March 2021

Until There's A Cure, There's Care.

Language Changes

by Teepa Snow, MS, OTR/L, FAOTA

The 2021 theme of our Online Dementia Journal is: Changes. The theme for the month of March is Language Changes. Here are a couple of questions to ponder for self-reflection as you read through this month's Online Dementia Journal.

How do we know if our language skills are changing?

How can we build in ways to check our abilities?

Is there value in learning a new language or using a native tongue when dementia is present?

What about Love Languages and how we communicate them for better relationships?

Can we notice the meaning behind the changes and identify what to do for better connections? 

Visual Processing Changes will be the theme for April.

Language and Rhythm Awareness

by Teepa Snow, MS, OTR/L, FAOTA

This month I am providing a video update on Language and Rhythm Awareness. In this segment I am covering where various abilities are housed in the human brain. I also highlight how changes in structures and wiring between sections can impact what is coming in, being processed, and going out in the areas of language, hearing sound, and rhythmic abilities. My goal is to provide evidence that supports the need to recognize and respond to changing language and rhythm abilities in ourselves and others when trying to successfully connect, interact, and communicate with people who may have changing brains.

How to Interact with Someone Who is in the Later States of Dementia

by Polly Logan and Rachel Voelkers

When someone is living in the later states of dementia, interactions can often be a bit tricky. If the person living with dementia has few words left, it can be difficult to know what to say. When someone has a harder time maintaining attention for a significant period of time, it can be challenging to find activities to engage them. When their ability to express themselves with voice, eye contact, or facial expressions is diminished, it can sometimes be tough to tell if they are enjoying your presence or not. So what can you do?

Here are some tips for interactions with those living in the later states of dementia. We have included some video clips from a recording of a Zoom chat between our PAC team member, Rachel, and her grandfather, David, who was in an Amber/Ruby State at that time. Although Rachel and David’s visit was a virtual one, these tips apply to in-person interactions, as well.

Something is Changing... Is It Me?

by Teepa Snow, MS, OTR/L, FAOTA

What happens when you notice your abilities aren’t what you expect them to be? Do you find you are getting surprised by reactions from others? Are some outcomes totally unexpected and frustrating? Is it taking a lot more effort to do something that used to seem so simple and easy? Could it be that you only realize you made a mistake after someone else notices, whereas before, you would have caught it and fixed it on your own?

It turns out different people have different reactions and responses to changing abilities and situations. It can depend on the type or form of dementia that is being experienced. It is also possible that reactions will be based on lifelong patterns and habits when confronted with a surprising situation or outcome. It turns out that human beings vary greatly in how each of us reacts when we uncover a difference in what we believe or think is going to happen and what actually occurs in these situations.

Continue reading Teepa's full article

Language Changes

by Dan Bulgarelli,   
PAC Chief Financial Officer

Without context, the words Language Changes could mean many different things. A short list of meanings would include how language changes based on location, how language changes between generations, or how language changes over time. Another way to look at it, is that as our brains change with dementia, our ability to understand, process, and create language changes. Teepa and my colleagues will cover the effects dementia has on language throughout the rest of the journal, I’m going to have some fun and focus on how language changes over location, generations, and time.

For instance, if I were to tell you that I’m a troll that drinks pop on his way to a Euchre tournament in the thumb and I’ve got some Vernors in the trunk just in case, would that mean anything to you? Well, if you were from Michigan, as I am, it would make perfect sense. I will try to translate:

Continue reading for Dan's translation and other language changes

Positive Approach to Care's Relationship Guide

Relationships take work, understanding, and honesty. If you are willing to put those qualities in and so is your significant other, sibling, parent, friend, co-worker, or anyone else, this guide can help you have a better relationship.

In This Issue:

Our theme this month - Language Changes

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Positive Approach to Care's Online Dementia Journal  (ODJ) is a free monthly e-newsletter designed for families and professional care partners who are looking to grow their awareness and knowledge in order to provide better care for people living with dementia.

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This is a paid advertisement, and PAC does not promote or endorse any product not produced by PAC. 
This is a paid advertisement, and PAC does not promote or endorse any product not produced by PAC. 

