DementiaDementiaA Privilege A Privilege

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Types of DementiaAlzheimers alteration chemistry/structure changes

Vascular Dementia/stroke oxygen lack

Dementia with Lewy Bodies in nerve cells

Frontal lobe dementia personality/ behaviour

Parkinson’s Huntington’s

Multiple Sclerosis Motor Neurone Disease

Korsakoff (alcohol) C-J-D HIV

What is Dementia

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Progressive, not just memory loss or forgetting names, may not recognise people or things,may get lost

Reduced attention span, ability to do things, understand or communicate increased agitation confusion

Caused by amyloid plaques/tau tangles (‘rungs’ in communication ladders) increased inflammatory response (TNF)

There is always a reason

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Every action has a reason Every communication has a purpose.

What sounds nonsense is showing a need, expressing a feeling, or wanting a response.

The meaning of words may be disconnected from their sound; so may not understand or may produce a word salad.

Questions

Asking What time is it?, might mean “I have no idea what I am meant to be doing”.

Asking Can I go home?, perhaps means “I do not feel comfortable ”

Listen to the meaning behind the question

Dementia Time Travel

May think it is 1960 when X not born Y not married Z still alive

Children have to learn social skills In dementia lose social inhibitions do not always ignore or accept

May have ‘comforter’ be aware

Actions there is always a reason

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Wandering may have a purpose or be responding to an hallucination.

Sleep patterns may get muddled not aware difference between am & pm.

Might not recognise an item (fork) so not know what to do with it.

Behavioural Patterns in Sundowning (memories work/childhood late afternoon)

Visual Spatial Muddle

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Might not recognise self in a mirror and think it is someone else.

May misjudge the edge of the table or bathroom furniture unless distinct/contrasting colours.

Pouring liquids can be dangerous.

May be frightened by carpets/floors

Strange behaviourDifficult behaviour to who?

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Aggression often due to frustration misinterpretation of events such as reflections in windows or mirrors

Incontinence can sometimes just forgetting to go

Might not be able to distinguish dreams from reality. Don’t laugh or call them a liar, is it a fantasy?

Unwillingness to ‘cooperate’ may be due to fear eg showers may not have been used in their childhood

SITUATIONS that can precipitate agitation or confusion

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Unfamiliar People

Unfamiliar Surroundings

Large Gatherings

A Task that is too complicated

Noise Lights

Travel

Illness

see it from their perspective

loss of blue purple green colour strange lighting busy patterns

contrasts (puzzles, carpets, bathroom, food)

walking, steps, feel as if falling visual barriers

misidentification/misnaming misinterpretation/misperception

When agitated

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Simplify/calm the environment

Don’t ask questions or overwhelm with words Reassure, show what to do, make a cup of tea

Too many people - take to a quieter place. Engage in a familiar activity, music, a walk.

When caring

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Introduce yourself with context

Approach from the front don’t tap on the back

Show Respect, their name, how dress, do hair, how touch

Involve...choice, (blue? not, which? jumper)

Buttonless clothes / digital time

Always leave with a smile

Feelings remain when facts are forgotten

SPECAL explained in Contented Dementia

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No need to tell lies

Exit strategy

Absent people

Affirming statements

Reasons to sit

Memories

There are several ways to reach the same destination

There are several ways to enter the same house

Don’t give up when it appears the key is lost (neurons die)

Carers family or others

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Younger family members may feel trapped, be fearful of their own future may even ‘run away’

Carers need a regular break to enable them to carry

on can become exhausted /depressed / deny such / hide it well

Suffer great guilt if unable to cope or cope badly This can add to their ‘grieving’ and they may be hypersensitive

Don’t assume you know what they are going through

Extra resources

Just put into google

Alzheimer’s Society

Somerset Dementia

Gloriousopportunity.org

DementiaDementiaAlways a reasonFeelings remain

Patterns continue

Always a reasonFeelings remain

Patterns continue

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