3. Module 1:
Understanding Memory Loss
In this section, we will cover:
Definition of dementia and Alzheimer’s
disease
Stages of the disease and the
expectations
Current medications and treatments
4. What is Dementia?
Dementia is a disease process
– Progressive decline in cognitive function
– Memory loss
Over 170 irreversible dementias
– HIV, Vascular, Lewy Body, Parkinson’s,
Alzheimer’s
Some forms are reversible (treatable)
– Thyroid disorders, drug interactions,
dehydration
5. Delirium, Depression, and
Dementia
Delirium
– Acute onset, can be treated
– Altered state of consciousness
Depression
– Gradual onset, can be treated
– Look for signs, such as low self-esteem
Dementia
– Gradual onset, might be treated
– Memory loss and decline in cognitive function
6. Alzheimer’s Disease
Most common form of irreversible
dementia
– Nearly 70% of all dementias are Alzheimer’s
– Over 4.5 million Americans have Alzheimer’s
– It is estimated that 60% of all nursing home
residents have Alzheimer’s disease
Alzheimer’s is not normal aging
– Learning new information make take longer
– May be difficult to filter out noise
8. The Diagnostic Process
Multidisciplinary approach that is 80-
90% accurate
– Brain scan, blood and urine tests,
hearing/visual exams
– Neuropsychological testing and interview with
caregivers
The only way to confirm diagnosis is
with an autopsy
9. Stages
Early
Needs
reminders
Daily
routines
difficult
Concentrati
on-ion is
difficult
Middle
May need
hands on
care
May get lost
easily
Changes in
personality
Late
Severe
confusion
Needs hand
on care for
most
personal
care
May not
recognize
self or
family
10. Areas of the Brain Affected
Cognition
Memory
Learning
Language
Praxic
Function
Abstract
thinking
Psycho-
motor speed
Behavior
Communi-
cation
Safety
Personal
care
deteriorates
Lapses in
clarity
Hallucina-
tions
Delusions
Emotion
Disregulated
Disorganized
Apathy (loss
of energy,
willingness)
Lability
(moods
change)
12. Module 2:
Person Centered Care
In this section, we will cover
Understanding person centered care
and its characteristics
Identifying strategies for implementing
person centered care
Find ways to take care of the
professional caregiver
13. Person Centered Care
Person centered care is truly putting the
PERSON first
Characteristics
– Behaviors are a desire to communicate
– We must maintain and uphold the value of the
person
– Promote positive health
– All action is meaningful
14. Person Centered Care, Cont.
Core psychological needs must be met
to provide quality care
– Love
– Inclusion
– Attachment
– Identity
– Occupation
– Comfort
16. Stress!
Stress can lead to poor quality care,
quality of life, and abuse and neglect
Signs of stress
– Too little or too much sleep, nightmares
– Fatigue
– Headaches, backaches, joint pain
– Diarrhea/constipation
– Frequent accidents
17. Module 3:
Communication
In this section, we will cover:
The impact of verbal and non-verbal
communication
Examine and demonstrate techniques
for promoting meaningful
communication
Understand the correct use of validation
and reality orientation
18. Verbal and Non-verbal
Communication
Verbal
Tone
Pitch
Rate
Pause
Non-verbal
Gestures
Facial expressions
Posture
Each person is unique
Behaviors are a form of communication
Communication is only 10% verbal
People with Alzheimer’s maintain the ability to
understand non-verbal long after verbal is forgotten
19. Non-verbal Strategies
Your mood will be mirrored
Approach from the front
Establish eye contact
Speak at eye level
Use gentle touch
Point or demonstrate
20. Verbal Strategies
Use calm, gentle voice
Call person by name
Identify yourself
Use short, simple sentences
Speak slowly and respectfully
Eliminate distracting noises
Use familiar words
Give simple choices
Give one instruction at a time
Allow time for the person to respond
21. Validation vs. Reality
Validation
Become part of the
person’s reality
Acceptance
Feelings into words
Acknowledgement
Reality
Early stages, only if not
upsetting
Short explanations
New information can be
frustrating
Reality becomes based on
the past
22. Therapeutic Fibbing
The use of telling fibs or lies in an effort
to calm
We are never sure how much
information a person may be able to
process or remember
Should only be used when absolutely
necessary, look for other ways to calm
and support, such as redirection
23. Module 4:
Understanding Behaviors
In this section, we will cover:
Understanding of how and why
behaviors become challenging
Ways to prevent behaviors
Techniques for responding to
challenging behaviors
Emotions a person with dementia is
likely to experience
25. Respond to Feelings
Enter the person’s reality
Look for feelings behind the words
Empathize
Be non-judgmental
Respect their needs
Your emotions will be mirrored
Communicate comfort, warmth, and praise
Smile!
Put the person’s feelings into words
Allow for negative feelings
26. Problem Solving Behaviors
Task
– Too complicated, too many steps, not modified,
unfamiliar
Environment
– Too large, too much clutter, excessive stimulation, no
clues, poor sensory, unstructured, unfamiliar
Physical health
– Medications, impaired vision/hearing, acute illness,
chronic illness, dehydration, constipation, depression,
fatigue, physical discomfort
Miscommunication
27. The 11 W’s
Who has the behavior?
What is the specific behavior?
Why does it need to be addressed?
What happened just before?
Where does it occur?
What does the behavior mean?
When does the behavior occur?
What is the time, frequency?
Who is around?
What is the outcome?
What is the DESIRED change?
28. Preventing Behaviors
Diversion or distraction Removal
Redirection Task breakdown
Stimulus Control Environmental
manipulation
Reassurance Setting limits
29. Responding to Behaviors
Anxiety/agitation
– Response to misinterpretation of environment
or people
Aggressive reactions
– Usually directed at caregiver or another person
Rummaging
– Looking for something meaningful
Repetitive crying out
– Unresolved pain or discomfort
30. Module 5:
Activities of Daily Living
In this section, we will cover:
Causes for resistance to ADL’s
Strategies that promote participation
Possible techniques for managing ADL’s
Identifying signs of abuse and neglect
31. Causes for Resistance
Memory loss
Decreased attention span
Impaired judgment
Loss of ability to communicate
Difficulty with motor skills
32. Strategies for Participation
Anticipate problems or events
Provide a routine
Establish rapport
Talk with a calm voice
Do not attempt to use reason or logic
Do not rush
Avoid arguing
Focus on abilities
33. Strategies for Participation, Cont
Approach—knock, announce, privacy
Encourage the person to do as much as
they can
Praise for small successes
Provide for privacy
Do not keep person waiting
Demonstrate what you want done
Stop when frustration occurs
35. Module 6:
Families
In this section, we will cover:
Empathizing with feelings that a person with
Alzheimer’s and their families may experience
Identifying and informing families of resources
Identifying strategies for building a positive
relationship with families
Understanding the unique opportunity for a
long term relationship
37. Conflict Resolution
Denial can be healthy
Educate in small doses
Do not push to hard
Encourage support groups
Acknowledge
Listen
Feedback
Privacy
40. Strategies for Positive
Relationships
Show support
– Family tours, communication processes
– Validate emotions, develop realistic
expectations, compliment, report good news
Promote successful visits
– Offer suggestions and support
– Bring in family videos, pictures
– Activities