Positive Approach to Care® In This Moment Support Cards

Preview the 2021 Positive Approach To Care® Calendar with Mentor Trainings, Certified Community Events, and Public Virtual Events.

People Living with Dementia

At Positive Approach to Care (PAC), we cannot do what we do without help from our friends who are living with dementia. In this section of the Online Dementia Journal, we will share out info from our Core Team. If you are interested in being a part of the PAC Core Team or would like to contribute a story or video, please contact Corrie via email.

by Lauren U,
PAC Core Team Member

‘Til Death is Not Long Enough

How is it possible that he is no longer here? I don’t really remember a time when I did not know Andy. We grew up together. Our deep friendship began at age 15. We merged. Into one another. As a team, a lifelong pair. Bonded. Forever.

Our strictly platonic love affair was obvious to everyone. His parents and mine simply accepted it. My mother included Andy’s favorites at the grocery store and his mom did the same for me. I frequently spent the night in Andy’s adolescent bedroom. There were two beds, one his and one mine. I drew pictures on his walls with pencil. We ate pizza. We listened to music, went to concerts, and went on vacations together. We did plenty of stupid and silly things. We found each other hilarious and laughed a lot.

There’s a language that only the two of us understand. Now all that information begins and ends with me.

Forty-two years of Us. We were Andy and Lauren. We were like twins. And now he is gone. My Andy. Forever. How do I do this without him? I’m so very sad. I am overwhelmed with grief.

I can’t breathe.

Continue for a printable version of the complete article

In our Community Care Circle, we encourage you to become a voice for dementia care locally and around the world. Share your insights. Be a voice for those who cannot speak. Inspire others to take action!

Use #communitycarecircle in your posts to let folks know you support the full circle of community care and that we are all in this together. Share out your message and tag us on social media.

Courageous Conversations

by Teepa Snow, MS, OTR/L, FAOTA

Positive Approach to Care® (PAC) recognizes the value of providing an opportunity for individuals with a perspective or point of view in the world of dementia to speak up and speak out. This opportunity is designed to provide the space and support needed to talk through something that matters to that person and to the larger community. The topic and perspective is not always seen as acceptable or of importance by others.

Courageous Conversations happen Wednesdays at 10am on our Facebook page.  We typically follow up that posting with online comments, conversation, and a Teepa for Ten session on Thursday morning.  All videos can be seen on Teepa Snow’s Positive Approach to Care YouTube channel.


Next offering March 29, 2021 – 3:00pm ET

PAC has created various ways to play Bingo that moves your body and exercises your brain. Join Teepa and Cheryl for a free session that is open to anyone.

This session is held every other Monday from 3:00-4:00pm ET through the end of 2021. Doors open (virtually) at 2:45pm ET.

If you have questions, please contact us.

Family / Friend Care Partners

We will use this section of the journal to share out ideas, perspectives, and experiences from Family and Friend Care Partners just like you. If you are interested in contributing a story, photo, or video, please contact Christine via email.

5 Tips for Communicating Better When Dementia is Involved

by Christine Browdy,
PAC Product Development and
Valerie Feurich, Director of Marketing and Technology

When a person is living with dementia, communication can sometimes become difficult. As a person’s brain is changing, their ability to comprehend and process vocabulary can decrease. Learning how to get started at communicating better can therefore become critically important. We sometimes underestimate how soon issues with communication start and may miss the early signals that someone is probably struggling a bit more than they used to.

Every one of us has been in a situation where you couldn’t think of the right word, and so had to pause. In a healthy brain, the normal reaction to someone offering you a word is: oh good, now we can move on. Whereas when someone is living with dementia, suddenly jumping in with a word can cause confusion, as now they have to look at that word and figure out if that’s the word they were looking for. And when you factor in memory problems, it’s probable they’ll have a hard time remembering what their word was in the first place.

