Teepa Snow, Dementia Expert, on understanding Alzheimers patient behaviors
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Dementia: Why Do They Do That? How Can I Help? When Do I Need Help? TeepaSnow.com 1 © 2010 Teepa Snow . All rights reserved. Use only with permission. Presentation at Home Instead Senior Care of Sonoma County sponsored Dementia and Alzheimer’s event, March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA.
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Teepa Snow, dementia and Alzheimer's expert, gave this presentation as one of several at an all-day caregiving workshop sponsored by Home Instead Senior Care of Sonoma County, located in Rohnert Park, CA. The event was held on March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA. About 100 people were in attendance including RPNs and CNAs. CEU credits were available. The event was sponsored by Home Instead Senior Care of Sonoma County and Brighton Gardens Assisted Living in Santa Rosa. Home Instead Senior Care of Sonoma County provides home care, personal care and companionship services to the seniors and the elderly in Petaluma, Santa Rosa, Rohnert Park, Sonoma, Windsor and throughout the County.
Transcript of Teepa Snow, Dementia Expert, on understanding Alzheimers patient behaviors
Dementia:Why Do They Do That?
How Can I Help? When Do I Need Help?
TeepaSnow.com
1© 2010 Teepa Snow. All rights reserved. Use only with permission. Presentation at Home Instead Senior Care of Sonoma County sponsored Dementia and Alzheimer’s event, March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA.
REALIZE …
• It Takes TWO to Tango …
or two to tangle…
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Being ‘right’ doesn’t necessarily translate into a good outcome for both of you
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It’s the relationship that is MOST critical
NOT the outcome of any one encounter
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As part of the disease people with dementia ‘tend to’ develop typical patterns of speech, behavior, and routines. These people will also have skills and abilities that are lost while others are retained or preserved. 5
What is it NOT…
NORMAL Aging• Slower to think• Slower to do• Hesitates more• More likely to ‘look
before you leap’• Know the person but
not the name• Pause to find words• Reminded of the past
NOT Normal Aging• Can’t think the same• Can’t do like before• Can’t get started• Can’t seem to move on• Doesn’t think it out at all• Can’t place the person• Words won’t come –
even later• Confused about past
versus now
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What Could It Be?
• Another medical condition• Medication side-effect• Hearing loss or vision loss• Depression• Acute illness • Severe but unrecognized pain• Other things…
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Alzheimer’sDisease
•Early - Young Onset•Normal Onset
VascularDementias(Multi-infarct)
Lewy Body Dementia
DEMENTIA
Other Dementias•Genetic syndromes•Metabolic pxs•ETOH related•Drugs/toxin exposure•White matter diseases•Mass effects•Depression(?) or Other Mental conditions•Infections – BBB cross•Parkinson’s
Fronto-Temporal Lobe Dementias
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Alzheimer’s
• New info lost• Recent memory worse• Problems finding words• Mis-speaks• More impulsive or indecisive• Gets lost• Notice changes over 6 months – 1
year9
Vascular Dementia
• Sudden changes• Picture varies by person• Can have bounce back & bad days• Judgment and behavior ‘not the
same’• Spotty losses• Emotional & energy shifts
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Lewy Body Dementia
• Movement problems - Falls• Visual Hallucinations• Fine motor problems – hands &
swallowing• Episodes of rigidity & syncopy• Nightmares• Fluctuations in abilities• Drug responses can be extreme &
strange11
Fronto-Temporal Dementias
• Many types• Frontal – impulse and behavior
control loss– Says unexpected, rude, mean, odd things to
others– Dis-inhibited – food, drink, sex, emotions,
actions
• Temporal – language loss– Can’t speak or get words out– Can’t understand what is said, sound fluent
– nonsense words12
What is Dementia?...
It is BOTH • a chemical change in the brain AND• a structural change in the brain
• So…Sometimes they can & sometimes they
can’t
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PET Scan of 20-Year-Old BrainPET Scan of 80-Year-Old Brain
PET and Aging
ADEAR, 200314
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Learning & Memory Center
HippocampusBIG CHANGE
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Understanding Language – BIG CHANGE 17
Hearing Sound – Not Changed 18
Sensory StripMotor Strip
White Matter Connections
BIG CHANGES
Formal Speech & Language
CenterHUGE CHANGES
Automatic SpeechRhythm – Music
ExpletivesPRESERVED
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Executive Control Center
Emotions Behavior JudgmentReasoning
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Vision Center – BIG CHANGES21
Positron Emission Tomography (PET) Alzheimer’s Disease Progression vs. Normal Brains
G. Small, UCLA School of Medicine.G. Small, UCLA School of Medicine.
NormalNormalEarly Early Alzheimer’sAlzheimer’s
Late Late Alzheimer’sAlzheimer’s ChildChild
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So… What is Dementia?
• It changes everything over time• It is NOT something the person can
control• It is NOT always the same for every
person• It is NOT a mental illness• It is real • It is hard at times
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Dementia can be treated
• With knowledge• With skill building• With commitment• With flexibility• With practice• With support• With compassion
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How to Get Started…
• Be Honest …• What is Going on NOW?• Get someone to help you look at it• Talk about ‘what is’ …– The GOOD– The BAD– The UGLY!
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Take Some Time To…
• Figure out WHO you are And• WHO your partner is…
• Similarities & Differences And • Respect Both Partners’ Needs
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Who Are You?... Your Partner?
• Introvert
• Logical & Reasoning
• Big Picture
• Plan it Out
• Extrovert
• Emotional & Feeling
• Lots of Details
• Just Do It
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Four Key Building Blocks
• Activities to Relax & Re-energize
• Activities to Feel Productive & Valued
• Activities for Fun & ‘Just Because’
• Activities to Take Care of Yourself28
Its all about BALANCE
• Some of each
• Not too much of any
• Get into a routine & stick to it
• With a little changing up
• And time in between to chill
• Some old, some new
• Some for me, some for you
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Things that will HELP…
• Build activities• Get active• Socialize• De-Stress• Get enough sleep• Get sleep apnea & depression treated• Control blood pressure & diabetes• Take meds CAREFULLY
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Some Specifics…
• Help to make new friends – form partnerships• Help keep the old – familiar contacts• Explore & create volunteer opportunities• Use old skills and routines in new ways• ‘Give it a try’ – offer more than once• Start low, go slow… build a little at a time• Consider a support group for talking about
changes• Get away from your partners… some• Build a WHOLE day – 24/7
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Care Partners…
• Be a partner, not a boss• Be an advocate, build a team• Do with me, not for me or to me…• Learn the ‘SO WHAT?’ philosophy…• Learn to let go not give up• Learn what you are good at, & what
not…• These ideas are for you TOO!
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Some Key Beliefs & Principles:
• All people need to be needed – nurturing is a critical part of life worth living
• Dementia Steals Away Roles and Responsibilities that Make Us WHO We Are
• Activities can make a critical difference in the health and well-being of people with dementia
IF• Used Appropriately for the degree of
involvement – the ‘Just Right’ Challenge33© 2010 Teepa Snow. All rights reserved. Use only with permission. Presentation at Home Instead Senior Care of Sonoma County
sponsored Dementia and Alzheimer’s event, March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA.
