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 © 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…

Being ‘right’ doesn’t necessarily translate into a good outcome for both of you

It’s the relationship that is MOST critical NOT the outcome of any one encounter

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.

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

What Could It Be?
Another medical condition
Medication side-effect
Hearing loss or vision loss
Depression
Acute illness
Severe but unrecognized pain
Other things…

Alzheimer’s
Disease
Early - Young Onset
Normal Onset
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 Vascular Dementias (Multi-infarct)

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 year

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

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 & strange

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 words

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

PET and Aging ADEAR, 2003 PET Scan of 20-Year-Old Brain PET Scan of 80-Year-Old Brain

Learning & Memory Center Hippocampus BIG CHANGE

Understanding Language – BIG CHANGE

Hearing Sound – Not Changed

Sensory Strip Motor Strip White Matter Connections BIG CHANGES Formal Speech & Language Center HUGE CHANGES Automatic Speech Rhythm – Music Expletives PRESERVED

Executive Control Center Emotions Behavior Judgment Reasoning

Vision Center – BIG CHANGES

Positron Emission Tomography (PET) Alzheimer’s Disease Progression vs. Normal Brains G. Small, UCLA School of Medicine. Normal Early Alzheimer’s Late Alzheimer’s Child

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

Dementia can be treated
With knowledge
With skill building
With commitment
With flexibility
With practice
With support
With compassion

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!

Take Some Time To…
Figure out WHO you are
And
WHO your partner is…
Similarities & Differences
And
Respect Both Partners’ Needs

Who Are You?... Your Partner?
Introvert
Logical & Reasoning
Big Picture
Plan it Out
Extrovert
Emotional & Feeling
Lots of Details
Just Do It

Four Key Building Blocks
Activities to Relax & Re-energize
Activities to Feel Productive & Valued
Activities for Fun & ‘Just Because’
Activities to Take Care of Yourself

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

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

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

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!

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’ Challenge
© 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 Expert, on understanding Alzheimers patient behaviors

by Home Instead Senior Care of Sonoma County, CA on Mar 27, 2010

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Teepa Snow, Dementia Expert, on understanding Alzheimers patient behaviors — Presentation Transcript