Continue reading for our 5 tips for better communication

Dealing with Dementia Requires Inspiration, Planning, and Support

by Julie Cook Downing,  
Founder and President of Caregivers' Comfort Creations, LLC

Caregivers’ Comfort Creations®, LLC., was originally inspired by my parents, Katherine Kitty Cook and Culbreth Cookie Cook, when my mother was diagnosed with Alzheimers disease in 1996. At the age of 84, my father, a W.W.II Veteran, became her primary caregiver and my husband and I became her long-distance caregivers. Caregiver responsibilities vary from family to family and patient to patient, but there is one common thread: All caregivers risk their own physical, mental, and emotional well-being because they are so deeply affected by their caregiving circumstances.

After many long-distance conversations and visits, it became apparent to me that all caregivers need daily reminders telling them how much they are loved and appreciated for what they do. When I could not be there daily to personally express my appreciation to my dad, I decided to create something that would. As a result, I created Caregivers’ Comfort, an inspirational 366-day journal and record book for my father to receive daily uplifting inspiration with his caregiving.

Continue reading the full article and learn where to find your calendar

Language - It Goes Both Ways

by Carolyn Lukert, MBA, CGCM,  
PAC Consultant and Mentor

As a PAC Consultant and Family Care Partner, I often get questions and encounter situations that revolve around language changes. In hearing this, you might be thinking I am referring specifically to changes that are happening with persons living with dementia. You know, those three areas of language that Teepa and team often reference: speech production, vocabulary, and comprehension.

I’d like to offer a different spin on this very same topic. What about the language on the part of the care partners? What changes are we noticing in ourselves as we navigate the oftentimes choppy waters of this experience?

Continue reading the entire article

When Words Fail, Music Speaks

by Mary Sue Wilkinson,  
Founder of Singing Heart to Heart and Author of "Songs You Know by Heart: A Simple Guide for Using Music in Dementia Care"

The language of love is often told through music. I’m sure you’re not surprised to learn that a quick search for the most popular songs of any given year shows that love is a very common theme.

What do you picture when you hear someone say; They’re playing our song?

Could it be a teenage couple parked in the shadows of a side street listening to the radio as they share their first kiss?

Could it be a high school dance when the shy young man finally gets up the nerve to ask the girl from his homeroom class to dance?

Fast forward fifty years or more. Will those songs be remembered? Will they still bring a smile or a warm and comforting feeling?

When words fail, will music speak?

Continue reading Mary Sue's article

Professional Connections

Professional Connections will focus on providing information, resources, and products for dementia care professionals. We hope in 2021 to provide valuable information while building a network of dementia care professionals who share our mission, core values, and passion.

Tell Me What?

by Stephanie "Teffie" Landmann, COTA/L,  
PAC Support Mentor, Coach, and Trainer

Fast forward a few more years to where I learned what is happening with comprehension for someone with brain change. For someone in an Emerald (moderate) State the brain is processing about four words at a time. Let me tell you again. Only four words are being processed. One more time, comprehending only four words. Whoa, that’s not a lot of words, even for me. What can I do? Only say four words during an entire hour treatment? That’s not going to work. The answer is the pause. Here’s the new formula: use a four-word sentence, pause (wait for comprehension) use another four-word sentence (pause), and finally get to the task with a four-word sentence.

Continue reading the complete article

What is Teepa Reading?
Here are a few articles that Teepa has recommended recently.

The articles vary from those containing scientific research to opinion pieces. They are meant to inform and create discussion on important and relevant topics.

Positive Approach to Care has launched an Amazon Storefront

Organization Care

Creating a culture that cares is easy. Creating a culture that is positive and skilled in person-centered care with dementia is much trickier. Organizational Care will explore ways to positively impact your organization.

When Words Match Vision and Touch

by Debi Tyler-Newsom, OTR/L,  
PAC Client Relations Director

Think about the typical interactions in a care facility, lots of activity, gloved hands waving and pointing, smiles cloaked in masks, muffled instructions to Get up, Come here, or Stop. Even touch, when necessary to complete a care task.

How is your community doing at slowing the pace, showing a smile, and giving simple words and touch in a way that match the abilities and needs of the resident? What responses do you see when your visual, verbal, and touch cues are effective? Think of one area where you could try something different in your match of cues, perhaps using hand motions that fit your simple words, using a touch cue on yourself to demonstrate the task that they can see, or reflecting a facial expression with a single word that lets them know you understand how they feel.

