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Reaching Beyond the Shadows… An Overview of Dementia

10th Annual Michigan Traffic Safety Summit. Reaching Beyond the Shadows… An Overview of Dementia. Macomb County Department Senior Citizen Services Presented by Karen D. Bisdorf Kathryn Ann W. Kozlinski. Aging In America.

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Reaching Beyond the Shadows… An Overview of Dementia

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  1. 10th Annual Michigan Traffic Safety Summit Reaching Beyond the Shadows…An Overview of Dementia Macomb County Department Senior Citizen Services Presented by Karen D. Bisdorf Kathryn Ann W. Kozlinski

  2. Aging In America • 1 in 10 Americans have a family member with a cognitive impairment • 1 in 3 knows someone with dementia • 2002 - 4.5 million 2010 - 5.1 million • Census now 65/85 85/105 105/115 • 2030 the baby boomers will have turned 65 • 7.7 million persons will present with a dementia-related illness in the US

  3. What is Dementia? • Dementia is an umbrella term • The loss of mental function two or more areas of the brain Language, memory, judgement, personality, or visual–spatial comprehension.Severe enough to interfere with daily life. • Damage causes the death/malfunction of brain cells.

  4. Alzheimer’s Disease Lewy body dementia Vascular dementia Stroke - CVA Multi-infarct dementia Medication imbalance Alcohol/drugs Korsakoff’s Syndrome Parkinson’s Disease Tumors Head injury Nutritional Environmental If it affects the heartIt may affect the brain Dementia Related Illnesses

  5. Ages 10 percent Over 65 years 45 per cent Over 85 years 60 percent 90 years and over Phases Beginning 3-5 years Middle 8-13 years Late 1-3 years Prevalence of Dementia No cure – insidious - progressive disease 2-21 years diagnosis to death 8-12 years hands on caregiving needed

  6. Profound memory loss Misplacing things Abstract thinking Difficulty with routine tasks Change in mood & behavior Language skills Loss of initiative Disorientation time/ place Poor or weak judgement Personality changes Warning Signs

  7. Driving Appearance of DUI Traffic Violations Traffic Accidents Erratic Driving Wandering 60 – 20% Lost and Confused Walking & Driving Endangered Adult Critical Incidence False Reports Home Invasion Theft Misplaced items Shoplifting Victimization Scams, Schemes, Swindles Abuse & Neglect Sexual Misconduct Indecent Exposure Circumstances in Which You May Encounter a Person With Dementia

  8. Macomb CountySenior Assessment Request • Endangered adults • False reports • Victimization • Abuse or neglect • Unsupervised activities • Community service referrals

  9. Communication Guidelines • Approach from the front when possible • Approach with respect • maintain their dignity • Introduce yourself • call them by name if possible • Maintain eye contact • establish some type of rapport • Speak in slow distinct tones

  10. Encounter Tools • Look for physical and medical needs first • Look for a medical alert or ID bracelet • Pay close attention to mood & emotion • Easily redirected if not agitated • Allow as much space as possible • Avoid backing them into a corner • Environmental noise & bright light areconfusing

  11. Communication Tools • Be clear about your expectations • Project the feeling that you assume they can and will do what you ask of them • Request their assistance • Don’t order or demand • Don’t push or pull • Walk beside • Direct with gestures • Instructions one at a time

  12. Communication Tools • This is a disease of emotions • Control the emotional environment • Maintain control-they will mimic you • Don’t argue • There is no logic- they can’t follow your reasoning • Don’t try reorientation to time & place • Find out where they are in time • Work at that level • Do not lie • Ask them non-threatening questions

  13. Signs of Unsafe Driving • Forgetting how to locate familiar places • Failure to observe traffic signals • Slow or poor decisions in driving • Driving at inappropriate speeds • Becoming angry or confused while driving • Night blindness • Being uncomfortable on the road

  14. Restricting a Driver • Family doctor may write a “do not drive” prescription • Family maintain control access to the car keys • Disable the car - remove the distributor cap or battery • Park the car on another block or in a neighbor’s driveway • Discuss unsafe driving practices with insurance agent • Encourage family members to keep a record of their observations to share with person, other family members and health care professionals

  15. Why Do People Wander • Restless - Bored • Confused about time and place • Change in physical environment • Over stimulated environment “getting away” • Argument with caregiver • Fear caused by delusions or hallucinations • Medication side effects • Sundowning a biological clock

  16. Endangered Person • These persons are not “missing” • They are “endangered” • Time is of the essence • Do they have an ID bracelet? • Are they registered in the Alzheimer’s associations safe return program?

