2. Supporting People with Dementia

3. How to use this Power Point Start and end with a time of introspection or prayer if that is what you are used to (some are included at the end of this power point). Spending time sharing in teams about a particular individual might be helpful. Be as interactive as possible. Give people time to give examples or share knowledge that they have.

4. Introduction Those who have dementia will teach us a whole different way of being with each other. They may require more support than we are able to provide. The disease presents slightly differently in each individual but there are some commonalities

5. The following information is from A presentation by Pamela Singleton, Kathy Johnston and Dianne Hope of York South Association for community Living.They have given permission to adapt for our use. The Down Syndrome Scotland Website

6. Before Assuming Someone has Dementia Do The Following The conditions on the following pages are usually treatable. Therefore it is of utmost importance that a thorough medical assessment be completed before a diagnosis of dementia is made. A gerontologist may be the most appropriate person to do this.

7. Other conditions that may mimic symptoms of dementia Abnormal Thyroid function Infections Pernicious anemia Adverse drug reactions Acute physical illness Diabetes Cardiac Abnormalities Sleep apnea Depression Constipation Hearing /vision losses Multiple Stokes Recent bereavement

8. Risk Factors  Down’s Syndrome - Ages 40-4911% - Ages 50-5970% - Ages 60-6990% - Over 70100%  Family History  Age

9. Effects of Alzheimer's Disease 1. Mental Abilities 2. Emotions and Moods 3. Reactions 4. Physical Abilities ** Alzheimer’s Disease does NOT affect the person’s ability to appreciate, respond to & express feelings such as joy, anger, fear, love or sadness!

10. The Three Stages: Stage 1 MentalMild forgetfulness, difficulty in learning new things, problems with orientation, communication difficulties, limited attention span. EmotionMild mood shifts, depression ReactionPassiveness, withdrawal from usual activities, restlessness PhysicalMild co-ordination problems

11. Stage 2 MentalMemory problems, forgetfulness about personal history, inability to recognize friends/family, disorientation, gets lost easily EmotionsPersonality change, confusion, anxiety, paranoia, sadness/depression, hostility/aggression ReactionRestlessness, repetition, delusions, aggression, uninhibited behaviour, extreme passiveness, crying and screaming PhysicalAssistance required for daily tasks, disrupted sleep patterns, appetite fluctuations, language difficulties, visual spatial problems, frequent falls

12. Stage 3 MentalLoss of ability to remember, communicate or function, inability to process information, severe speaking difficulties, severe disorientation to people, time and place EmotionsPossible withdrawal, limited facial expressions ReactionsIncoherent muttering, non-verbal methods of communicating (eye-contact, crying, groaning) PhysicalBedridden, aspiration, prone to pneumonia and bedsores, loses ability to speak, complete incontinence, unable to dress/ bathe, weight loss

13. Remaining Strengths Awareness of memory and emotions Ability to use senses (smell, touch, taste, hearing) Ability to remember well-learned skills Long-term memory Sense of humor Music Appreciation

14. Communication  Finding ways to be communicate is crucial in maintaining our relationship with someone who has dementia.  Communication is a two way street. I am communicating with the other person and they are communicating with me.  The following are some suggestions for facilitating communication both ways.

15. Communication From The Person Listen with your ears and heart Don’t take things said personally Don’t argue Don’t reason Don’t confront Don’t remind them they forgot Don’t question recent memory Do agree with them then distract/redirect them Do accept the blame if something is wrong Do use touch

16. Communicating To the Person Face to face Eye contact Speak slowly and clearly Calm, gentle approach Use short sentences Allow natural breaks and periods of silence One message at a time Repeat the message Use actions, along with words Use humor and cheerfulness

17. Other Things That Facilitate Communication  Belief—that every person, regardless of abilities, maintains a core of self that can be reached.  Creativity—in expressing both your feelings and your message.  Understanding—of the effect of the disease on communication  Patience—to slow down, listen, watch, wait for a response, repeat a phrase.  Skills—to convey the message or feelings effectively

18. Always Remember That we all communicate by emotion, expression and touch. Holding a hand, or smiling when talking can convey more than any words. That feelings remain despite the losses caused by Alzheimer Disease. Feelings may be the only way an individual understands what is going on.

19. Always Remember To be aware of your body and facial expressions. Harsh glances can be just as negative as harsh words. To include the individual. It is painful to be ignored because of your difficulties in communicating. From “Day to day Communication” from Alzheimer Society

20. Factors To Consider That Might be Increasing Symptoms Medication Stress Time Confusion Basic Needs Restlessness Lack of recognition Fear Past Behaviour

21. Some Typical Challenging Behaviors Sundowning & Shadowing Agitation Anger Catastrophic Reactions Confrontation Paranoia Depression Eating Forgetfulness Hoarding Hygiene/Bathing Incontinence Dehydration Repetitive questioning Wandering

22. Where To Get Help  Most often the people best able to respond to questions, make suggestions and provide support are your local Alzheimer’s Society.  Down Syndrome Scotland has helpful information as well including a booklet for explaining dementia to other people with intellectual disabilities. www.dsscotland.organization.uk

23. Don’t Forget That the understanding, compassion and care we show those who have dementia is teaching us new ways of being with each other.

24. Some Prayers O Lord look with favor on your people, and impart your love to us- not as an idea or concept but as a lived experience.We can love each other only because you have loved us first. Let us know that first love so that we can see in all human love, a love without conditions and limitations.

25. May the power and the mystery go before us, to show us the way, Shine above us to lighten our world, Lie beneath us to bear us up, Walk with us and give us companionship, And glow and flow within us to bring us joy. Amen Judith Walker-Riggs

26. Loving God, We thank you for the gift of life and love. Thank you too for all the seasons of life: for birth, for youth, for adulthood and for old age. Help us to know that no matter what season we are in, we are all loved and valued by you. Help us, as well, to trust always in you goodness, for we ask this in the name of your son Jesus Christ who is alive and reigns with you and the Holy Spirit. Amen

27. Merciful God, you know our weakness and distress. Yet the weaker we are, the stronger is your help. Grant that we may accept with joy and gratitude the gift of this time of grace, and bear witness to your work in our lives.