1. ‘Losing the books of life’
Buijussen .H (2005) Simplicity of Dementia

2. How memory disappears - Buijssen

3. Carl Rodgers : Person Centred Approach (1951)
Empathy
Congruence
Unconditional Positive Regard
(Lorna Coulson – Plymouth Based Person Practitioner (

4. Dementia Detectives
We need to use empathy to communicate with a person who struggles with expressing words
They may use muddled words
They may be slow to talk
They may walk over to something
They may be agitated.
We can be most helpful when we try to work out what they need rather than being dismissive.

5. Empathy exercise – how would you feel if you were not heard?
With a buddy Tell the person beside you where you last went on holiday Use only gestures and no words The only sound should be the person guessing

6. Self regard Do people with dementia have good self regard?
What words do they use about themselves?
People with dementia have low self regard – stupid, burden.
Focus on what the person is good at.

7. Congruence or genuineness
Congruence Rogers describes a ... “congruent, genuine and integrated person”. ..who does not either intentionally or unintentionally hide behind a façade or front; that he or she actually is the person they are feeling themselves to be at the time.” (Person Centred Approach South West website )
Act out scene in ward meal time.

8. Unconditional Positive Regard (or unconditional acceptance)
Clients with dementia may not be valuing themselves, as they feel they are losing sense of self, losing control. As workers we can counteract this by honest caring acceptance. Again, be careful what you say as so often people understand more than we know.
Wollop on the head.

9. Genuineness Tell me of a time where you came across
Someone who was not genuine?
When was it?
How did you feel about them?

10. Puzzling Behaviours Aggression Agigitation Crying Shouting
Night time waking

11. Scenerios In groups, see if you can :
Find out what the trigger behaviour is
Where might the person be in lifespan
What strategies can we use to calm the person ?
Give out scenerios – Mabel etc

12. Repetitive Movements May rock backwards and forwards,
Calling out the same sound or word ‘help’ ‘take me home’
Have excessive hand activity, constantly wrings their hands, pulls at their clothes, taps or fidget – try to get out of bed
Have periods of physical inactivity during which the person remains still, with their eyes open but not focused on anything

13. Older people often need less sleep than younger people
Dementia can affect people’s body clocks

14. Suspicion

15. Hiding or Losing things
People with dementia sometimes hide things and then forget where they are – or forget that they have hidden them at all.
The wish to hide things may be due to feelings of insecurity and a desire to hold on to what little the person still has.

16. Trailing & Checking
Living with dementia makes many people feel extremely insecure and anxious. This can result in the person constantly following their carers or loved ones around, or calling out to check where they are.
A few moments may seem like hours to a person with dementia, and they may only feel safe if other people are nearby.

17. Wandering/ restless
Pacing up and down – Pacing may indicate that the person wants to use the toilet but is unable to tell you. Try asking the person whether they need to use the toilet, or lead them towards it. If they are adamant that they want to pace, try to find somewhere they can walk safely.
Become restless because they need more physical activity
Mix night and day

18. Crying & shouting out They could be in pain or ill
may feel lonely or distressed
If the person shouts out at night, a nightlight in the bedroom may be reassuring

19. Tips Don’t take it personally
Try to stay calm and don’t enter into an argument
Show them you are listening
Try to distract them
Give them space if they become violent
Walk away if needed
Triggers ??
Signs

20. Attachments
Anxious people may need to be reassured many times. This may be …
Verbally
Sensing the space, people and surroundings
Touch and comforting
Visual prompts
Special Objects
Comfort blankets -

21. Security and end of life
People with advanced dementia can be complex to work with.
They may have ‘young’ needs but we can be criticised if we are infantilising
It is a tricky path to walk.
Buijssen talks honestly about this in
‘ The Simplicity of Dementia’

22. Use touch, to hold, to stroke gently, to achieve eye-contact, to try to make them smile, to soothe them when they cry and to make sure they are comfortable.
Getting to know someone in end-stage dementia requires us to use these same set of skills.
We need to recognise that we are caring for someone who has a long life behind them and many stored memories and experiences. If we can find a bridge into these memories we can find a way into nurturing the spirit at this final stage of life.

23. Naomi Feil: “Empathy builds trust, reduces anxiety, and restores dignity” (2012) The Validation Breakthrough Communication Breakthrough with Gladys