Gayleen Bradley Certified Dementia Specialist

2. Presented by: Gayleen BradleyCertified Dementia Specialist

3. Learning Objectives Causes of Alzheimer’s Disease & Other Dementia Types Recognize the Symptoms Understand Behaviors Caused by Dementia Techniques to deal with behaviors

4. What is Dementia? • A decline in cognitive function or mental ability • Visual Perception • Reasoning & Judgment • Memory • Communication & Language • Ability to focus & pay attention • Difficult time carrying out daily tasks they had performed routinely throughout their lives

5. Fact about Dementia 5 Million in the United States 6th Leading Cause of Death 36.5 Million Worldwide 1 in 3 Seniors Die with Dementia 250,000 with Younger Onset

6. Dementia Clock Test Dementia Clock Test

7. Clocks - Dementia Perception

8. Causes of Dementia • A decline in cognitive function or mental ability • Visual Perception • Reasoning & Judgment • Memory • Communication & Language • Ability to focus & pay attention • Difficult time carrying out daily tasks they had performed routinely throughout their lives

9. Healthy Diet Quality Sleep Six Steps for a Healthy Brain Regular Exercise Stress Management Mental Stimulation Active Social Life

10. Types of Dementia

11. Types of Dementia Alzheimer’s • 60 to 80 percent of people have Alzheimer’s who have dementia • Symptoms are mild at first and get worse over the years • Short term memory is usually affected first

12. Types of Dementia Vascular • Caused by strokes • Symptoms can begin with poor judgment or trouble planning, organizing and making decisions Other symptoms may include • Trouble speaking or understanding speech • Problems recognizing sight and sounds that use to be familiar • Changes in personality and mood • Problems walking and having frequent falls

13. Types of Dementia - Irreversible Dementia with Lewy Bodies Lewy Bodies are microscopic deposits of a protein that forms in the brain Symptoms Include: • Problems thinking clearly, making decisions, or paying attention • Memory problems • Seeing things that are not there • Unusual sleeping during the day • Periods of blanking out or staring • Problems with movement • Dreams that you act out physically

14. Types of Dementia Parkinson’s Disease Dementia • People with Parkinson’s get this type of Dementia about 50 to 80 percent of the time • On average, the symptoms of dementia develop about 10 years after Parkinson’s • This type is very similar to Lew Body and experience the same symptoms

15. Types of Dementia Frontemporal Dementia Symptoms of FTD: • Personality and behavioral changes • Sudden lack of inhibitions in personal and social situations • Problems coming up with the right words when speaking • Movement and balance problems

16. Types of Dementia Mixed Dementia • This is a combination of two types of dementia • The most common combination is: • Alzheimer’s and Vascular

17. Reversible Reversible types of Dementia Toxic & Metabolic Disorders Depression Head Injury Alcohol Induced Medications Infections

18. Types of Medications

19. Alzheimer’s 10 Warning Signs

20. Know the 10 Signs Memory loss that disrupts daily life Challenges in planning or solving problems Difficulty completing familiar tasks at home, work or at leisure

21. Know the 10 Signs Confusion with time or place Troubles understanding visual images and spatial relationships New problems with words in speaking or writing

22. Know the 10 Signs Misplacing things and losing the ability to retrace steps Decreased or poor judgement Withdrawal from work or social activities Changes in mood & personality

23. Anatomy of the Brain

24. Health Concerns that can Cause Behaviors • Dehydration • Malnourishment • Depression • Infections - UTI • Pain • Sight and Hearing Problems

25. As Dementia Advances… Inability to understand what is being communicated to them. Too much stimuli is confusing and overwhelming. Lose ability to express their needs Lose ability to navigate their world.

