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What does Ruby mean to you?

In my world, as a Dementia Consultant, a Ruby means so much more than just a shiny red gem that sits on my finger or a flashing red stoplight in traffic.

To me, a Ruby means mid-to-late stage dementia, where the person is still able to enjoy life, but others stop seeing what they're still capable of. Someone who may have a loss in visual skills, problems with chewing and swallowing, or problems with balance and coordination might be in the Ruby Gem Stage. They are still able to walk, watch others to follow visual cues, and love music. They can pick up, hold, carry, push, wipe, grip, squeeze, pinch and slap things. The last three actions (squeezing, pinching and slapping) all may happen if you don’t approach someone in the Ruby stage in the "right way." If you startle them, you'll trigger their amygdala, which will set off their fright, flight and fight automatic responses.

To help someone in the Ruby Gem State be successful, they'll need you to structure their day and create a supportive environment where their world is familiar, functional and safe. You'll need to slow down with words and actions, give them time to process what you are asking them to do. Take the time to get in the visual regard of your loved one living with dementia and say their name and greet them to get connected before you do anything else. A rule of thumb that people need to remember when caring for those living with dementia is "relationship first, your agenda second." Don’t push them if they are resistant because they don’t understand what you are wanting them to do or just simply do not want to do it. The more you push, the more likely they are to push back and not end in the positive outcome that you want.

Ultimately the main mission when caring for Rubies is to make their life happy and joyful. They can be very social and respond well to others with social chit-chat or light conversation. Enjoy your time with them, share stories, sing songs together or go for a walk together. Just don’t count a Ruby out, make sure you use the right system to connect with them and slow down so they can process, participate and contribute to their wellbeing and understanding of the world around them.

If you believe you know someone in the Ruby Gem State, remember the following:

  1. Don't stop recognizing what they are capable of.

  2. Remember their slower speed doesn't equal zero speed. Please wait for them to respond because they do not like when people take away or assume their ability.

  3. Use the practice "hand under hand" contact to better help your loved one understand something. This will connect the dots from what you're asking them to do and what they should be doing when you show them using their own hands.

For more information or questions about the different processes and characteristics in the Ruby Gem Stage or Trublu Confidence in Dementia Care please go to to message a Dementia Specialist today.

Copyright 2018 to 2020, Trublu Confidence in Dementia Care

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