1. New Hire Orientation Maria Freidlund, Administrator
Dementia
New Hire Orientation
Maria Freidlund, Administrator

2. Dementia What it is; What it isn’t The brain Strategies for employees
Practice

3. What it is; what it isn’t
Dementia
What it is; what it isn’t

4. Dementia Umbrella term describes multiple conditions
characterized by the gradual loss of intellectual functioning

5. Dementia Umbrella term covers: Alzheimer's Vascular Lewy bodies
Frontal Temporal
Parkinson’s
Huntington’s

6. Dementia Different from “Age Associate Memory Impairment”
Starts in late 20’s
Increases as you age
Around age 40 you fall off a cliff!
Age Associate Memory Impairment happens to everyone.

7. Dementia Text Book Definition: 1. Memory impairment, AND
2. One or more of the following cognitive difficulties:
Language difficulties (aphasia)
Impaired ability to conduct motor activities
Failure to recognize or identify objects
Disturbances in intellectual functioning
Such as planning, organizing and abstract thinking.

8. Dementia
Dementia in itself is NOT a disease
DISEASE

9. Dementia Dementia is a term for a cluster of symptoms Faulty reasoning
Difficulty remembering
Impaired judgment
Loss of communication skills
Failure to identify objects
Difficulty recognizing
Short term memory loss
Impaired motor activity
Loss of abstract thinking
Disorientation to time/place

10. Dementia
The Brain

11. The Brain: Parts of the Brain
Judgment & Behavior Memory Language Understanding (how to understand spoken language AND how to speak)

12. The Brain: Healthy vs Dementia

13. The Brain: the Hippocampus
“Memory Glue Guy”

14. The Brain: the Hippocampus
“Memory Glue Guy”
Filters through information
Determines what to keep that is important
Determines what is temporary (not so important)
Example of retaining what I had for breakfast this AM might remember tomorrow but goes away. Alz don’t recall

15. The Brain: What Remains?
Procedural memories
Deeply stored long-term memory
Automatic responses
Social rituals
Procedural Memories: Also known as ‘hand memories’ – folding, sorting, sanding, painting, etc.
Deeply-Stored Long-Term Memory: Often from childhood or young adult years.
Automatic Responses: Songs, hymns, prayers, poems, old sayings & proverbs – things repeated
many, many times over the years.
Social Rituals: Handshakes & hugs; passing food at the dinner table; etc.
Desire for Purpose: A strong need to be “good for something.” Daily tasks, broken into very
simple steps, often work well.
Individual Strengths: Examples: Sense of Humor; a Nurturing Spirit; Playing the Piano; Singing;
Artistic Abilities; etc.
<<flinch>>

16. Strategies for employees
Dementia
Strategies for employees

17. Strategies for Employees
Every impression is a first impression
Carefully monitor yourself
exaggerate facial expressions (big smile)
body language (warmth)
make eye contact
tone of voice (calm)
Remain below eye level
Treat every interaction as if it is your first
It may feel this way to the person

18. Strategies for Employees
Approach gently from the front
let them see you approach
never “sneak up” or startle
Offer physical contact
a handshake
hand over hand
a hug or kiss

19. Communication Strategies
Use good vocal quality –
Low and slow, loud and clear
Low pitch
Slow speech
Slightly louder
Very clear enunciation

20. Communication Strategies
Simple words
Use the 7&7 rule
Speak 7 words or less
Allow 7 seconds for them to respond
Concrete language - no jargon, no baby talk
(“It’s time for bed”, not “Let’s go beddy-bye”)
Use words the person has used in their lifetime

21. Communication Strategies
Fill in the gaps
If struggling for a word, suggest one
Prevent embarrassment when language or memory fails (they try to cover it up!)
Use positive wording - not negative
Not: Don’t grab someone else’s wheelchair
Instead: Let’s go further ahead so you can grab the railing.

22. Strategies for Employees
Resident Choice and Dementia
Use statements instead of questions
Re-approach, don’t force
Example:
It’s dinner time so you tell Joe Dementia, “It’s dinner time. (pause) Let’s go to the dining room.”
If Joe refuses, walk away, re-approach.

23. Strategies for Employees
DON’Ts
Ban this Phrase: “DON’T YOU REMEMBER?”
Don’t you remember me?
Don’t you remember, it’s time to eat?
Quizzing residents about recent events
Don’t you remember your family was just here?

24. Practice Pair up with another person
Tell them your plans for the evening
Non-verbal skills for cueing - Pointing, Placing, Hand-over Hand
Low and slow, loud and clear
7 simple words, wait 7 seconds
Can ask a question (“Do you like…” not “Do you remember…”)

25. Dementia
Review

26. Dementia Review What is Dementia? What Happens in the Brain
An umbrella term
A cluster of symptoms
Not a disease in itself
What Happens in the Brain
Gradual erosion
Hippocampus - “Memory Glue Guy” starts to let memories go

27. Dementia Review Communication Strategies Positive non-verbal cues
Choose simple words
Speak 7 words; wait 7 seconds
Low and slow, loud and clear
Remember