Continue reading the complete article

"Just like gems, each person is precious, valuable, and unique, and given the right setting and care, can shine." - Teepa Snow

Expressive Language Changes for each GEMS State.

  • Sapphire State - with aging, word finding will get a little slower.
  • Diamond State - ability varies with affect, word finding problems, misspeaking in times of stress.
  • Emerald State - gets stuck in social chit-chat, may repeat phrases or words, intonation matters for meaning of what is said.
  • Amber State - repetitive, varied volume, echo speech they hear.
  • Ruby State - less articulated speech, babble, hum or sing, rhythmic vocalizations.
  • Pearl State - may make sounds to single words, responsive to voices at times.
Become Skillful in Engaging with Others When Dementia is Part of Life
  • Teepa Snow in a four hour master class on a specific GEMS State exploration with mentored support
  • On-line videos to build your awareness and knowledge about GEMS States, and Engagement Abilities
  • Digital resources that will be yours to use after the workshop to share with others and use yourself
    • Three Brain Connection Café sessions
    • Access to or a copy of Filling the Day with Meaning and Teepa’s GEMS YouTube Clip

If you have questions, please contact us.

Certified Community
Connections (C3)

This corner is designed to provide a forum for sharing among our Certified Community of over 1,800 members. There will be articles and interviews that will help this community become better connected and more aware of each other and the work that is being done to change the culture of dementia care!

Tip of the Tongue Moments and Physical Fitness

by Gretchen M. Ashton, CFT, SFT, SFN, SSC, NBFE, and PAC Certified Independent Consultant

We all know that what we say and how we say it makes a difference. Controlling the tongue can be a challenge in more ways than one. For most of us, with minimal mental effort we can change tone, volume, pronunciation, and words to be persuasive, directional, compassionate, or even silly. According to various studies, talking also requires minimal physical effort; not much more than sitting silently. However, talking loudly might utilize about 20% more oxygen than speaking at a moderate volume. Singing requires about the same physical exertion as a casual walk and can improve lung function for better breathing. Laughing requires the most physical energy and is stated to improve brain health. Benefits involve increased heart rate, which helps oxygenate the blood, muscles and organs, along with releasing chemicals in the brain that positively affect brain function. Laughter may help reduce high blood pressure and has been demonstrated to break pain spasms.

Click to continue reading the entire article

Self- Awareness: When Things Become Not So Crystal Clear

by Julie Gala, MA, CCC-SLP, Assistant Director of Clinical Services, and PAC Certified Independent Trainer

Life isn’t always seen through rose-colored glasses, especially for our Persons Living with Dementia (PLwD) who are transitioning GEMS States from Diamond to Emerald. Clarity becomes more muddled and they start losing their sense of self. As PAC trained care partners, we may be the first to notice when the disease process progresses and the PLwD is transitioning to the next state. Maybe we start hearing phrases such as, Where am I, Why are you playing that music, Of course, I can drive home; give me my keys, That’s not my husband, or I already changed my clothes. The PLwD is starting to lose awareness about themselves including hobbies, interests, relationships, orientation, safety awareness, and participation in daily tasks.

As trained care partners, we know that Emeralds present with the following common issues related to the progression of dementia and we have the skills to connect each to the decline in self-awareness:

Click to continue reading the complete article

Resource Connection

This section will highlight and share out the latest and greatest ways to stay connected with PAC. You will find PAC products, services, events, relationship opportunities, and FREE resources every month. Stay up to date with PAC Certification options, especially our newly expanded PAC Champion offerings, the PAC Annual Conference, and Teepa's Master Courses. If you don’t see what you are looking for, let us know here.

You’re never too young, or old, to work on your relationships.

Let's work on improving our relationships by changing the conversation to a more positive one for all.

$50 Public Care Partner Support Series - starting each month. Our next series of five weekly sessions is from April 5th - May 3rd.

Looking for an educational forum where you can gain awareness and knowledge of care strategies to help you provide better care for a loved one or friend living with dementia?

