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DEMENTIA INFORMATION SESSION. Terezie Holmerova – Westminster Dementia Adviser Housing & Care 21. Introductions. Name + any experience of dementia?. Objectives. By the end of this session, you should: U nderstand what dementia is and how it affects people
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DEMENTIA INFORMATION SESSION Terezie Holmerova – Westminster Dementia Adviser Housing & Care 21
Introductions Name + any experience of dementia?
Objectives By the end of this session, you should: • Understand what dementia is and how it affects people • Have a clear picture of all the main types of dementia including alcohol related dementia • Feel more confident about communicating and engaging with a person with dementia
Facts • There are 850,000 people with dementia in the UK • There are 40,000 younger people with dementia • There will be 1 million of people with dementia in the UK by 2025 • 1 in 14 people over 65 has dementia, and 1 in 8 people over 80 • 1 in 8 people with alcoholism - W.K syndrome
Symptoms • day-to-day memory • concentrating, planning, organising • language • visuospatial skills • orientation • mood changes
Hyppocampus – factual memory, logic and reason, attention • Amygdala – feelings, emotional memories
What causes dementia? • Alzheimer’s disease • Vascular dementia • Mixed dementia • Dementia with Lewy bodies • Frontotemporal dementia • Alcohol related dementias
Alcohol related brain damage: Wernicke-Korsakoff syndrome • caused by severe deficiency of thiamine (B1) • most commonly caused by alcohol misuse but also malnutrition, HIV, anorexia • alcoholics: lack of thiamine + poor diet + alcohol interferes with the ability of the body to store vitamines (damanged stomach and liver lining) • affects younger people than A.D. and V. D • can be treated and halted
Wernicke’s encephalopathy • develops suddenly • nystagmus • ataxia • confusion, drowsiness • medical emergency, requires intravenous injection of vitamin B1, 20% die, 85% of survivors develop Korsakoff syndrome
Korsakoffsyndrome • develops if K.E. untreated but also gradually • short term memory loss, ability to learn new skills • lack of insight • confabulation • changes in personality
Alcohol significantly increases risk of other, more common dementias!
Communication – practical aspects • Make sure that the person can see you clearly • Make eye contact • Minimise competing noises • Avoid asking too many direct questions • Try not to ask the person to make complicated decisions • You may need to speak at a slightly slower pace, • Don't talk about people with dementia as if they are not there or talk to them as you would to a young child
Never stand too close or stand over someone to communicate, drop below their eye level. • Don’t interrupt them even if you think you know what they are saying • Try not to finish their sentences, look for cues • If the person says something you know to be incorrect, try to find ways of steering the conversation around the subject rather than contradicting them directly. Try to see behind the content to the meaning or feelings they are sharing.
Tom Kitwood • founder of ‘person-centred’ approaches - ‘personhood’ • Dementia equation: D = NI + PH + B + SP D= Dementia NI = Neurological impairment PH = Physical health B = Biography SP = Social psychology
Disempowerment – not allowing the person to use the abilities they have
Labelling – using category such as ‘dementia’, ‘organic mental health disorder’ as the main basis for interacting with the person and for explaining their behaviour
Outpacing – providing information, presenting choices at a pace too fast for person to understand
Invalidation – failing to acknowledge the subjective reality of the person, and especially what they are feeling