Goal: Maintain comfort • Reduce stiffness • Support circulation • Prevent pain • Reduce agitation • Maintain dignity

• Sessions must be very short: 3–6 minutes
• 100% hands-on assistance
• Only one step instructions
• Slow, gentle, predictable movements
• No standing or walking unless physiotherapist approved
• Comfort, safety, and calmness come first
• Stop immediately if uncomfortable, frightened, or tired

These movements are caregiver-guided and keep joints from tightening.

• Support elbow and wrist
• Gently lift arm up and down
• Repeat 5 times each arm

• Bend and straighten the elbow slowly
• 5 times each side

• Open/close the hand
• Move each finger gently
• 5–10 repetitions

• Bend knee toward body
• Straighten slowly
• 5 times each leg

• Support foot
• Circle ankle gently
• 5 times each direction

Purpose: Prevents stiffness, reduces pain, supports mobility.

Very soft, slow, caregiver-assisted.

• Tilt head slightly to each side
• Hold 2–3 seconds

• Straighten leg, flex foot gently
• Hold 3 seconds

• Lift arms slightly outward
• Hold 3 seconds
• Return slowly

Purpose: Avoids contractures, improves comfort, helps posture.

This is extremely important for Stage 6.

Choose one:

Small circular motions with lotion.

Very light rhythmic tapping, 20–30 seconds.

Caregiver holds shoulders and gently rocks side to side.

Move hands/arms gently in rhythm to soft music.

Purpose: Reduces agitation, calms anxiety, improves emotional connection.

Helps reduce distress and regulate mood.

• “Breathe in… 2… out… 3…”
• No forcing, just calming
• 3–4 slow breaths

Soft, slow instrumental or hymns can help synchronise breathing.

Purpose: Reduces anxiety and sundowning symptoms.

Short and simple:

• Gentle passive range of motion (3 minutes)
• Hand/finger activity

• Leg movements + ankle circles (2–3 minutes)
• Sensory activity (hand massage)

• Shoulder and neck stretch
• Calming breathing (1 minute)

Consistency helps reduce agitation and discomfort.

• Stop if there is pain, fear, or resistance
• Never force a joint
• Keep movements slow and predictable
• Speak softly and reassure (“You’re safe… I’m here…”)
• Support joints fully
• Use pillows for comfort and positioning
• Best done after toileting or after a calm activity

• Prevents pressure sores
• Reduces risk of contractures
• Improves comfort and sleep
• Helps digestion
• Lowers agitation and behaviours
• Encourages emotional connection
• Maintains dignity and mobility for longer