GREAT Cognitive Rehabilitation

The GREAT CR process can be divided into 5 stages:

1. GREAT CR assessment: establishing the person’s current level of functioning

Talk to the person with dementia, and family/care supporters if available, about the current situation and how the person with dementia is managing.

• • Get to know the person

  • Understand what the person currently can or could potentially do

  • Discuss the areas of everyday life where the person would like to see improvements

  • Get a clear idea of what exactly causes difficulty in these areas

2. GREAT CR goals: defining clear therapy objectives

Together with the person with dementia and family/care supporters, if available, agree goals for GREAT CR. Using the SMART criteria (Specific, Measurable, Attainable, Relevant, Time-limited) when formulating the goals will help you pin down all the necessary details, like the exact outcome and timeline of the work.

3. GREAT CR plan: developing a personal therapy plan

To plan GREAT CR you will need to understand the person’s current level of ability, and what makes a particular activity difficult. Then you can decide which GREAT CR strategies might be most suitable to assist the person in achieving the goal. Key areas to consider are:

• • Are there any problems that need attention before you can focus on the goal?

  • What activities are involved in achieving the GREAT CR goal?

  • What exactly makes the goal-related activities difficult?

  • Can the GREAT CR plan build on the person’ usual ways of coping??

  • Could family/care supporters help in applying the GREAT CR plan?

  • What GREAT CR methods could help in achieving the goal?

4. GREAT CR: Carrying out the plan

Support the person with dementia in working on the goal in line with the plan. Start by completing initial ratings of attainment and outlining the therapy plan using the GREAT CR templates. There is also a set of handouts you can use to support the process.

5. GREAT CR: Evaluation and re-assessment

Review progress and adapt the plan if the chosen strategies are not working well. When you reach the end of your agreed time for working on the goal, re-assess attainment to see how much progress has been achieved.