1. Sheryl Bagshaw, MBA, SSW, CVW Certified Dementia Practitioner Cognitive Interventionist

3.  How do I deal with his/her behavior?  How do I get through to him/her?  What is the trick to understanding dementia?

4.  How do I communicate with someone with dementia?  How do I deal with behaviors?

5. BEHAVIORS

6.  Managing negative behavior using a learning behavior model that includes triggers, behaviors, and consequences (reinforcement or punishment)  Relies on manipulating triggers, setting boundaries, and providing reinforcements  May affect identity and self-esteem  Assumes specific cognitive abilities such as awareness, judgment and reasoning

7.  Is the demented person aware of his/her behaviors?  Can the person with dementia manipulate his/her own behaviors?  How disruptive is the behavior?  Is it ok to allow the individual to be demented?  And, most importantly…

8. Whose Behavior Needs to be Managed? OURS!!!

9.  Not listening  Impatience – the more you hurry, the more time it’s going to take  Arguing – Join their journey  Not explaining  Expecting them to act/behave a certain way (Allow them to be demented) (They are not in our world – we are in THEIRS)  Trying to get them to do something that is not their idea

10. Need-Driven Behavior Approach And Validation

11.  Normal needs + abnormal conditions = disruptive behavior  Uses the environment and individual strengths/preferences to meet and prevent unmet needs  Assumes that behaviors are not abnormal, deliberate, or good/bad  Behaviors do not need to be resolved, needs do and then behaviors will cease BASICALLY…

12. NEEDS! Look for the NEED and you will know how to respond to the behavior!

13. Maslow’s Hierarchy of Needs: Act. Esteem Love/Belonging Safety/Security Physical

14. Medical Needs: Physical Care Needs: PAIN Constipation Infection Oxygen Blood Sugars Sleep Disturbances Med Interactions Hot/Cold Hungry/ Thirsty Continence Tired Over/Under- Stimulation Movement

15. Safety/Security Needs: Safety/Security Looking for a family member Thinking they are being poisoned Thinking people are stealing Want to go home Hiding things Feeling unsafe/paranoid Unsure of others Locking/barring doors Elopement risk

16. Love/Belonging Needs: Love/Belonging Space invaders Use a lot of physical touch Sexually inappropriate In the middle of everything

17. Esteem Esteem Needs: Looking for something to do Ask if they can help Pick up familiar items In the middle of everything Negative self-statements

18. Self Actualization Needs: Act. Looking for something to do Ask if they can help Pick up familiar items In the middle of everything Negative self-statements

19. Validation Empathy Reminiscence

22. The best way to explain VALIDATION is by using examples of some of our communication failures with demented individuals and showing how we can use validation to improve them.

23. 1. Arguing with them Example: Day of the week Validation: Don’t Argue! “WE are in THEIR world” – it only frustrates them when we try to bring them back to ours. Method: Ask questions

24. 2. We approach them wrong and/or don’t communicate Example: Moving a resident Validation: Approach is everything. “Be on their level.” Method: Eye contact, Empathy

25. 3. Reassure them/don’t let them express emotions (sympathy vs. empathy) Example: Patient wanting to leave (blocking the entryway) Validation: Allow them to safely express emotions. “The cat ignored becomes the tiger.” Method: Empathy, Need

26. 4. We assume we know the problem and how to fix it Example: Resident angry about his money. Validation: Look deeper “Look for the need.” Method: Reflective listening, Ask the extremes

27. 5. We fail to see the world from their view. Example: Patient who needs a brief change. Validation: Perception is reality. “It has to be his/her idea.” Method: Look for the need

28. 6. We lie to them Example: “Where is my husband?” Validation: Therapeutic Lies are harmful “Demented individuals have it within themselves to solve their own issues.” Method: Ask ?’s, Reminisce

29. 7. We bombard them with information Example: Doctor’s appointment Validation: Keep it simple, overstimulation is not good “Overstimulation, like boredom, causes anxiety.” Method: Matching, ambiguity

30. 8. We expect them to remember things Example: “You remember…” Validation: Keep self-esteem intact. “Has there ever been a time when...” Method: Reminisce

31. 9. We don’t stimulate them Example: Henry Validation: All individuals have worth and deserve our attention. “Music is to the soul what words are to the mind.” Method: Reminisce, music

33. 10. We don’t listen to the non-verbal Example: Gladys Validation: Communication is 70% non-verbal. “Please hear what I’m not saying.” Method: empathy, music, touch, eye contact

35. Communicating with someone with dementia is about: 1. Accepting their realities 2. Listening 3. Validating their experiences 4. Sharing their emotions 5. Simplifying your communications 6. Looking for the need 7. Asking for their input 8. Providing appropriate stimulation 9. Reminiscing 10. Being honest/truthful with them

36. If you want to learn more about communication, Validation, and other dementia issues, you can access my website: www.dementiaassist.com (You can also find dementia assist on Facebook)