Seeing the GEMS® Workbook

Includes Bonus Videos!

Seeing the GEMS® Workbook is a 48-page full-color workbook designed to help learners develop a deeper understanding of Teepa Snow’s GEMS State Model. This workbook details the characteristics of the GEMS States and the retained abilities associated with each.

Relationships. Guidebook for Teepa Snow’s Positive Approach to All Relationships

Special Introductory Price of $25- Limited Time Only.

This 90 page full-color guidebook is designed to help you develop a deeper understanding of all relationships. We intentionally designed this to be an easy to understand, go-to, in-the-moment support.

Bring in Support (with a Real Person, Virtually)

Watching videos is a great start, but all theory needs to be practiced to turn into genuine skill. Pair your team with a PAC Mentor for LIVE, virtual training via Zoom to help make the vision of quality care a reality.

Organizations can book their own Private Care Partner Support Series (CPSS) at $750 for 5 sessions for up to 15 of your families! Support the families you serve with dementia knowledge and language to open the conversation!

[thrive_2step id='268169']Click to download Positive Approach to Care's FREE GEMS Dementia Care App[/thrive_2step]

PAC Partners and Sponsors

Summit: A Guide from Pain to Peace by Cindy Paige

Are you stuck in the aftermath of life's storm? This book is a collection of practical strategies artfully woven together with storytelling of the pain of the journey and the humor of life. Told as a metaphor to climbing Mt. Everest, Summit will meet you in your current situation and set you up to reach your personal destination of peace and happiness. You will be guided to:

  • Prepare. From where you are to where you want to be--you will map your destination and gather what you need.
  • Climb. Learn practical tips and strategies to tackle your mountain and hear from others on their trek. You are not alone.
  • Summit. The journey is hard, but not impossible.

If you are someone who has experienced a loss and would like to move forward in your recovery, this book is for you. You can reach your Summit. Begin the journey today. For more tips, and thoughts on reaching your summit out of pain, visit my website.

This is a paid advertisement, and PAC does not promote or endorse any product not produced by PAC.

Word Walls

Care partners knew my mother as they saw her, but we wanted them to know more, to get a glimpse into her beautiful life story and how much she was loved. The Word Walls brought communication to her in a new way. It became her voice, a conversation starter for care partners to engage with her in a more meaningful way. We had pictures and personal belongings throughout her room but seeing her story was powerful and could not be ignored. That was my goal. I wanted everyone that engaged with my mom to know the wonderful woman she was and would forever be.

Visit our Word Wall Builder found on the create page of our website to customize your own wall. Please visit our website,  Facebook, or Linkedin for more examples and information.

This is a paid advertisement, and PAC does not promote or endorse any product not produced by PAC. 

Meal Lifter eating aid, specifically created for senior living communities, nursing homes, and home healthcare providers.

Originally created to assist individuals suffering from Parkinsons disease, it has also proven beneficial to Alzheimers and memory care patients, and individuals who no longer have the physical ability or coordination necessary to comfortably feed themselves. The device increases visibility of the dinner plate making eating more enjoyable, while providing greater ease and dignity.

It has proven to be beneficial to dementia patients by using a red plate to increase visibility.

The Meal Lifter is available through Direct Supply and can also be viewed on our website, Instagram, and Facebook.

This is a paid advertisement, and PAC does not promote or endorse any product not produced by PAC.

The Picture This app gives the classic, card-matching memory game a modern twist. Use your own pictures as the images to match!

When a loved one’s memory declines, the ability to recall names and faces can become a struggle. Picture This goes beyond the simple memory exercising game with the ability to use your own pictures for an interactive experience, which will help connect past memories to present realities. Picture This engages the long-term and short-term memory with the act of finding two matching cards. Identifying the friend or family member in the photo by guessing the correct caption will then trigger recall memory skills. Help facilitate communication with Picture This.

For more information on Picture This, seniors, and memory care, visit our Website and check out our Facebook page. Download Picture This for FREE!

This is a paid advertisement, and PAC does not promote or endorse any product not produced by PAC. 

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