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Dementia

Dementia. A Privilege. 1. 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

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Dementia

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  1. Dementia • A Privilege 1

  2. Types of Dementia • Alzheimersalteration 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

  3. What is Dementia • 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) 3

  4. There is always a reason • 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. 4

  5. 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

  6. 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

  7. Actions there is always a reason • 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) 7

  8. Visual Spatial Muddle • 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 8

  9. Strange behaviourDifficult behaviour to who? • 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 afantasy? • Unwillingness to ‘cooperate’ may be due to fear eg showers may not have been used in their childhood 9

  10. SITUATIONS that can precipitate agitation or confusion • Unfamiliar People • Unfamiliar Surroundings • Large Gatherings • A Task that is too complicated • Noise Lights • Travel • Illness 10

  11. 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

  12. When agitated • 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. 12

  13. Whencaring • 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 13

  14. Feelings remain when facts are forgotten • Exit strategy • Absent people • Affirming statements • Reasons to sit SPECAL explained in Contented Dementia No need to tell lies 14

  15. 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)

  16. Carers family or others • 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 16

  17. Extra resources • Just put into google • Alzheimer’s Society • Somerset Dementia • Gloriousopportunity.org

  18. Dementia • Always a reason • Feelings remain • Patterns continue 18

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