Western Illinois Area Agency on Aging 2016 Conference

Transcription

1 Western Illinois Area Agency on Aging 2016 Conference

2 Dr. Alzheimer

3 Auguste Deter November 25, 1901, 51 years old Problems with every day tasks Jealousy, delusions Memory I have lost myself

4 Dementia today 6 th leading cause of death in the US Only one of the top 10 without an effective treatment No known way to prevent or delay (research pending) Most expensive illness in the USA Over 10 years since a new FDA approved drug

5 Your local math 15 percent over 65 have AD or other dementia; 40 percent over 85 have AD or other dementia Moline, IL, Population approx. 43,000

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7 Dementia vs. Alzheimer s disease Dementia = Soup (broad category) Alzheimer s disease = chicken noodle! (chicken noodle is a type of soup like AD is a type of dementia) 7

8 Ten Warning Signs 1. Memory loss that disrupts daily life 2. Challenges in planning or in solving problems 3. Difficulty completing familiar tasks. 4. Confusion of time and place 5. Problems with visual images and spatial relationships 6. New problems in words in speaking or writing 7. Misplacing things and losing the ability to retrace steps 8. Decreased or poor judgment 9. Withdrawal from work and social activities 10. Changes in mood and personality. - Alzheimer s Association

9 Mild Cognitive Impairment (MCI) Mild Cognitive Impairment (MCI) Memory loss that disrupts daily life Challenges in planning or in solving problems Difficulty completing familiar tasks. Confusion of time and place Problems with visual images and spatial relationships New problems in words in speaking or writing Misplacing things and losing the ability to retrace steps Decreased or poor judgment Withdrawal from work and social activities Changes in mood and personality.

10 Alzheimer s disease Leading cause of dementia Average course of illness 8 years Slow moving Key symptom short term memory loss, confusion, mistakes AD is a fatal illness causing complications like falls, infection, pneumonia Behavior consequences: Every person is different some are pleasantly confused, stay in good cheer. Others may have agitation, paranoia, combativeness, make false accusations. Delusions fixed, false ideas.

11 The growing power of scans

12 Alzheimer s doesn t travel alone Alzheimer s disease often comes with other challenges that can worsen impairment Michael McCloud, MD UC Davis Alzheimer s Center Inappropriate medications Alcohol Stroke Depression Malnutrition Hormone deficiency Blood sugar/diabetes issue Hearing/visual impairment Vitamin B12 or D deficiencies Loneliness, Isolation

13 Vascular Dementia 2 nd or 3 rd leading cause Mini Strokes or Multi Infarct Interruption of blood flow to the brain May be treatable; scans tell the story Note: Mixed dementia Vascular + AD Behavior consequences: Problems with thinking, walking and performing everyday activities are the most prominent symptoms. Apathy/depression Anxiety Agitation may occur as people become less able to interpret their environment and control or express their feelings.

14 Lewy Body Dementia Named after Dr. Lewy Combination of AD and Parkinson s Movement disorders Hallucinations Sensitivity to psychotropic meds Behavior consequences Fluctuations in cognition, attention or alertness Greater fall risk Hallucinations can be benign or fearful

15 Frontal Lobe Dementia The term 'fronto-temporal dementia' covers a range of conditions, including Pick's disease. Impact on behavior, emotion & language About 10% of the dementias involve FTD with peak age of 55 to 65 Avoid cholinesterase inhibitors Behavior consequences: Personality change Narcissism Disinhibition Language issues Agitation

16 Mild Cognitive Impairment Mild cognitive impairment (MCI) causes a slight but noticeable and measurable decline in cognitive abilities, including memory and thinking skills. A person with MCI is at an increased risk of developing Alzheimer's or another dementia. - Alzheimer s Association 16

17 Depression in AD Quite common Anti-depressant medications recommended Create an activity rich environment Get them outside Animals & Music

18 Pain management Pain often goes unreported Be a detective

19 Pain management Some simple tests Observation touch/wincing/facial expression Moaning/sounds do they cease after a favorite redirection/activity or continue

