Types of Dementia Alzheimers alteration chemistry/structure changes Vascular Dementia/stroke oxygen lack Dementia with Lewy Bodies in nerve cells Frontal lobe dementia personality/ behaviour Parkinson’s Huntington’s Multiple Sclerosis Motor Neurone Disease Korsakoff (alcohol) C-J-D HIV
What is Dementia 3 Progressive, not just memory loss or forgetting names, may not recognise people or things,may get lost Reduced attention span, ability to do things, understand or communicate increased agitation confusion Caused by amyloid plaques/tau tangles (‘rungs’ in communication ladders) increased inflammatory response (TNF)
There is always a reason 4 Every action has a reason Every communication has a purpose. What sounds nonsense is showing a need, expressing a feeling, or wanting a response. The meaning of words may be disconnected from their sound; so may not understand or may produce a word salad.
Questions Asking What time is it?, might mean “I have no idea what I am meant to be doing”. Asking Can I go home?, perhaps means “I do not feel comfortable ” Listen to the meaning behind the question
Dementia Time Travel May think it is 1960 when X not born Y not married Z still alive Children have to learn social skills In dementia lose social inhibitions do not always ignore or accept May have ‘comforter’ be aware
Actions there is always a reason 7 Wandering may have a purpose or be responding to an hallucination. Sleep patterns may get muddled not aware difference between am & pm. Might not recognise an item (fork) so not know what to do with it. Behavioural Patterns in Sundowning (memories work/childhood late afternoon)
Visual Spatial Muddle 8 Might not recognise self in a mirror and think it is someone else. May misjudge the edge of the table or bathroom furniture unless distinct/contrasting colours. Pouring liquids can be dangerous. May be frightened by carpets/floors
Strange behaviour Difficult behaviour to who? 9 Aggression often due to frustration misinterpretation of events such as reflections in windows or mirrors Incontinence can sometimes just forgetting to go Might not be able to distinguish dreams from reality. Don’t laugh or call them a liar, is it a fantasy? Unwillingness to ‘cooperate’ may be due to fear eg showers may not have been used in their childhood
SITUATIONS that can precipitate agitation or confusion 10 Unfamiliar People Unfamiliar Surroundings Large Gatherings A Task that is too complicated Noise Lights Travel Illness
see it from their perspective loss of blue purple green colour strange lighting busy patterns contrasts (puzzles, carpets, bathroom, food) walking, steps, feel as if falling visual barriers misidentification/misnaming misinterpretation/misperception
When agitated 12 Simplify/calm the environment Don’t ask questions or overwhelm with words Reassure, show what to do, make a cup of tea Too many people - take to a quieter place. Engage in a familiar activity, music, a walk.
When caring 13 Introduce yourself with context Approach from the front don’t tap on the back Show Respect, their name, how dress, do hair, how touch Involve...choice, (blue? not, which? jumper) Buttonless clothes / digital time Always leave with a smile
Feelings remain when facts are forgotten SPECAL explained in Contented Dementia 14 No need to tell lies Exit strategy Absent people Affirming statements Reasons to sit
Memories There are several ways to reach the same destination There are several ways to enter the same house Don’t give up when it appears the key is lost (neurons die)
Carers family or others 16 Younger family members may feel trapped, be fearful of their own future may even ‘run away’ Carers need a regular break to enable them to carry on can become exhausted /depressed / deny such / hide it well Suffer great guilt if unable to cope or cope badly This can add to their ‘grieving’ and they may be hypersensitive Don’t assume you know what they are going through
Extra resources Just put into google Alzheimer’s Society Somerset Dementia Gloriousopportunity.org
Dementia Always a reason Feelings remain Patterns continue Always a reason Feelings remain Patterns continue 18
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