quiz time! · 2020-07-13 · 6/21/2020 6 © teepa snow, positive approach, llc –to be reused only...

6/21/2020

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Positive Approach, LLC

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6/21/2020

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Using a

Positive Approach®

to Dementia Care


Quiz Time!

- What do we know?

- What do we think we know?

- What don’t we know?

- What surprised us most?

- What can we do about it?


Question #1

Dementia and Alzheimers are two

different words for the same condition

a.True

b.False

c.I don’t know

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Dementia Alzheimers Memory Problems


About 90-95% of the general public think



BETTER ANSWER:


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BEST ANSWER:



Having dementia

does not equal and is more

than just Alzheimers

does not equal and is more

than just Memory Problems


Animal Fluency:

- Name as many animals as you can

- Give one minute: don’t highlight time limit

- Count each animal named: not repeats

- Establish Baseline versus Normal/Not Normal

-Old Guidelines: 12 normal for > 65 and 18 for

<65

-New: Compare you to you over time

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Question #2

About how many types, forms, or causes of dementia are there?

a. 2-3

b. 5-10

c. 20-40

d. Over 100

e. I have no idea



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Question #3

What is one of the most common losses of ability

someone will experience when they get any form

of dementia?

a. Loss of ability to hear sound

b. Loss of ability to recognize familiar voices as

familiar

c. Inability to know another person is upset by

noticing their tone of voice

d. Loss of formal language skills – vocabulary,

comprehension, speech production

e. I have no idea


Understanding Language – BIG CHANGE

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.Hearing Sound – Not Changed

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Question #4

What is the how much of your brain tissue

will you typically lose by the end of the

condition?

a. About 95%

b. About 65%

c. About 50%

d. About 30%

e. I don’t know


For all that is lost,

some remains!

• 1/3 of brain remains

• Know what still works

• Know how we support in areas of loss

used with permission from Alzheimers:The Broken Brain, 1999

University of Alabama


Normal

Brain

Alzheimers Brain

Used with permission from Alzheimers:The Broken Brain, 1999 University of Alabama

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Sensory Strip

Motor Strip

White Matter

Connections

BIG CHANGES

Formal Speech

and Language

Center

HUGE CHANGES

Automatic Speech

Rhythm – Music

Expletives

PRESERVED


Executive

Control

Center:

Emotions

Behavior

Judgment

Reasoning


Learning and

Memory

Center:

Hippocampus:

BIG CHANGE

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Vision Center – BIG CHANGES


Question #5

What is the first change with dementia?

a. The brain begins to shrink

b. The chemistry of the brain changes

c. The person’s personality changes

d. The person’s behavior changes

e. I don’t know


PET Scan of 20-Year-Old Brain PET Scan of 80-Year-Old Brain

PET and Aging:

ADEAR, 2003

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Positron Emission Tomography (PET)

Alzheimers Disease Progression vs. Normal Brains

G. Small, UCLA School of Medicine.


Four Truths About

Dementia:

1. At least 2 parts of the brain are dying -

one related to memory and another part

2. It is chronic – can’t be fixed

3. It is progressive – it gets worse

4. It is terminal – it will kill, eventually


Question #6

What is it called when you have dementia and

continue to think you are as skilled as you

were before, even though you are making

mistakes now?

a. Anosognosia

b. Denial

c. Hippocampal damage

d. Confabulation

e. I really don’t know

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Positron Emission Tomography (PET)

Alzheimers Disease Progression vs. Normal Brains

G. Small, UCLA School of Medicine

Primitive

BrainPrimitive

Brain


INTENT

I'm sorry I was trying

to help

EMOTION

I'm sorry I made you angry

I’m sorry I disappointed

you

INTELLECTUAL CAPACITY

I'm sorry, I had no right to

make you feel that way

THAT HAPPENED

I'm sorry, it should NOT

have happened

THIS IS HARD

I'm sorry, this is hard, I

hate it for you


Question #7

What is an effective treatment for

dementia?

a. How we connect and respond to people

who are living with the condition

b. There are pills people can take to slow

the disease down

c. There is nothing that really helps

d. Exercise and eating right keeps it from

getting worse

e. I don’t know

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Beliefs:

People living with dementia are doing the

best they can

We must learn to dance with our partner

What we choose to do matters

We are a key to making life worth living

We must be willing to change ourselves


How Can We Become Better

Care Partners?

-Let go of the past to be in the moment

-Go with their flow

-Be willing to try something new

-Be willing to learn something different

-Be willing to see it through another’s eyes

-Be willing to fail and try again

-Be a detective, not a judge

-Match your help to their remaining abilities

-Look, listen, offer, think


Some Basic Skills:

1. Positive Physical Approach™

2. Hand-under-Hand® for connection and

assistance

3. Supportive Communication

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1. Positive Physical

Approach™:

-Pause at edge of public space (6 feet)

-Gesture and greet by name

-Offer your hand and make eye contact

-Approach slowly within visual range

-Shake hands and then maintain Hand-under-Hand®

-Move to the side

-Get to eye level and respect intimate space

-Wait for acknowledgement


A Positive Approach(To the Tune of Amazing Grace)

Come from the front

Go slow

Get to the side,

Get low

Offer your hand

Call out the name, then wait…

If you will try, then you will see

How different life can be.

For those you’re caring for!


2. Hand-under-Hand®:Protects aging, thin, fragile, forearm skin

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3. Supportive Communication

• Repeat a few of their words with a question at

the end

• Avoid confrontational questions

• Use just a few words

• Go slow

• Use examples

• Fill in the blanks

• Listen, then offer empathy:

“Sounds like…” or “Seems like…” or “Looks

like…”


Connect Emotionally:

-Offer your name: “I’m (name) and you are…?”

-Offer a shared background: “I’m from (place)

and you’re from…?”

-Offer a positive personal comment: “You look

great in that!” or “I love that color on you.”

-Make a positive observation: “What beautiful

flowers!” or “Great photo!”


Then, Get it Going!

- Give Simple and short information

- Offer concrete choices

- Ask for help

- Ask the person just to try

- Break the task down to single steps at a time

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Question #8Which message would you prefer if you had

dementia?

a. You seem incompetent, let me help you

b. I am glad to see you. I could use your help.

c. There is clearly something wrong with you

and I don’t know what to do

d. You are scaring me and I want you out of here

e. There is clearly something wrong with you

and I am going to call the authorities for

help


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This presentation is copyrighted by Positive Approach to Care and is protected under the US Copyright Act of 1976 and all other

applicable international, federal, state and local laws, with ALL rights reserved. No part of this may be copied, or changed in any

format, sold, or used in any way other than what is outlined within this under any circumstances without express permission from

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Copyright 2017, All Rights Reserved

Teepa Snow and Positive Approach to Care

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quiz time! · 2020-07-13 · 6/21/2020 6 © teepa snow, positive approach, llc –to be reused only...

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