1 / 35

Dementia : Why Do They Do That?

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.

anise
Télécharger la présentation

Dementia : Why Do They Do That?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Dementia:Why Do They Do That? How Can I Help? When Do I Need Help?

  2. REALIZE … • It Takes TWO to Tango … or two to tangle…

  3. Being ‘right’ doesn’t necessarily translate into a good outcome for both of you

  4. It’s the relationship that is MOST critical NOT the outcome of any one encounter

  5. 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.

  6. What is it NOT… NORMAL Aging 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 • 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

  7. What Could It Be? • Another medical condition • Medication side-effect • Hearing loss or vision loss • Depression • Acute illness • Severe but unrecognized pain • Other things…

  8. Cognitive Changes with Aging • Normal changes = more forgetful & slower to learn • MCI – Mild Cognitive Impairment = • Immediate recall, word finding, or complex problem solving problems (½ of these folks will develop dementia in 5 yrs) • Dementia = Chronic thinking problems in > 2 areas • Delirium =Rapid changes in thinking & alertness (seek medical help immediately ) • Depression =chronic unless treated, poor quality , I “don’t know”, “I just can’t” responses, no pleasure can look like agitation & confusion

  9. Vascular Dementias (Multi-infarct) DEMENTIA Lewy Body Dementia • Alzheimer’s • Disease • Early - Young Onset • Normal Onset • 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 Fronto- Temporal Lobe Dementias

  10. 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

  11. 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

  12. 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

  13. 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 • Can’t understand what is said, sound fluent – nonsense words

  14. 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

  15. PET Scan of 80-Year-Old Brain PET Scan of 20-Year-Old Brain PET and Aging ADEAR, 2003

  16. Positron Emission Tomography (PET) Alzheimer’s Disease Progression vs. Normal Brains Early Alzheimer’s Late Alzheimer’s Normal Child G. Small, UCLA School of Medicine.

  17. Brain atrophy • the brain actually shrinks • cells wither then die • abilities are lost • with Alzheimer’s area of loss are fairly predictable • … as is the progression • BUT the experience is individual…

  18. Memory Loss • Losses • Immediate recall • Attention to selected info • Recent events • Relationships • Preserved abilities • Long ago memories • Confabulation! • Emotional memories • Motor memories

  19. Understanding • Losses • Can’t interpret words • Misses some words • Gets off target • Preserved abilities • Can get facial expression • Hears tone of voice • Can get some non-verbals • Learns how to cover

  20. Sensory Changes • Losses • Awareness of body and position • Ability to locate and express pain • Awareness of feeling in most of body • Preserved Abilities • 4 areas can be sensitive • Any of these areas can be hypersensitive • Need for sensation can become extreme

  21. Self-Care Changes • Losses • initiation & termination • tool manipulation • sequencing • Preserved Abilities • motions and actions • the doing part • cued activity

  22. Language • Losses • Can’t find the right words • Word Salad • Vague language • Single phrases • Sounds & vocalizing • Can’t make needs known • Preserved abilities • singing • automatic speech • Swearing/sex words/forbidden words

  23. Impulse & Emotional Control • Losses • becomes labile & extreme • think it - say it • want it - do it • see it - use it • Preserved • desire to be respected • desire to be in control • regret after action

  24. 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

  25. Dementia can be treated • With knowledge • With skill building • With commitment • With flexibility • With practice • With support • With compassion

  26. 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!

  27. Take Some Time To… • Figure out WHO you are And • WHO your partner is… • Similarities & Differences And • Respect Both Partners’ Needs

  28. Introvert Logical & Reasoning Big Picture Plan it Out Extrovert Emotional & Feeling Lots of Details Just Do It Who Are You?... Your Partner?

  29. Four Key Building Blocks • Activities to Relax & Re-energize • Activities to Feel Productive & Valued • Activities for Fun & ‘Just Because’ • Activities to Take Care of Yourself

  30. 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 • Some old, some new • Some for me, some for you

  31. 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

  32. Some Specifics… • 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

  33. 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!

  34. 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

More Related