Working with People with Dementia and Other Cognitive Impairments

PowerPoint Presentation Working with People with Dementia and Other Cognitive Impairments Terry R Barclay, Ph D Clinical Neuropsychologist Brought to you by Background Neuropsychologist Training UCLA.

Working with People with Dementia and Other Cognitive Impairments Terry R Barclay, Ph.D Clinical Neuropsychologist Brought to you by Background  Neuropsychologist – Training: UCLA School of Medicine – Specialist: Aging/Dementia    HealthPartners Neurology Alzheimer’s Research Center Independent practice, Edina – Practice:     Cognitive/Psychological evaluations Medical/Legal cases Geriatric consultation Psychotherapy Brought to you by Objectives Signs, symptoms, and stages of common forms of dementia Strategies for early recognition and assessment Effective interview and communication techniques Tips for intervention and referral Brought to you by Normal (Healthy) Aging Characteristic pattern: – Sensory declines (i.e., hearing, vision) – General slowing of information processing – Intelligence remains stable – Mild decrease in:  Ability to recall names of people, places, objects  Mental flexibility  Memory Independence preserved in daily activities Brought to you by What is Dementia? A disease of the brain that causes a decline in memory and intellectual functioning from some previously higher level of functioning severe enough to interfere with everyday life Brought to you by Dementia is NOT normal aging Common Signs of Dementia  Memory loss – Newly learned information vs old memories     Disorientation to time, place, and people Language problems Diminished concentration Visual-spatial and perception problems – Sense of direction    Difficulty with complex tasks and learning new concepts Problems with abstract reasoning, problem-solving, judgment Changes in personality / mood / behavior Brought to you by How is Dementia Diagnosed?       Complete medical history Physical exam Neurological exam Lab tests Neuroimaging (CT, MRI) Mental Status exam –  Neuropsychological testing Functional assessment of ADLs and IADLs – OT/PT evaluation No single test can diagnose Dementia Brought to you by Dementia vs Alzheimer’s What is the difference between dementia and Alzheimer’s disease? Brought to you by Flowers Pansies Mums Tulips Daisies Roses Brought to you by Dementia Frontotemporal dementia Vascular dementia Parkinson’s dementia Lewy body dementia Alzheimer’s dementia Brought to you by Verbal vs Non-Verbal Brought to you by Communication Strategies  Slow down – Be careful to match the pace of the individual – Speak at leisurely pace, in shorter sentences – Be patient and give them time to respond – Try not to interrupt  Paraphrase – Acknowledge what the other person is saying  Be active – Enhance your message with gestures, inflection, objects – Ask for clarification when needed Brought to you by Communication Strategies Distraction – If the person becomes agitated, not argue – Distract them with more pleasant, benign topic You not have to understand everything that is said – Interpret the emotion – Mirror their facial expressions and body language Brought to you by Communication Strategies  Confabulation – Some individuals may make assertions that are not true to cover for memory loss – Trying to argue them out of such beliefs is usually futile because person is not lying – Circle back around to topic later  Reluctance to participate – Often fear of someone finding out how bad things are getting & losing freedoms – Help individual feel in control (e.g., join with them, acknowledge fear, offer choices) Brought to you by Communication Strategies  Avoidance – If person begins to move away from questions, changes subject, becomes tense – go back to building rapport  Reactions to caregivers – Note reaction and comfort level when caregiver comes into room – Does the caregiver resist letting you speak with the senior alone? – Do they try to answer for them? Brought to you by Getting People to Accept Help  Work from the familiar – Who is already a trusted part of their routine? – Which trusted person is available and willing to introduce new things?  Take small steps – Is there a way to start something as a “social visit” or “one time trial”? – Would they try it out with a trusted escort? – Could the service (or provider) come to them? – Have a good plan that is shared with all involved Brought to you by Getting People to Accept Help  Routine is security – How can you build things into their existing structure/routine?  Reassure fears of losing control – Give control to them wherever possible through choices, opinions, being involved in decision making, etc  Focus on their values and interests – How can you tie the service or intervention into what the person already likes or enjoys? Brought to you by Keeping PWD at Home Promote: – Family education about dementia – Regular (annual) visits to the doctor  Formal memory loss work-up  Empower family members to join – Increased (daily) physical activity, mobility – Regulated sleep patterns (short naps okay) – Balanced diet, frequent hydration Brought to you by Keeping PWD at Home  Promote: – Frequent social interactions (but not over – – – – stimulation) Regular mental stimulation Early support and intervention for mood disturbances Safety (medication adherence, cooking, driving) Psychological, medical, social, and respite support for caregivers Brought to you by Community Resources  Alzheimer’s Association – Memory loss: not just AD – 24 hour helpline (800-272-3900) – Care consultation – Safe return – Meeting of the Minds (St Paul, March) – One stop shop  Local memory disorders clinics, support groups, novel community programs, home supports, service referrals, healthcare and legal planning, etc Brought to you by Community Resources Memory Clubs – Validated education and support program – Wilder Foundation (651-280-2295) Statewide care planning and support – Family Memory Care – Early Memory Care – 800-333-2433 Coach Broyles’ Playbook for Alzheimer’s Caregivers Brought to you by This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a Brought to you by noble cause Our views have increased the mark of the 79,000   Thank you viewers Looking forward for franchise, collaboration, partners Brought to you by :-Contact Us ,011-41425180 ,011-25464531 011-66217387 91-+,91-9818308353+ 9818569476 othermotherindia@gma il.com www.other-mother www.parveenchadha.com in https://cparveen.wix.com /other-mother https:// twitter.com/othermotherindi http://www.linkedin.com/profile/view?id=326103341&trk= nav_responsive_tab_profile https://www.facebook.com/pages/Other-Mother-Nursing-Crusade/224235 031114989?ref=hl A WORLDWIDE MISSITION JOIN US Questions & Discussion ... Roses Brought to you by Dementia Frontotemporal dementia Vascular dementia Parkinson’s dementia Lewy body dementia Alzheimer’s dementia Brought to you by Many Causes of Dementia       ... best  Familiarity helps those with dementia feel safe and comfortable  Rapport building – Heightened sensitivity to other people? ??s moods, feelings, body language and tone of voice – Warm smile,... reassurance and understanding in order to feel comfortable – Withholding judgment builds trust Brought to you by Setting The Stage Ask all family, caregivers, and others to leave the room Begin with