remember visits even though the visitor just left
    • Can’t follow written signs, write name, add or subtract

Severe

    • Loose ability to understand or use speech
    • Incontinent
    • Little or no recognition of friends or family
    • Needs assistance with eating, washing, bathing, toilet and dressing
    • Aggressive tendencies, such as attempting to hit the person next to them
    • Requires assistance walking, or confined to a wheelchair
    • Looks in mirror and talks to own image or becomes afraid