SIA DEMENTIA TRAINING
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1 SIA DEMENTIA TRAINING
2 Introduction About us Opened November 2007 Cover Palm Beach, Martin, St. Lucie, Indian River, Okeechobee Counties; Jacksonvillearea Certified DementiaWise TM training office Who we are ComForcare Non-medical home health care agency Provides personal care and private skilled services Expert in delivering dementia care services
3 Agenda Community impact Facts you should know Alzheimer s and dementia basics and tips Effective communication tools and techniques Addressing special challenges Conclusion Questions
4 Goals Provide education on Alzheimer s disease and other types of dementia Talk through strategies and tactics for specific situations you may encounter Reduce stress in your personal life if you are caring for a loved one with dementia
5 Before we start It s important to understand the difference between dementia and Alzheimer s: Dementia is a condition resulting in changes in memory and other cognitive abilities that interfere with a person s ability to function; there are many types Alzheimer s disease is the most common type of dementia
6 Stages of Alzheimer s EARLY STAGE (What day is it?) MIDDLE STAGE (Who are you?) LATE STAGE (Who am I?) Starts in the Hippocampus, then spreads to the frontal temporal lobe affecting recent memories, learning new information, thinking, planning and organization Moves further into the frontal temporal lobe affecting sensory perception, communication, behaviors, impulse control (cursing, sexual aggression), judgement and attention to personal appearance Final stages spread throughout the brain; affects the ability to recognize anyone including themselves, control bodily function and to eat and drink; eventually the brain can no longer tell the body what to do Source: Alzheimer s Community Care
7 COMMUNITY IMPACT AND FACTS YOU SHOULD KNOW
8 Community impact: encountering dementia on the job Your challenge: how to quickly manage situations where people with dementia may be frightened and confused Might be unclear whether dementia is present, or how it affects the current situation Could be the person you respond to does not have dementia, but someone else in the family does
9 Community impact: challenging dementia dynamics People with dementia may not understand your commands, or what is happening Their difficult behavior can interfere with the job Agitation and violence can escalate quickly, resulting in possible injury May not respond well to strangers
10 Show of hands: how many of you Interact with citizens with dementia on the job? Are you now or were you previously helping care for someone with dementia?
11 Approaching things differently People with dementia need to be handled differently in order to become and remain calm and understand what you need them do We will focus today on ways to make situations with dementia easier and safer
12 Facts you should know 5+ million people now have Alzheimer s could triple by in 3 elders develop some type of dementia by the end of their lives 70% of people with dementia live in the community not in nursing homes, assisted living or memory care units
13 ALZHEIMER S AND DEMENTIA BASICS AND TIPS
14 Dementia basics Dementia is more than just memory loss it s brain failure Dementia is not part of the normal aging process
15 The Alzheimer s brain
16 Abilities: What stays? What goes?
17 Dementia impacts sensory processing The deteriorating brain causes deteriorating sensory processing Not due to disease of sensory organs All humans need sensory stimulation to be healthy People with dementia selfstimulate senses if they are bored with potentially negative consequences
18 Sensory processing changes: vision Loss of depth perception Loss of peripheral vision Need for high color contrast Need for brighter lighting Need for visual simplicity
19 Sensory processing changes: hearing Noisy environment can cause person with dementia to become confused, agitated, distracted or emotional Avoid noisy places or too many people speaking at once Simplify communication someone with dementia may not understand or respond to spoken commands, especially under acute stress Use music to calm and warmly connect passive or active music listening is powerful
20 Why people with dementia act out Trigger can often be other people Acting out may be their only way to communicate Act out due to terror, panic, desperation, pain Feel disconnected, alone, disrespected or bored Can be surprised by the consequences of their (or others ) actions Have undermanaged or unidentified pain Don t understand or may misinterpret Sundowning Responding to hallucinations or delusions
21 Vital tools: check yourself Check and correct your body language before every interaction, and any time things go wrong If necessary, be an actor to evoke positive emotions in others Exhibit the emotions you want the person to experience
22 Vital tools: warm connection Goal: create positive emotions for the person with dementia Make a warm connection before every interaction, and any time things go wrong
23 Vital tools: enter their reality They often live in a different reality than we do Join in their personal reality Don t argue, correct, criticize, or try to convince Otherwise, they may feel angry, disrespected, or trigger difficult behavior
24 Vital tools: use therapeutic fiblets Fiblets are little white lies we tell people with dementia Fiblets honor a higher truth that we must provide the person with a safe environment while maintaining their dignity
25 Signs of dementia Can be adept at fooling others with intact superficial chit-chat Longer conversations Conversations don t make sense Repeating subjects or sentences, often verbatim Repeating personally meaningful stories Disorganized activity or speech Confusion Shuffling, odd or slow gait Markedly stooped posture Not able to recall home address or personal information What is in their fridge? Don t dismiss younger people early onset dementia is becoming more prevalent
26 Review Dementia basics Sensory changes Why they act out Four vital tools Recognizing someone with dementia What information surprised you? What will you keep foremost in your mind during your next encounter with dementia? Any questions?
27 EFFECTIVE COMMUNICATION TECHNIQUES
28 Communication best practices
29 More communication best practices Keep questions simple, use yes/no format Do not ask open-ended questions Ask for or give only one small piece of information or make one small request/command at a time Would you like something to eat or drink? is two questions Ask only one at a time If communicating over the phone, ask for confirmation for each thing asked or requested Avoid saying: no, don t, you can t, focus on what you want instead Avoid saying: don t you remember, and I told you
30 Review Approaches to prevent and calm aggression Best communication practices Use yes/no questions, or give only 2 choices no open-ended questions QUICK CHECK: How can you ask this differently? Tell me about your day What do you want for lunch Why are you so upset
31 ADDRESSING SPECIFIC DEMENTIA CHALLENGES
32 Common dementia challenges
33 Where good solutions start Check yourself and make a warm connection Be sure not to argue Know how to de-escalate difficult situations Know how to avoid triggering difficult behavior Use communication best practices
34 Review Wandering Driving Responding to (or causing) danger Disaster response Aggressive behavior Hoarding Misuse of 911 Pain
35 CAREGIVER STAFF
36 What you should know CNAs, HHAs, Private Important questions to ask Who are you? Who do you work for? Are you a professional or family caregiver? What kind of training in Alzheimer s or dementia do you have? *Palm Beach County Caregiver Ordinance
37 CONCLUSION
38 Goals for today Provide education on Alzheimer s disease and other types of dementia Talk through strategies and tactics for specific situations you may encounter Reduce stress in your personal life if you are caring for a loved one with dementia
39 How we can help Provide suggestions, tips and assistance in situations that involve people with dementia Offer education to families and healthcare professionals Coordinate with other local resources Provide DementiaWise TM -trained caregivers for short- or long-term care at home or in any setting Dr. Deborah Bier, creator of DementiaWise TM, offers a variety of free educational webinars Palm Beach ComForCare 9121 N. Military Trail, Suite 216 Palm Beach Gardens, FL (561) palmbeach@comforcare.com
40 QUESTIONS?
41 THANK YOU!
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