Dementia A Glorious opportunity 1

What is Dementia Progressive, not just memory loss Reduced attention span, ability to do things, understand or communicate May get lost or not recognise people Caused by amyloid plaques/tau tangles (‘rungs’ in communication ladders) Same effect from TIA’s (mini strokes) 2

Yesterday Today Forever Jesus is the same Yesterday Most remember how a person used to be in the past Today Some recognise the worth of the individual as they are today and treat them with respect and dignity Forever Christians should see how the person will be welcomed in heaven and treat them accordingly Do we believe this, as how God sees us? 3

There is always a reason ‘Every communication has a purpose, the challenge is to discover it. No word or action is meaningless, what sounds like nonsense or repetition is, to express a feeling, to show a need, to give information or to get a response. What appears to be inappropriate, may be a form of communication.’ 4

Words The meaning of words may become disconnected from their sounds so may not understand, or be able to construct a logical sentence in reply, may produce a word salad. May not understand letters in words so reading can be difficult. Talking about something familiar might enable them to ‘join in. 5

Actions Perhaps a need is being expressed. Wandering may have a purpose or be responding to an hallucination. Sleep patterns might get muddled. Might not recognise an item (fork) so not know what to do with it. 6

Visual Spatial 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 tricky or dangerous. 7

Questions Asking What time is it?, might just mean, “I have no idea what I am meant to be doing”. Asking Can I go home?, perhaps means “I do not feel comfortable ” 8

Strange behaviours Aggression often due to frustration misinterpretation of events such as reflections in windows or mirrors Incontinence can sometimes just be 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 9

Large Gatherings Noise Unfamiliar People A Task that is too complicated Travel Unfamiliar Surroundings Illness SITUATIONS that can precipitate agitation or confusion 10

When agitated Don’t ask questions Don’t overwhelm with words Simplify/calm the environment Reassure, show what to do, make a cup of tea Too many people - take to a quieter place. Engage in a familiar activity a walk or a car ride. Playing suitable music can calm and reassure 11

Approach from the front Don’t tap on the back Introduce yourself with context Wear bright clothes Talk about hobbies, or subjects, that meant a great deal earlier in their life. Show videos or pictures of events or outings. When visiting 12

Feelings remain when facts are forgotten Exit strategy Absent people Affirming statements Reasons to sit (No need to tell lies) SPECAL explained in Contented Dementia 13

Pastoral Visiting research their background, if possible use a bible version familiar to them (not you) common prayer book, SU resources brief visits, approach from front, sit near, make eye contact, look interested, calm, perhaps touch hand talk slowly, clearly, one subject at a time, be patient don’t ask questions tell of God’s unconditional love reassure of God’s acceptance, confirm spiritual truths 14

Resources Contented Dementia.. Oliver James And still the music plays... Graham Stokes Dementia Frank & Linda’s story.. Louise Morse Alzheimer’s from the Inside Out.. Richard Taylor My journey into Alzheimer's.. Rev Robert Davis Still Alice.. Lisa Genova Books explaining why & how Books by those with A Novel explaining what it is like for a professional to have A 15

Carers Dementia also effects the carers Can become exhausted and very depressed and hide it well Need a break from the responsibilities some family members even go abroad to escape Suffer great guilt if unable to cope This can add to their loss/grieving and may be hypersensitive Younger people can find it more distressing they may feel trapped and be fearful re their own future Some aren’t able to make use of offered help walk their path with them Novel by Carer 16

How do we see it? Alzheimer’s photo 2010 Our society glorifies youth individual accomplishment and independence. The Maoris have a shared `memory’ and all age groups equally valued. Zulu proverb `a person becomes a person through other people’. Christians all members of one body. 17

Dementia A Glorious opportunity 18