Senior Gems® Guides How Caregivers Care for seniors with Alzheimer’s & Dementia

The Senior Gems® created by Senior Helpers®, is based on the Gems™, techniques, strategies, and overall approach to care which was created and developed by Teepa Snow, Positive Approach, LLC. The Senior Gems® is one way Senior Helpers ensures your loved one is in good hands. The Senior Gems® is a classification system using gems to compare the different stages of dementia. The gems are used as a metaphor to define normal aging and the many appearances, behavior changes, skill sets and needs of those living with the effects of neurocognitive failure (dementia) or other brain changes. The Senior Gems® is also used to train and prepare caregivers to engage in activities that seniors at each stage of dementia can do. These gem categories, from Sapphires to Pearls, enable trained caregivers to assess, prepare, and engage with seniors who exhibit the symptoms of dementia.

Senior Gems® Sapphires

Sapphires like to choose the activities in which they participate. They are still aware of their own interests and what they enjoy.


  • Normal aging, and may feel depressed due to changes associated with aging.
  • There are no significant changes in cognition.
  • Can learn new things, but takes time, effort and practice to do so.


  • Ask what they would like to do and let them decide. Spend time doing one of their favorite things.
  • Pamper them with something like a spa day or a trip to the barber / beauty shop to make them feel a little less “blue”.

Senior Gems® Diamonds

Diamonds like to feel competent and valued, and it is important for them to feel comfortable and in control.


  • Can do old habits and routines, and prefer the familiar. May have difficulty with change.
  • Becomes rigid especially under pressure.
  • Repeats self by telling the same stories and asking the same questions.


  • Have lunch or dinner at a familiar place, such as at home or at a restaurant.
  • Attend a concert or play. Get some fresh air by walking or chatting on the porch.

Senior Gems® Emeralds

Emeralds are most comfortable when doing familiar tasks. They like to engage, help others, and want to feel like they have a purpose.


  • May get lost in their past life, places and roles.
  • May have problems with communication and comprehension asking who, what, where, and when often.
  • Loses or misplaces important things and may become afraid and accusatory.


  • Use social preferences to choose activities. Choose favorites of the past, but do limit the amount of time doing the task to not overwhelm them.
  • Perform a familiar task together. Cook a meal, go fishing or make jewelry.
  • At a family meal, engage them to help set the table and clean up. Keep gathering small to minimize increased level of stress.

Senior Gems® Ambers

Ambers like to manipulate, gather and touch things. When thinking of an activity, think of things that would be sensory stimulating. They also enjoy what is familiar.


  • Focused on sensations (touch, feel, smell, etc.).
  • Gets into things.
  • Impatient.


  • Select activities that allow them to use their senses like sorting fabric squares, or watering the garden and picking flowers. Be aware that they may not do what is expected so being flexible and calm is key.
  • Enjoy a sing-a-long or musical program or go to a place that is visually interesting.

Senior Gems® Rubies

Rubies like rhythmic movements and actions and may be fascinated by watching others and checking things out. They like to pick up, hold, carry, rub, or grip things.


  • Fine motor skills are lost or stop in the mouth, eyes, fingers and feet.
  • Limited visual awareness.
  • Can move forward but can’t back up safely. May need help to get going.


  • Go for a short walk, if capable, to a park where people, birds, and animals are to listen to the sounds. Use caution as Rubies can fall easily.
  • Give them something soft, like a stuffed animal, to hold and nurture.
  • Sing, hum, or sway with them.

Senior Gems® Pearls

Pearls like pleasant sounds and familiar voices. They also like to feel warm and comfortable.


  • Not aware of the world around them.
  • Hardly moves.
  • Problems swallowing.
  • Hard to get connected.


  • Spend time reading or talking about good memories. They might not understand the words, but the voice soothes.
  • Brush their hair and apply lotion to their hands.

SENIOR GEMS® is based on GEMS™, techniques, strategies, and overall approach to care which was created and developed by Teepa Snow, Positive Approach, LLC GEMS and POSITIVE APPROACH are trademarks of Positive Approach, LLC. SENIOR GEMS® is a registered trademark of Senior Helpers®.


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