dementia a privilege 1. types of dementia alzheimers alteration chemistry/structure changes vascular...
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DementiaDementiaA Privilege A Privilege
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Types of DementiaAlzheimers alteration chemistry/structure changes
Vascular Dementia/stroke oxygen lack
Dementia with Lewy Bodies in nerve cells
Frontal lobe dementia personality/ behaviour
Parkinson’s Huntington’s
Multiple Sclerosis Motor Neurone Disease
Korsakoff (alcohol) C-J-D HIV
What is Dementia
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Progressive, not just memory loss or forgetting names, may not recognise people or things,may get lost
Reduced attention span, ability to do things, understand or communicate increased agitation confusion
Caused by amyloid plaques/tau tangles (‘rungs’ in communication ladders) increased inflammatory response (TNF)
There is always a reason
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Every action has a reason Every communication has a purpose.
What sounds nonsense is showing a need, expressing a feeling, or wanting a response.
The meaning of words may be disconnected from their sound; so may not understand or may produce a word salad.
Questions
Asking What time is it?, might mean “I have no idea what I am meant to be doing”.
Asking Can I go home?, perhaps means “I do not feel comfortable ”
Listen to the meaning behind the question
Dementia Time Travel
May think it is 1960 when X not born Y not married Z still alive
Children have to learn social skills In dementia lose social inhibitions do not always ignore or accept
May have ‘comforter’ be aware
Actions there is always a reason
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Wandering may have a purpose or be responding to an hallucination.
Sleep patterns may get muddled not aware difference between am & pm.
Might not recognise an item (fork) so not know what to do with it.
Behavioural Patterns in Sundowning (memories work/childhood late afternoon)
Visual Spatial Muddle
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Might not recognise self in a mirror and think it is someone else.
May misjudge the edge of the table or bathroom furniture unless distinct/contrasting colours.
Pouring liquids can be dangerous.
May be frightened by carpets/floors
Strange behaviourDifficult behaviour to who?
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Aggression often due to frustration misinterpretation of events such as reflections in windows or mirrors
Incontinence can sometimes just forgetting to go
Might not be able to distinguish dreams from reality. Don’t laugh or call them a liar, is it a fantasy?
Unwillingness to ‘cooperate’ may be due to fear eg showers may not have been used in their childhood
SITUATIONS that can precipitate agitation or confusion
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Unfamiliar People
Unfamiliar Surroundings
Large Gatherings
A Task that is too complicated
Noise Lights
Travel
Illness
see it from their perspective
loss of blue purple green colour strange lighting busy patterns
contrasts (puzzles, carpets, bathroom, food)
walking, steps, feel as if falling visual barriers
misidentification/misnaming misinterpretation/misperception
When agitated
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Simplify/calm the environment
Don’t ask questions or overwhelm with words Reassure, show what to do, make a cup of tea
Too many people - take to a quieter place. Engage in a familiar activity, music, a walk.
When caring
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Introduce yourself with context
Approach from the front don’t tap on the back
Show Respect, their name, how dress, do hair, how touch
Involve...choice, (blue? not, which? jumper)
Buttonless clothes / digital time
Always leave with a smile
Feelings remain when facts are forgotten
SPECAL explained in Contented Dementia
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No need to tell lies
Exit strategy
Absent people
Affirming statements
Reasons to sit
Memories
There are several ways to reach the same destination
There are several ways to enter the same house
Don’t give up when it appears the key is lost (neurons die)
Carers family or others
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Younger family members may feel trapped, be fearful of their own future may even ‘run away’
Carers need a regular break to enable them to carry
on can become exhausted /depressed / deny such / hide it well
Suffer great guilt if unable to cope or cope badly This can add to their ‘grieving’ and they may be hypersensitive
Don’t assume you know what they are going through
Extra resources
Just put into google
Alzheimer’s Society
Somerset Dementia
Gloriousopportunity.org
DementiaDementiaAlways a reasonFeelings remain
Patterns continue
Always a reasonFeelings remain
Patterns continue
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