6 Dementia Different from “Age Associate Memory Impairment” Starts in late 20’sIncreases as you ageAround 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 activitiesFailure to recognize or identify objectsDisturbances in intellectual functioningSuch as planning, organizing and abstract thinking.
8 DementiaDementia in itself is NOT a diseaseDISEASE
9 Dementia Dementia is a term for a cluster of symptoms Faulty reasoning Difficulty rememberingImpaired judgmentLoss of communication skillsFailure to identify objectsDifficulty recognizingShort term memory lossImpaired motor activityLoss of abstract thinkingDisorientation to time/place
14 The Brain: the Hippocampus “Memory Glue Guy”Filters through informationDetermines what to keep that is importantDetermines 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 memoriesDeeply stored long-term memoryAutomatic responsesSocial ritualsProcedural 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 repeatedmany, 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 verysimple 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 DementiaStrategies for employees
17 Strategies for Employees Every impression is a first impressionCarefully monitor yourselfexaggerate facial expressions (big smile)body language (warmth)make eye contacttone of voice (calm)Remain below eye levelTreat every interaction as if it is your firstIt may feel this way to the person
18 Strategies for Employees Approach gently from the frontlet them see you approachnever “sneak up” or startleOffer physical contacta handshakehand over handa hug or kiss
19 Communication Strategies Use good vocal quality –Low and slow, loud and clearLow pitchSlow speechSlightly louderVery clear enunciation
20 Communication Strategies Simple wordsUse the 7&7 ruleSpeak 7 words or lessAllow 7 seconds for them to respondConcrete 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 gapsIf struggling for a word, suggest onePrevent embarrassment when language or memory fails (they try to cover it up!)Use positive wording - not negativeNot: Don’t grab someone else’s wheelchairInstead: Let’s go further ahead so you can grab the railing.
22 Strategies for Employees Resident Choice and DementiaUse statements instead of questionsRe-approach, don’t forceExample: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’TsBan this Phrase: “DON’T YOU REMEMBER?”Don’t you remember me?Don’t you remember, it’s time to eat?Quizzing residents about recent eventsDon’t you remember your family was just here?
24 Practice Pair up with another person Tell them your plans for the eveningNon-verbal skills for cueing - Pointing, Placing, Hand-over HandLow and slow, loud and clear7 simple words, wait 7 secondsCan ask a question (“Do you like…” not “Do you remember…”)
26 Dementia Review What is Dementia? What Happens in the Brain An umbrella termA cluster of symptomsNot a disease in itselfWhat Happens in the BrainGradual erosionHippocampus - “Memory Glue Guy” starts to let memories go
27 Dementia Review Communication Strategies Positive non-verbal cues Choose simple wordsSpeak 7 words; wait 7 secondsLow and slow, loud and clearRemember
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