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PAC Workshop C Outline

Workshop C Seeing GEMS® As More than Just Loss: Progression Patterns

Part 2 Chapter 4

▪ Workshop C may be presented in two 30-minute sessions or one 1-hour session

▪ NOTE for CEUs: Only the full content, up to 1-hour session may be submitted for CEU approval

(guidelines provided in PAC Trainer Manual).

▪ As you master the information, you may use the video as needed. It is never acceptable to have

people watch the video without your facilitation.

Workshop Objectives: By the completion of this 30-min to 1-hour workshop learners will be able to:

1. Describe 3 number-based systems that are used to label stages/progression of dementia

2. Discuss the value and importance of seeing people living with dementia as having retained abilities, value, and benefiting from the right support and care to optimize performance and quality of life

3. Identify six GEMS – highlighting GEMS state characteristics

4. Compare and contrast 6 states of cognitive function and ability as GEMS

5. Use structured table to correctly identify GEMS states in shared scenarios through behaviors, abilities, and sensory processing examples

Chapter 4 – Teepa’s GEMS DVD Chapter structure:

START VIDEO 0:00 Overview – 3 systems – need for respectful non-number based system that emphasizes retained abilities, interests, and what cues and supportive environmental features can be used to help. STOP VIDEO at 4:05 after “What I came up with are these GEMS.”

Ask the group

• “What kind of models for identifying people living with dementia have you been using?”

• “What do you notice is different about the GEMS model for identifying different stages of living with dementia?”

Ask the group

• “Why do you think there is such a difference?” Ask the group

• “How do you think a Person Living with Dementia (PLwD) who is aware of their shifting

Experience:

Share:

Process:

Apply:

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abilities would respond to being identified as one of the GEMS vs. being identified as a number or in a stage?”

• “How do you think a family member of someone living with dementia, at any part of the progression of the syndrome, would feel about discussing their loved one being as a number or in a stage vs. being identified as a GEMS?”

• “What might the impact be for all when interacting using the GEMS model vs. the other three standard models Teepa described?”

Continue with the Adult Experiential Learning Cycle (AELC) Steps: CHOOSE AN OPTION FOR PROCEEDING

Option 1: Play through each of the GEMS, one at a time using the following sequence of STARTS and STOPS. Share and Process after each video segment – Connect and Apply at the end of all the clips that cover all of the GEMS.

Option 2: Play through all of the clips, then Share, Process, Connect, and Apply at the end of all the clips.

Ask learners for each of the GEMS:

• “So what are the characteristics of this one of the GEMS state?”

• “What are the characteristics of a PLwD at this state?”

• “What abilities are still present?” (Note: in the visual, verbal, movement, executive function, limbic system)

• “What skills are lost?” (Note: in the visual, verbal, movement, executive function, limbic system)

Ask the learners to:

• “Turn to your partner or table and think for each of the GEMS states this way: o “What types of CUES might be helpful?” o “What changes in the setting or environment should we think about?”

Ask learners for each of the GEMS:

• “So what does this mean for us as care supporters and partners?”

• “What does it mean about other people around the person?”

• “What does it mean about doing tasks? Offering support and care?

• “What does it mean about ability to their occupy themselves safely and effectively?”

• “What types of challenges might happen because of these changes?”

Use the scenarios and worksheet provided to determine which GEMS state each person is currently showing. For your learners, choose one of the three options below and then go through the Share, Process, Connect, and Apply below.

• Option 1: You can read the scenarios out loud or have each person read them independently (Can work best with a slightly smaller group of 4 to 8 people).

• Option 2: You can work through one scenario together and then have each group or person do another one.

• Option 3: You can have pairs or teams work separately and then share and discuss their thoughts.

Experience:

Experience:

Connect:

Share:

Process:

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Ask the group:

• “What GEMS state did you think this person is currently in?”

• “What is the evidence? What did you read that made you think that?”

• “What cues is the PLwD getting or not getting?”

• “What are they able to do? Not able to do?”

Discuss findings with their partner or table:

• Use support sheets to work through each scenario

• Offer role-plays to emphasize points, clarify possible ideas, and highlight what was missed or misunderstood

• “What support might be helpful?”

Ask the learners to:

• “Compare the various cases and situations you are familiar with, and think about the value and usefulness of this system versus other number based systems”

Note: Highlight the flexibility of changes based on stressors, time of day, people and stimulation, health and overall well being

• Discuss use of the support materials to help with GEMS identification and supportive care

Ask learners to identify their next steps for incorporating this knowledge into practice:

• “How might you use this information? Where? When?” Offer other resources for their consideration such as video clips at www.teepasnow.com, specifically scroll down on the homepage to view the video on GEMS. START VIDEO 4:05 “Sapphire!” Sapphires – True blue – you and me on a good day STOP VIDEO at 4:19 after “Boy! You’re fantastic.” START VIDEO 4:19 “Diamonds!” Diamonds – Clear sharp, rigid, formed under pressure STOP VIDEO at 6:47 “It’s so surprising to you that they do that.” START VIDEO 6:47 “Emeralds!” Emeralds – On the go, vague about time, place, situation, words, internal

cues STOP VIDEO at 8:01 after “Weight gain is as common as weight loss with Emeralds.”

START VIDEO 8:01 “The next GEM is Amber.” Ambers – caught in a moment of time, all about sensation,

no caution STOP VIDEO at 11:21 after “WHAT?!?”

START VIDEO 11:21 “The next of the GEMS…” Rubies – fine motor stops, but gross motor and strength may continue – skills limited, gets stuck or can’t stop STOP VIDEO at 12:41 after “They can’t get the details at all.” START VIDEO 12:42 “Now, the last of the GEMS.” Pearls – in a shell, reflexes rule, moments of awareness and presence only, letting go. STOP VIDEO at 17:08 after “…cause they are changing.”

Connect:

Apply:

Share:

Process: