1. Life is a Highway & Every Mile a Memory Sharing life with individuals with dementia as a journey and not a destination

2. Life is a highway and Every Mile a Memory Taking a look at the journey of individuals with Dementia and those who travel the road with them.

3. What is Dementia? Dementia is a loss of intellectual functions of sufficient severity to interfere with a person’s daily functioning. It is not a disease in itself, but rather a group of symptoms which may accompany certain diseases or physical conditions

4. What is Alzheimer’s Disease A degenerative brain disease of unknown cause that is the most common form of dementia. Usually starts in late middle age or in old age. It results in progressive memory loss, impaired thinking, disorientation, and changes in personality and mood.(Dementia) It leads in to a profound decline in cognitive and physical functioning. It is marked by the degeneration of brain neurons and by the presence of neurofibrillary tangles and plaques containing beta-amyloid

5. Normal Brain Function Perception The brain is receiving information from our environment and all of our senses, what we see, what we smell, what we taste, what we feel, what we touch. Memory The brain then calls upon our memory to interpret those things. The brain cannot go to the next step if the memory piece is missing. Action Thought After interpreting the information, the brain then can have an appropriate thought and/or take action If the brain did not interpret the information at all or it interpreted incorrectly, the behavior may not be appropriate.

6. So… all actions/behaviors begin with a perception. Normal Traffic Patterns in the brain becomes disrupted when individuals have Alzheimer’s Disease. Normal Traffic Patterns

7. Traffic Patterns in Individuals with Dementia The “roads” or pathways are damaged and eventually are closed to traffic.

8. Roads/Pathways are closed due to the formation of plaque and tangles Perception – Memory - Action Neurons inside the brain of someone with Advanced Alzheimer’s Disease Information cannot be received properly A memory cannot be formed or interpreted Consequently the behavior may not be appropriate

9. A Digital Map of the Aging Brain could aid the diagnosis of Alzheimer's disease Brain scans of normal older adults were compared to brain scans of individuals with Cognitive Impairment. The atlas was able to pinpoint changes in patients brain structure that can be an underlying sign of Alzheimer's Disease

10. Our brain – The Super Highway Our brain is like a super highway, full speed ahead, merging traffic, passing lanes, traffic jams and the occasional rest stops.. For those individuals with Alzheimer's disease, the brain changes, the superhighway shuts down and avenues that were familiar may now become a dead end. They may have to explore alternate routes

11. Alternate Routes Taking the alternate route may feel strange and awkward at first An alternate route may take longer at first. The more the route is taken the easier it will become The alternate route will become familiar as long as the directions stay the same

12. Using Procedural Memory as the Alternate Route Also known as Implicit or the "know how memory” Knowing how without being able to explain how. Procedural memory remains robust in the face of early memory loss and even into dementia. This means that a task or activity that has been repeated or practiced over and over can be remembered.

13. Life is a Highway..I want to ride it all night long. Entering the world of Dementia

14. This is going to be a difficult journey. I will need help and understanding from those who are taking this ride with me. Alzheimer’ s Dementia

15. The Driver The Resident The driver may not be able to go as fast as he/she would like to go. The driver may be fearful of getting lost on this road less traveled. The driver may know that regardless of their driving skills, they may have to stop now and then and ask for directions. The driver may become frustrated and angry and this may lead to “road rage”

16. The Road Map The life story Every individual has their own road map This road map is their personal history. The map shows where they have been, what they have seen, the places and the things they have enjoyed and the people they have met along the wa y. Every Mile a Memory!!

17. The GPS The Care or Support Plan The GPS will keep the driver and the co-pilot on track even when they miss a turn, or take the wrong exit. A plan that is up to date A plan that is adjusted as new roads open A plan that shows not only highways but rest stops and construction zones. A plan that shows speed limits and other conditions that could change the course.

18. The Co-pilot (Family and Staff) The driver should have an understanding co-pilot. The co-pilot can take over when the driver starts to feel tired. When the driver is exhausted they know they can let someone else drive for a while. The Co-pilot should be following the same GPS as the driver. The Co-pilot recognizes when the vehicle is “overheating”, knows when to stop and allow the vehicle to “cool off” The Co-pilot always needs to be willing and able to learn new ways and not be afraid to try a new road, when the road on which they are traveling becomes bumpy.

19. Knowledge – Knowing the way Getting an understanding of what lies ahead on this journey Before you can be a co-pilot and get behind the wheel you will need some driving education. Knowledge is Power. Knowledge is the fuel needed to keep moving forward. Without knowledge you may simply run out of gas. – You should top off your tank daily by reading an article, watching a short video, taking a class, or talking to an individual with dementia or their family. – As your knowledge grows, your confidence builds and you will be better prepared to handle the curves ahead.

20. 10 Early Warning Signs of Dementia 1.Memory loss that disrupts daily life 2.Challenges in planning and problem solving 3.Difficulty completing familiar tasks 4.Confusion about dates and time 5.Trouble with spacial images 6.Word finding difficulties 7.Misplacing things and loss of ability to retrace steps 8.Poor judgment – more vulnerable 9.Withdrawal from social events 10.Changes in mood and personality

21. Early Stages of Alzheimer’s Dementia One Way – Their Way!!!  Mild Cognitive Impairment  Use old habits and routines to get by  Cover up their mistakes  Get angry at others  Fears getting “found out”  Likes being valued  Likes to tell old stories  Likes to let you know who they are and where they have been  Likes to give to others  Does not adapt well to change Teepa Snow; gems of caregiving

22. Early to Middle Stages of Alzheimer’s Dementia They believe they have the “Right of Way” and don’t want “back seat drivers” telling them what to do !! Depression is common Cognitive loss may only be noticed by family and close friends Repeats or skips steps Fears being disrespected Gets lost in time and space Mis-remembers, so makes things up to fill in the holes Wants to be in the action Wants to help or supervise Makes mistakes in social settings Wants to talk about the past Repetitive questions and stories Teepa Snow; gems of caregiving

23. Middle Stages of Alzheimer’s Dementia CAUTION: Not always aware of danger or risk SAFETY BECOMES AN ISSUE ! In the moment Into touch, fiddling and “getting into stuff” Not aware of the “big picture” Not aware of how their actions affect others Like what they like and avoids what they don’t Always in motion All about exploration All about sensations Change in reasoning skills Dis-inhibition Withdrawal from social events Teepa Snow; gems of caregiving

24. Middle to Late Stages of Alzheimer’s Dementia FULL SPEED AHEAD OR STOPPED Seldom stays still unless totally exhausted Big movement – loss of fine motor skills Repetitive words Repetitive actions and movement Word soup Loss of depth perception Startles easily May not remember names of family members or friends Teepa Snow; gems of caregiving

25. Late Stages of Alzheimer’s Dementia Moments of Clarity !! Limited Movement Reactions can be extreme Needs stimulation Limited awareness of the world around them Responds to tactile stimulation Changes in sleeping patterns Slow to respond Teepa Snow; gems of caregiving