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
QUESTIONS?
THANK YOU!