20 Sudden changes Aren t typically dementia Person is sick or in pain

21 Late stage dementia Key areas of engagement Sensory Music Outdoor time Animals/pet therapy Key areas for dignity Being aware of language Offer simple choices Maintain dignity

22 Late stage dementia Key areas of engagement Sensory Music Outdoor time Animals/pet therapy Key areas for dignity Being aware of language Offer simple choices Maintain dignity

23 Late stage dementia Use affirming language: Non verbal includes: I m here for you. I m glad to be your friend Body language Smiles Handshakes Welcomed hugs/touch

24 Late stage dementia/ enhanced care Special topics Food and dining Key areas concern Supporting families Spiritual connections Work with hospice

25 Contemporary Best Practices and the Best Friends Approach

26 Being Person Centered

27 Daphne Gormley, Santa Barbara Dx at 59. Credits dementia meds with helping. Uses water soluble crayons and felt tipped markers for my paintings. Rather than limiting my artwork, my Alzheimer s seems to have unleashed a whole new area of creativity for me. Emphasizes process rather than outcome. Ambitious, motivated.

28 Key elements for relationships Life Story accessibility

29 We Know how to Create a Good Day Creative activities Conversation Using the Life Story Exercise Music Word games and trivia Being outside Art Learning & growth Laughter Animals

30 What can you tell me about...

31 Key Elements of the Life Story Childhood Birth date and birthplace Parents and grandparents Brothers and sisters Early education Pets Young Adulthood College and work Marriage(s)/relationship(s) Family Clubs and/or community involvement First home Military service Adolescence High school name Favorite classes Friends and interests Hobbies and sports First job Middle Age Grandchildren Hobbies Work / family role Clubs and organizations Community involvement

32 Key Elements of the Life Story Older Adulthood Life achievements and accomplishments Hobbies Travel Family Other Major Ingredients Ethnicity Religious background Awards Special skills Favorite personal stories

33 Best Friends Empathy Knowing and using Life Story Activities and Engagement Friends do things together Communication Friends talk and communicate Recasting relationships being a Best Friend to a person helps them feel safe, secure and valued.

34 Best Friends

35 Moving Toward Quality Care

36 Changing the Outcome Loss Fulfillment Isolation & Loneliness Connection Sadness Cheerfulness Confusion Orientation Worry/Anxiety Contentment Frustration Peacefulness Fear Security Paranoia Trust Anger Calm Embarrassment Confidence

37 What are your challenges? Behaviors

38 Develop the Knack Knack is the art of doing difficult things with ease. or clever tricks and strategies! Helps us turn a no into a yes.

39 Knack Use the Life Story Humor Flexibility Don t argue or correct Communicate with emotion as much as words Give lots of compliments Ask for help Creative activities Let s discuss how you can employ the Knack

40 Patricia Artist, active in her church Makes load vocalizations What are some ideas for this situation

41 Masako From Japan, Buddhist, loves Japanese traditions like formal tea ceremonies. She gets agitated easily. What are some options

42 Harry Retired dentist from New Orleans. Loved nature, food, jazz, his home town. Younger onset person with AD (under 65) Needs activity and engagement or gets tearful/sad. What are some ideas?

43 5 New Idea Meeting Get the team together Brainstorm Be sure to go back to the Life Story Discussion/Problem solving

44 Communication & Language Words and language begin to fail in later stages Strategies involve staff training with listening, body language, cueing.

45 Contemporary view Persons with dementia have all the same needs that we do. Language matters community and neighborhood vs facility and unit

46 Communication Stop, look & listen Non verbal emotional communication Compliments Asking for an opinion Offering simple choices Don t ask too many questions Fill in the blanks

47 Teaching staff (and families) that it only takes 30 seconds to be a little less task oriented and a little more person centered. 30 Second Rule

48 Creating a therapeutic environment one that is healing Knowing that in many ways, socialization is the treatment for dementia! What now? 48

49 Activities vs. Engagement A walk Bingo!

50 30 Second Activities Activities can be more than what s on a calendar Consider moments of serendipity

51 Develop ongoing activities/projects to do Collage Making dog biscuits Letters to troops Gifts for children/back to school

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53 The Impact of Best Friends

54 Coming 2014!