Hi! I'm Teepa Snow. I'm a dementia-care education specialist with a background in occupational therapy and over 30 years in clinical practice. I've worked in a variety of settings, with a variety of people, and would say I have learned a lot. I do a special kind of experiential training called multi-modal learning. I help people go from what they think they know about dementia to greater awareness. I help build knowledge (the why and the how) behind why people with dementia, or other forms of brain change, are doing what they are doing. I help build skill because, if you are going to make a difference, you've got to change. The condition is changing them. The question is, what are you going to do about it? You are on the journey. Take a look, and then try some of the tips I have provided because you can be the big difference. Not in where you end up, but in how you get there.
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Normal Aging or Dementia? Before you start assuming that symptoms or behaviors you see in someone who is changing are due to the effects of dementia, it's important to get things checked out. Many health challenges like depression, hypothyroidism, diabetes, new medication side effects, or vision and hearing loss, for example, may present with "dementia-like" symptoms but not be dementia. They might be treatable conditions or symptoms that can be addressed with support or environmental modification. Dementia, is not treatable, not fixable, not normal aging, and it is terminal. It is considered a syndrome and is made up of symptoms caused by approximately 90 different health conditions including Alzheimer's, Lewy Body, Parkinson's, MS, Frontal Temporal, Vascular, or Post Traumatic Stress Disorder, or Alcohol related challenges.
There are several progression models used to classify and define changes in a person due to the effects of dementia. Teepa wanted to improve upon existing models and intends for the GEMS® to be utilized not just to classify a state or stage of dementia, but as a means to improve interaction and appreciation of individuals. The GEMS® characteristics focus on ability instead of loss and are an invaluable tool to assist with changing abilities that impact relationship and expectations. Learn more about what it means to be living in the world with Sapphire, Diamond, Emerald, Amber, Ruby or Pearl cognitive and physical ability. Teepa believes all individuals, whatever their state of being, in the right setting and with the right care, can shine!
What is happening when someone has dementia? It's important to understand the job of the brain because it is the guiding system, the maintenance system, and the managing system of the body. Learn more about the role of the limbic system, the prefrontal cortex, the sensory motor strip, and the importance of the occipital lobe for seeing and doing. It is estimated that with most dementias the brain shrinks one third of it's original size causing many changes in structural and chemical ability. Dementia is not a memory problem, it means brain failure and causes many changes in structural and chemical function.
Unexpected and different behavior is part of the journey of living with dementia. One of the mistakes providers make is to judge behavior as challenging or problematic and then attempt to "stop it" before taking the time to notice what's really going on. Human behavior is almost always an attempt to communicate or meet a personal need. Remember, individuals are doing the best they can with their remaining cognitive or physical ability. They are often expressing what they like or don't like about an environment or what providers are doing or not doing to them. When this happens, it will require a pause or "time out" to observe and think through what might be behind the presenting behavior. Often time's providers don't realize they are the cause of challenging behaviors because of approaches that don't work or lack of understanding about an individual's unique preferences or needs. It is important to partner and "work with" a person when they are behaving in a way that surprises us. In order to be successful in changing behavior, it will be about how we respond to what is happening, and what we choose to do that will make the difference.
Meaningful days matter to all people. This need does not change for someone who is living with dementia. There are four categories of activity that help human beings feel valued, productive and purposeful. #1 Work: This is a very important life experience that gives a person the sense they are making a difference. It is not about money, but that we experience who we are and what we can do as being of value to others. This is critical in creating a sense of wellbeing and continued self-esteem. #2 Leisure: These are things we do because they are fun to us, make us feel good, or give us joy. These activities can be either passive or active, but will always improve a person’s mood and energy levels. #3 Self Care: Taking care of ourselves includes the big and the little things in our personal "world of needs" and include tasks and attention to our body, our mind, our environment, our business, and even how we move ourselves from place to place. #4 Rest & Restoration: This, is one that we don’t often think of as activity, but is a part of how we fill our day, and especially important to be aware of when someone is experiencing brain change. Rest includes sleep but also “time” taken, alone or with others, that helps a person to “recharge or restore” themselves. Restorative activity usually includes spiritual renewal, and introverted or extroverted personality preferences.
Teepa recommends using music at least twice a day for both providers and those living with dementia. It is an available and powerful resource that can lift spirits, stimulate or calm behavior, and provide meaningful connection even when communication is limited. Because rhythm is typically a preserved skill for those effected by dementia, music becomes the gift and is a valuable tool if you know how to use it. When utilized with activity, music can promote a sense of value, and meaning or purpose. It can also help relax, calm, or change a mood when used in leisure or quiet times. Music allows a brain to organize as well, promoting arousal and movement for those who may have trouble getting started or energized. Emotional memories are hard-wired in the brain rhythmically. Music is an effective and often quick way to elicit a sense of peace, joy, remembrance, and positive feelings for everyone.