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SIA DEMENTIA TRAINING

Introduction

About us

• Opened November 2007

• Cover Palm Beach, Martin, St. Lucie, Indian

River, Okeechobee Counties; Jacksonville-

area

• Certified DementiaWiseTM training office

• Who we are

ComForcare

• Non-medical home health care agency

• Provides personal care and private skilled

services

• Expert in delivering dementia care services

Agenda

Community impact

Facts you should know

Alzheimer’s and dementia basics and tips

Effective communication tools and

techniques

Addressing special challenges

Conclusion

Questions

Goals

Provide education on Alzheimer’s disease

and other types of dementia

Talk through strategies and tactics for

specific situations you may encounter

Reduce stress in your personal life if you

are caring for a loved one with dementia

Before we start

It’s important to understand the difference

between dementia and Alzheimer’s:

Dementia is a condition resulting in changes in

memory and other cognitive abilities that

interfere with a person’s ability to function; there

are many types

Alzheimer’s disease is the most common type

of dementia

Stages of Alzheimer’s

EARLY STAGE (What day is it?)

Starts in the

Hippocampus, then

spreads to the frontal

temporal lobe affecting

recent memories,

learning new

information, thinking,

planning and

organization

MIDDLE STAGE (Who are you?)

LATE STAGE (Who am I?)

Moves further into the

frontal temporal lobe

affecting sensory

perception,

communication,

behaviors, impulse

control (cursing, sexual

aggression),

judgement and

attention to personal

appearance

Final stages spread

throughout the brain;

affects the ability to

recognize anyone

including themselves,

control bodily function

and to eat and drink;

eventually the brain

can no longer tell the

body what to do

Source: Alzheimer’s Community Care

COMMUNITY IMPACT AND

FACTS YOU SHOULD KNOW

Community impact: encountering

dementia on the job

Your challenge: how to quickly manage

situations where people with dementia may

be frightened and confused

Might be unclear whether dementia is

present, or how it affects the current

situation

Could be the person you respond to does

not have dementia, but someone else in

the family does

Community impact: challenging

dementia dynamics

People with dementia may not understand

your commands, or what is happening

Their difficult behavior can interfere with

the job

Agitation and violence can escalate quickly,

resulting in possible injury

May not respond well to strangers

Show of hands: how many

of you …

Interact with citizens with dementia on the

job?

Are you now or were you previously

helping care for someone with dementia?

Approaching things differently

People with dementia need to be handled

differently in order to become and remain

calm and understand what you need them

do

We will focus today on ways to make

situations with dementia easier and safer

Facts you should know

5+ million people now have Alzheimer’s –

could triple by 2050

1 in 3 elders develop some type of

dementia by the end of their lives

70% of people with dementia live in the

community – not in nursing homes,

assisted living or memory care units

ALZHEIMER’S AND DEMENTIA

BASICS AND TIPS

Dementia basics

Dementia is more

than just memory loss

– it’s brain failure

Dementia is not

part of the normal

aging process

The Alzheimer’s brain

Abilities: What stays? What goes?

Dementia impacts sensory

processing

The deteriorating brain

causes deteriorating sensory

processing

Not due to disease of sensory

organs

All humans need sensory

stimulation to be healthy

People with dementia self-

stimulate senses if they are

bored – with potentially negative

consequences

Sensory processing changes:

vision

Loss of depth perception

Loss of peripheral vision

Need for high color contrast

Need for brighter lighting

Need for visual simplicity

Sensory processing changes:

hearing

Noisy environment can cause person with

dementia to become confused, agitated,

distracted or emotional

Avoid noisy places or too many people

speaking at once

Simplify communication – someone with

dementia may not understand or respond to

spoken commands, especially under acute

stress

Use music to calm and warmly connect –

passive or active music listening is powerful

Why people with dementia “act out”

Trigger can often be other people

Acting out may be their only way to

communicate

Act out due to terror, panic, desperation, pain

Feel disconnected, alone, disrespected or

bored

Can be surprised by the consequences of

their (or others’) actions

Have undermanaged or unidentified pain

Don’t understand or may misinterpret

Sundowning

Responding to hallucinations or delusions

Vital tools: check yourself

Check and correct your body language – before every

interaction, and any time things go wrong

If necessary, be an actor to evoke positive emotions in others

Exhibit the emotions you want the person to experience

Vital tools: warm connection

Goal: create positive emotions for the person with dementia

Make a warm connection before every interaction, and any time

things go wrong

Vital tools: enter their reality

They often live in a different reality than we do

Join in their personal reality

Don’t argue, correct, criticize, or try to convince

Otherwise, they may feel angry, disrespected, or trigger difficult

behavior

Vital tools: use therapeutic fiblets

Fiblets are little white lies we tell people with dementia

Fiblets honor a higher truth – that we must provide the person

with a safe environment while maintaining their dignity

Signs of dementia

Can be adept at fooling others with intact superficial chit-chat

Longer conversations

Conversations don’t make sense

Repeating subjects or sentences, often verbatim

Repeating personally meaningful stories

Disorganized activity or speech

Confusion

Shuffling, odd or slow gait

Markedly stooped posture

Not able to recall home address or personal information

What is in their fridge?

Don’t dismiss younger people – early onset dementia is becoming

more prevalent

Review

Dementia basics

Sensory changes

Why they act out

Four vital tools

Recognizing someone with dementia

What information surprised you?

What will you keep foremost in your mind during your next

encounter with dementia?

Any questions?

EFFECTIVE COMMUNICATION

TECHNIQUES

Communication best practices

More communication best practices

Keep questions simple, use yes/no format

Do not ask open-ended questions

Ask for or give only one small piece of information or

make one small request/command at a time “Would you like something to eat or drink?” is two questions

Ask only one at a time

If communicating over the phone, ask for

confirmation for each thing asked or requested

Avoid saying: “no,” “don’t,” “you can’t,” – focus on

what you want instead

Avoid saying: “don’t you remember,” and “I told you”

Review

Approaches to prevent and calm aggression

Best communication practices

Use yes/no questions, or give only 2 choices

– no open-ended questions

QUICK CHECK: How can you ask this

differently?

“Tell me about your day”

“What do you want for lunch”

“Why are you so upset”

ADDRESSING SPECIFIC

DEMENTIA CHALLENGES

Common dementia challenges

Where good solutions start

Check yourself and make a warm

connection

Be sure not to argue

Know how to de-escalate difficult

situations

Know how to avoid triggering difficult

behavior

Use communication best practices

Review

Wandering

Driving

Responding to (or causing) danger

Disaster response

Aggressive behavior

Hoarding

Misuse of 911

Pain

CAREGIVER STAFF

What you should know

CNAs, HHAs, Private

Important questions to ask

Who are you?

Who do you work for?

Are you a professional or family caregiver?

What kind of training in Alzheimer’s or dementia

do you have?

*Palm Beach County Caregiver Ordinance

CONCLUSION

Goals for today

Provide education on Alzheimer’s disease

and other types of dementia

Talk through strategies and tactics for

specific situations you may encounter

Reduce stress in your personal life if you

are caring for a loved one with dementia

How we can help

Provide suggestions, tips and assistance in situations that

involve people with dementia

Offer education to families and healthcare professionals

Coordinate with other local resources

Provide DementiaWiseTM-trained caregivers for short- or

long-term care at home or in any setting

Dr. Deborah Bier, creator of DementiaWiseTM, offers a variety

of free educational webinars

Palm Beach ComForCare

9121 N. Military Trail, Suite 216

Palm Beach Gardens, FL 33410

(561) 630-1620

palmbeach@comforcare.com

QUESTIONS?

THANK YOU!