DEMENTIA. Stephanie Janka Spurlock and Mandy Nagy T&SDFT trainers and assessors

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1 DEMENTIA Stephanie Janka Spurlock and Mandy Nagy T&SDFT trainers and assessors

2 Definition Dementia is an umbrella term used to describe a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language. These changes are often small to start with, but for someone with dementia they have become severe enough to affect daily life. (

3 Functions affected by dementia Memory Thinking Orientation Comprehension Calculation Learning capacity Language Judgement

4 Alzheimer's Disease Most common form of dementia Loss of brain cells, shrinkage of brain tissue Presence of neurofibrillary tangles and amyloid plaques causing brain cells to die Deterioration of behaviour, intellect, visuo-spatial skill Short term memory loss, gradual unawareness Disorientation in time and place, inversion of day and night Loss of ability to think becomes more marked Difficulty with simple tasks such as tying shoelace Decline may be rapid, gradual or uneven

5 Multi-Infarct or Vascular Dementia The second most common type of dementia Infarction of brain tissue due to haemorrhage or emboli Blood supply to the brain is impaired, depriving the brain of oxygen The most common cause is stroke with 20% developing cognitive problems including dementia Cognitive function deteriorates then stabilises or even improves for a time Episodes of acute confusion common There is preservation of personality May have speech difficulties, emotional instability

6 Lewy Body Dementia Lewy body are abnormal proteins, thought to cause brain cells to die, deposits found in the cerebellum and occipital lobes Progressive memory loss, language calculation and reasoning as well as other higher mental functions Problems sustaining a line of thought and locating objects in space Fluctuations in confusion varying from hour to hour Visual hallucinations (little boy standing in doorway) Sensitivity to medication May develop Parkinsonian syndrome

7 Fronto-temporal Dementia Formally known as Picks disease or Frontal lobe degeneration Dementia associated with motor neurone disease. A rarer form of dementia affecting younger people under 65 Memory Is not affected in the early stages Lack insight and lose ability to empathise with others, may appear selfish and unfeeling Become extrovert when previously introvert and withdrawn when previously outgoing, behave inappropriately, make tactless remarks, rude, joking at the wrong moment

8 Perception Activity Do You See All 3??

9 Three stages of Memory ENCODING STORAGE RETRIEVAL Encoding- registering, storing and retrieving via verbal, visual, auditory Then we filter significant and important to us. Storage keeping it safe Retrieval - to locate the information in memory

10 Memory Book-case analogy (

11 Group Activity How would you feel in this situation? What approaches/techniques could you use as a member of staff to help a person with dementia in this situation?

12 Approaches Reality Orientation: This approach tries to place the individual in the here and now. Reminding them of the day, place, time and situation they are in. Validation Approach: Responds to the feeling behind the words, show empathy, their expressed feelings are valid. Stepping into the Person s Reality: This approach responds to the person s reality

13 What to do Prevention: Look for triggers and reduce the risk of a unwanted reaction Toleration: Inappropriate and disinhibited behaviour may cause a problem, try to give the person some privacy If the behaviour is not causing the person or anyone else distress, is it necessary to intervene? Moderation: Try distraction therapies such as talking about something they like, activities they enjoy, music

14 Top Tips for Communication Focus on the feeling behind the words, as their choice of words may not always be under control. Involve the carer, ask if there is a preferred way to communicate. Read This Is Me document, care plans and risk assessments. Understand what the Forget me not symbol means.

15 Top Tips for communication continued Avoid statements such as you can t and don t do that. Approach a person with dementia in an open and friendly manner - address them by name and introduce yourself. Observe the person you are communicating with. Record and report any changes or triggers to a senior person.

16 Challenging behaviours Managing risk - Joe

17 Downloadable King s Fund environmental assessment tools available from

18 Walk a mile in my shoes Walk a mile in my shoes. See what I see. Hear what I hear. Feel what I feel. Then, Maybe you ll understand why I do what I do. Till then, don t judge me. (Cherokee tribe of Native American proverb)