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D. Kuhn – All Trust Home Care
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Presented by: All Trust Home Care • 630 920-9999 • alltrusthomecare.com
Keeping Connected to Someone with Dementia
Daniel Kuhn, LCSW
Chicago, IL
Symptoms of Dementia
• Brain failure, usually due to one or mores diseases that kill brain cells for unknown reasons.
• Slow & progressive loss of skills:
Activities of daily living
Behavior/mood
Cognition (memory, language, reasoning, orientation, etc.)
Different Types
• Alzheimer’s disease
• Lewy Body dementia
• Vascular dementia
• Mixed dementia
• 50+ rare types
Changes in ADLs
Early Middle Late
Difficulty with
finances, cooking,
shopping, driving,
& medications.
Also difficulty with
personal care
tasks.
Totally
dependent on
others for simple
tasks.
Changes in Behavior
Early Middle Late
Apathy, anxiety,
depression.
Disinhibition,
agitation.
Passive, tires
easily.
Changes in Cognition/Memory
Early Middle Late
Loss of short-term
memory; repeats
oneself, loses &
misplaces things.
Loss of short-
term memory and
some long-term
memory loss.
Mixes up the
past and the
present.
D. Kuhn – All Trust Home Care
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“People living with Alzheimer’s tend more and more to
experience a point rather than a line of time. Someone
might talk about a long-dead relative as if he were just
about to arrive for a visit. It is as if the past and the
present have drawn together as one; much like how our
unconscious combines time and place when we dream.”
~ John Zeisel, I'm Still Here: A New Philosophy of
Alzheimer’s Care
Time TravellingDoris & Debbie
Early Middle Late
Trouble finding
words & tracking
conversations;
avoids talking on
the phone.
Trouble
completing
sentences &
understanding
others; diminished
vocabulary.
Severe difficulty
expressing &
understanding
words; reverts to
first language.
Changes in Cognition/Language What color is the sky?
Symptoms May Cause Fear
“Certainly one of the real fears felt by anyone with Alzheimer’s disease is the fear of failure. I live with the imminent dread that one mistake in my daily life will mean another freedom will be taken from me.”
~ Robert Davis, My Journey Into Alzheimer’s Disease
“It is much easier to stay in the safety of
my home, than to expose myself to people who don’t understand, people who raise their eyebrows when I have trouble making the right change at the cash register, or when I’m unable to think of the right words when asked a question.”
~ Larry Rose
Show Me the Way to Go Home
Symptoms May Cause Loneliness
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Symptoms May Cause Stigma
“Upon diagnosis people think that you have lost your intelligence. They no longer ask your advice on anything. They talk to the person you are with and not you.”
“Friends and family are uncomfortable and say they don’t know how to behave ‘normally’ around me anymore – they didn’t really give our relationship a chance to move forward.”
www.alz.co.uk/research/world-report-2012
Symptoms May Cause Helplessness
“Now that I have Alzheimer’s, he wants to take care of me, but sometimes he drives me crazy. I feel like he’s on top of me, asking me if I want lunch before I know I’m hungry! Telling me what to wear and what not to wear, as if I couldn’t get dressed myself.”
~ B. Smith, Before I Forget
Overcoming Fear
• Closeness with another person or a pet.
• Having a best friend.
Overcoming Stigma
• Raising awareness
• Challenging stereotypes
• Advocacy
Overcoming Loneliness
• Family
• Community (faith, memory cafes, adult day centers)
• 1:1 & group activities
Overcoming Helplessness
• Caring for self
• Caring for others.
• Purpose, joy.
D. Kuhn – All Trust Home Care
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Teaching & Learning French Making Connections
A connector…becomes the person’s memory, anticipates
needs, and supports independence whenever
possible.
A connector…
involves the person in daily tasks, initiates
activities, and ties activities to one’s
skills and interests.
A connector…
gives compliments, asks
for advice or opinions,
offers encouragement
and congratulations.
A connector…
tells jokes and funny
stories, and takes advantage
of spontaneous fun.
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A connector…
is a friend first, a caregiver second, by doing a task with someone instead of for someone.
A connector…
skillfully listens, speaks, and asks questions
to encourage conversation.
Communication Skills
• Make eye contact, smile, use gentle touch.
• Find a quiet place.
• Talk one-to-one.
Communication Skills
• Slow down!
• K.I.S.S: Keep It Short, Simple
• Listen deeply & learn.
• Narrow down choices.
e.g. - yes or no questions
• Break down steps.
• Redirect if upset
Communication Skills Connecting through Activities
• Preparing meals
• Dancing & moving
• Word & board games
• Prayers & hymns
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Connecting through Activities
• Physical exercise, walking
• Appreciating & making art: www.moma.org/meetme
Watercolor Paintings
Connecting through Activities
• Reminiscing, family history www.memory-well.com
• Storytelling www.timeslips.org
• Song & music www.givingvoicechorus.org
http://musicandmemory.org
Giving Voice Chorus
Henry: Alive Inside Websites
• Alzheimer’s Association (800) 272-3900 www.alz.org
• Alzheimer’s Disease Education and Referral Center (800) 438-4380 www.nia.nih.gov/alzheimers
• VideoCaregiving www.videocaregiving.org
• Using Improv to Improve Life with Alzheimer’s
http://tedmed.com/talks/show?id=526821
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A Final Thought