  17. Endangered Persons • Won’t knock on doors Won’t flag you down • They won’t answer if you call their name • They don’t think they are lost • They may not stand out in a crowd • Will be drawn to water, ditches, culverts • Will walk in the snow shoeless & coatless • Check the immediate area first • Then go to old familiar places • They wander on foot, by car, and by boat

  18. Survival Rates • 50% chance to find them alive in the first 16 hours • That percentage drops by 10% each hour they are lost • 46% of those found dead died of hypothermia or dehydration

  19. Safe Return Program • SRP provides identification products • ID bracelets/necklace /key chains • 24 hour hotline • Registration in National data base • Access to law enforcement agencies • Direct connect to nationwide Alzheimer’s Association offices

  20. Safety and Care Tips • Impaired person’s can’t be left alone or unattended in waiting rooms, offices or vehicles • Automatic car windows can be dangerous • The person should sit next to the driver, not alone in the back seat of cars without protection locks

  21. Rapid AssessmentLook, Listen and Test to determine the risk • Look • Body Language: • Clenched fist, staring or hyper-vigilance, inappropriate facial expressions, posture, red face • Psychomotor Activity: • Pacing, wringing hands, rapid breathing, clenched teeth, ballistic movements • Physical Appearance • Blank facial expressions, Inappropriate clothing, disheveled

  22. Rapid Assessment • Listen • Speech content • What is the person talking about, who is the person talking to, are they responding to real people and events. Do they have a legitimate gripe. • Speech organization: • Is the person fluent, does he/she jump from one topic to another, can he follow a conversation • Test • Receptivity: • Can you connect with the person, are they going to cooperate, do they react to their name, will they follow simple directions

  23. Good Judgement • Rapid assessment is completed in a matter of moments and does not guarantee freedom from risk, or the potential for a catastrophic reaction • Trust your gut • Get a history when possible • What medications are being taken • History of child or spouse abuse • History of violence during disputes

  24. Referral Resources • Michigan Department of State • Request for Driver Evaluation • Form OC88 • Elder Referral-Request for Individual/Family Assessment • Macomb County Senior Citizen Services • Adult Abuse Hotline • Adult Protective Services (APS) • Request for Investigation • 800.996.6228

  25. Information or Assistance • Macomb Co. Department of Senior Citizen Services • 586-469-6313 • Macomb Co. Adult Day Service Program • 586-466-6817 or 586-469-5579 • Alzheimer's Association -Greater Michigan Chapter • 800-621-0379 • Alzheimer’s Association 24/7 Helpline • 800-337-3827 • Alzheimer’s Safe Return Nationwide Program • 888-572-8566

  26. Information or Assistance State of Michigan Insurance Commission Traffic Associations of Michigan Offer driving assessments and safe driver classes Duke Family Support Program, Durham, NC 800-672-4213 North Carolina Division of Aging 919-733-0440

  27. Resources At the Crossroads, A Guide to Alzheimer’s Disease, Dementia and DrivingPublication # 105013 The Hartford, Hartford, CT. 06115 We Need to Talk, Family Conversations with Older DriversPublication # 105924 AARP /The Hartford Driving for Life, A Guide for Older Drivers and their FamiliesPublication # BBBB 000 Michigan Secretary of Statewww.michigan.gov/sos

  28. Resources • Alzheimer’s Association • Safe Return Program • Law Enforcement Official Training book • Publication # PF 203z • Safe Return Video Law Enforcement • Safe Return Program Applications • English Chinese • Korean Polish • Russian Spanish • Vietnamese

  29. Resources Michigan Area Agencies on Aging Handout Michigan Directors of Services to Aging Handout AARP www.aarp.org AARP Life Answers www.aarplifeanswers.com National Institute on AgingP.O. Box 8250 Silver Springs, MD 20907-8250

  30. Comments Questions? Concerns? Thank you for the opportunity of speaking with you today

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