Transcript What is Dementia? - Home Instead Senior Care
Dementia
: Why Do They Do That?
How Can I Help? When Do I Need Help?
REALIZE …
•
It Takes TWO to Tango … or two to tangle…
Being ‘right’ doesn’t necessarily translate into a good outcome for both of you
It’s the relationship that is MOST critical NOT the outcome of any one encounter
As part of the disease people with dementia ‘tend to’ develop typical patterns of speech, behavior, and routines. These people will also have
skills and abilities
that are
lost
while others are
retained or preserved.
What is it NOT…
• • • • • • •
NORMAL Aging Slower to think Slower to do Hesitates more More likely to ‘look before you leap’ Know the person but not the name Pause to find words Reminded of the past
• • • • • • • •
NOT Normal Aging Can’t think the same Can’t do like before Can’t get started Can’t seem to move on Doesn’t think it out at all Can’t place the person Words won’t come – even later Confused about past versus now
What Could It Be?
• • • • • • •
Another medical condition Medication side-effect Hearing loss or vision loss Depression Acute illness Severe but unrecognized pain Other things…
DEMENTIA Alzheimer’s Disease
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Early - Young Onset
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Normal Onset Vascular Dementias
(Multi-infarct)
Lewy Body Dementia Fronto Temporal Lobe Dementias Other Dementias
•Genetic syndromes •Metabolic pxs •ETOH related •Drugs/toxin exposure •White matter diseases •Mass effects •Depression(?) or Other Mental conditions •Infections – BBB cross •Parkinson’s
Alzheimer’s
• • • • • • •
New info lost Recent memory worse Problems finding words Mis-speaks More impulsive or indecisive Gets lost Notice changes over 6 months – 1 year
Vascular Dementia
• • • • • •
Sudden changes Picture varies by person Can have bounce back & bad days Judgment and behavior ‘not the same’ Spotty losses Emotional & energy shifts
Lewy Body Dementia
• • • • • • •
Movement problems - Falls Visual Hallucinations Fine motor problems – hands & swallowing Episodes of rigidity & syncopy Nightmares Fluctuations in abilities Drug responses can be extreme & strange
Fronto-Temporal Dementias
• • •
Many types Frontal – impulse and behavior control loss
– –
Says unexpected, rude, mean, odd things to others Dis-inhibited – food, drink, sex, emotions, actions Temporal – language loss
–
Can’t speak or get words out
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Can’t understand what is said, sound fluent – nonsense words
What is Dementia?...
• •
It is BOTH a chemical change in the brain AND a structural change in the brain
•
So… Sometimes they can & sometimes they can’t
PET and Aging
PET Scan of 20-Year-Old Brain PET Scan of 80-Year-Old Brain ADEAR, 2003
Learning & Memory Center Hippocampus BIG CHANGE
Understanding Language – BIG CHANGE
Hearing Sound – Not Changed
Sensory Strip Motor Strip White Matter Connections BIG CHANGES Automatic Speech Rhythm – Music Expletives PRESERVED Formal Speech & Language Center HUGE CHANGES
Executive Control Center
Emotions Behavior Judgment Reasoning
Vision Center – BIG CHANGES
Positron Emission Tomography (PET) Alzheimer’s Disease Progression vs. Normal Brains
Normal Early Alzheimer’s Late Alzheimer’s Child
G. Small, UCLA School of Medicine.
So… What is Dementia?
• • • • • •
It changes everything over time It is NOT something the person can control It is NOT always the same for every person It is NOT a mental illness It is real It is hard at times
Dementia can be treated
• • • • • • •
With knowledge With skill building With commitment With flexibility With practice With support With compassion
How to Get Started…
• • • •
Be Honest … What is Going on NOW?
Get someone to help you look at it Talk about ‘what is’ …
–
The GOOD
–
The BAD
–
The UGLY!
Take Some Time To…
• •
Figure out WHO you are And WHO your partner is…
• •
Similarities & Differences And Respect Both Partners’ Needs
Who Are You?... Your Partner?
•
Introvert
•
Logical & Reasoning
•
Big Picture
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Plan it Out
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Extrovert
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Emotional & Feeling
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Lots of Details
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Just Do It
Four Key Building Blocks
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Activities to Relax & Re-energize
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Activities to Feel Productive & Valued
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Activities for Fun & ‘Just Because’
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Activities to Take Care of Yourself
Its all about BALANCE
• • • • •
Some of each Not too much of any Get into a routine & stick to it With a little changing up And time in between to chill
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Some old, some new
•
Some for me, some for you
Things that will HELP…
• • • • • • • •
Build activities Get active Socialize De-Stress Get enough sleep Get sleep apnea & depression treated Control blood pressure & diabetes Take meds CAREFULLY
Some Specifics…
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Help to make new friends – form partnerships Help keep the old – familiar contacts Explore & create volunteer opportunities Use old skills and routines in new ways ‘Give it a try’ – offer more than once Start low, go slow… build a little at a time Consider a support group for talking about changes Get away from your partners… some Build a WHOLE day – 24/7
Care Partners…
• • • • • • •
Be a partner, not a boss Be an advocate, build a team Do with me, not for me or to me… Learn the ‘SO WHAT?’ philosophy… Learn to let go not give up Learn what you are good at, & what not … These ideas are for you TOO!
• • • •
Some Key Beliefs & Principles: All people need to be needed – nurturing is a critical part of life worth living Dementia Steals Away Roles and Responsibilities that Make Us WHO We Are Activities can make a critical difference in the health and well-being of people with dementia IF Used Appropriately for the degree of involvement – the ‘Just Right’ Challenge