26. Stages of Dementia • Early Stage • Feel they are having memory lapses • Forget familiar words or location of objects • Hard time with math & paying bills • Do not require any care at this point • Become moody or withdrawn

27. Stages of Dementia • Mid Stage • Losing objects • Becoming dangerous to leave alone • Forget where familiar stores are • Leave items cooking on the stove • Moderate • Can become suspicious • Losing track of time & day • Lose ability to initiate tasks like showing, changing clothes, remembering to eat

28. End Stage Stages of Dementia Trouble remembering to swallow Lose ability to walk without assistance Help with most or all ADLS Difficulty carrying on conversations

29. All Behavior Has Meaning Anxious – Worried & Uneasy Agitated – Upset & Distressed Aggressive – Hostile & Belligerent Abusive – Physically & Verbally Wandering - Walking aimlessly

30. Does the Behavior Need to Stopped? Does the behavior put the client at risk? Does the behavior put you at risk? Does the behavior put some else at risk? If the behavior is just annoying to you, it doesn’t merit you intervening.

31. Be a Detective • Last time they ate or drank? • Last time they went to the bathroom? • Do they wear glasses or hearing aides? • Is there too much noise around? • Are they tired? • Did they sleep well night before? • Are they comfortable? • Could they be in pain? • Is it time for medications? • Too cold or hot? • Need to be moved? • Are they out of their routine? • Are you new? • Are they bored? • Do an activity! The caregiver needs to find out what unmet needs are by being a good detective

32. Empathy – validate their feelings & read their body language Step into Their World Power of Touch Do not confront Don’t tell them NO! Don’t ever argue Make direct eye contact.

33. Redirect • Quickly change the subject • Change walking direction Techniques to Use • Triggers • Know their triggers & what soothes them • Favorite food or drink? • Pet Peeves • Life Story • What did they do for a living? • Where did they grow up? • Discuss family members Simple Choices Pick between two items

34. Techniques to Use • Physically Remove • Remove them from environment if necessary • Change Environment • Turn TV Off • Go for a walk • Go to different room • Intervene • Within 30 seconds • Calm • Stay calm • Don’t lose your patience

35. Apologize • Take the blame • Help diffuse the situation. • Relationship First • Relationship before task • Simple Questions • Ask simple open ended questions you know they can answer. • Clues • Give visual or verbal clues related to your requests. Techniques to Use

36. Communication Techniques • TONE OF VOICE • Friendly • Not bossy • SPEED • Slow • Not pressured • PITCH • Deeper is better

37. Communication Techniques • Task Breakdown • Give it one step at a time • ONLY ASK: “Are you ready to…” if you’re willing to come back later. • Short Message • Give a short message about what’s happening • Simple Choices • About what the person can do • Ask them to help • Ask them to help you do something • Will they try? • Ask if they will give it a try

38. Communication Techniques • Use Familiar Objects • Photo Albums • You will have same conversations again • Act interested and be friendly. • Friendly Interactions • Take it Slow • Talk to the person • Know Who the Person Was • Values • Who is Important to Them • They are doing the best they can! • Their tools are limited. • Don’t Correct their Stories • It’s their reality • They can’t come to yours • Acknowledge their Emotions • “I can see this makes you happy, sad, etc.”

39. Communication Techniques Be a detective and determine unmet needs. If what you’re doing is NOT working – STOP! Back off and give them space & time. Decide what to do differently 15 minutes later.

40. When is a bad time to ask? • Know when to ask if they want to do an activity. Techniques on Getting them to do an Activity • Variety of Activities • Know the types they like and have them available. • Start the Activity • You start and they will join in. • Ask for their help • Include them with your activities • Don’t ask, just do. • Begin the activity and bring them along.

41. All Tasks are Activities • Remember, any task you do with your client is an activity. Techniques on Getting them to do an Activity • Keep it Simple • Activities with just 1-2 steps • Mistakes Happen • Stay calm • Ignore them • Trial and Error • Try, try again. • Learn from your mistakes • Each client is different • Individualize your approach & activities • Evaluate, Learn & Revise • Look back on each interaction • Revise your approach.

42. Go for a Walk Games Photo Albums Make Cookies Listen to Music Fold Towels Puzzles Enjoy the Outdoors Feed & Watch the Birds Cut out Coupons Hold a Baby Doll Set the Dinner Table Newspapers & Magazines Types of Activities:

43. Moment by Moment