1. Holy Cross Village Dementia Training
Basic Principals of Care

2. Class Objectives Learn the leading causes of dementia
Understand What happens when someone has Alzheimer's disease
Learn a few communication techniques to use with resident’s who have dementia
Develop empathy for our residents suffering from dementia

3. In this Life one cannot do great things, only small things with great love.
Mother Teresa

4. Dementia Defined
Dementia is a broad term used to describe the symptoms of a group of illnesses that cause a progressive decline in a person’s functioning.
Dementia symptoms include loss of memory, intellect, rationality, social skills and normal emotional reactions.

5. Forms of Dementia Alzheimer’s disease Vascular dementia
Parkinson’s disease
Lewy Body dementia
Huntington’s disease
Alcohol related dementia
AIDS related dementia
Normal Pressure Hydrocephalus

6. Alzheimer’s Disease Is the most common form of dementia
Accounts for 50-70% of all cases
Affects about 5.4 million Americans
1 in 8 Americans over 65
2/3 cases are women
90% over age 75
5th leading cause of death over age 65

7. The Alzheimer’s Brain

8. Plaques and Tangles

9. Progression of Disease

10. Mild Alzheimer’s Disease
Problems getting lost
Trouble handling money and paying bills
Repeating questions
Taking longer to complete normal daily tasks
Poor judgment
Small mood and personality changes.
People are often seek medical advice when they notice these problems and are often diagnosed during this stage.

11. Moderate Alzheimer’s Disease
Difficulty with language
Memory loss increases
Confusion increases
Difficulty recognizing family members
May be unable to learn new tasks
May have hallucinations or delusions
May behave impulsively
In this stage, damage occurs in areas of the brain that control language, reasoning, sensory processing, and conscious thought.
Memory loss and confusion increase, and people begin to have difficulty recognizing family and friends.
They may be unable to learn new things or carry out tasks that involve multiple steps.
They may have hallucinations, delusions, paranoia, and may behave impulsively

12. Severe Alzheimer's Disease
People in final stages of the disease cannot communicate.
They are dependent on others for their care.
People may lose the ability to swallow.
Alzheimer's patients may be in bed most or all of the time as the body shuts down.

13. Vascular Dementia This is the second most common type of dementia
This type of dementia is caused by problems with circulation of blood in the brain.
Can be caused strokes and stroke related changes in the brain such as thickening of the arteries and poor blood flow.
Some people have both Alzheimer’s and Vascular dementia.

14. Diagnosis Cause of Disease is unknown
Doctors ask questions about changes
Doctors conduct memory tests
Rule out other medical causes
Lab tests to determine other causes
CT or MRI imaging of brain
Autopsy

15. Treatment No cure Medications to slow the progression Aricept Exelon
Razadyne
Namenda
Manage Behavioral Symptoms

16. How Would You Feel If . . .?
You just had your car keys in your hand and now you can’t find them.
You were lost and when you asked for directions, you found that they were too complicated to follow.
Coworkers were whispering and kept looking at you.
Your teenage son was 2 hours late coming home from a date.
You heard a strange noise in the middle of the night.
You were at a family wedding and you suddenly realized that you had on one black shoe and one brown shoe.

17. Do you think persons with Alzheimer’s disease ever have similar feelings? When and Why?

18. Problems with speaking and understanding are the result of damage to the brain, not stubbornness

19. Memory Last to learn, first to go
Memories blow off layer by layer from top to bottom
What happened yesterday
Grandchildren being born
Marriage
High School
Grade School
First Memories

20. Needs of Persons with Alzheimer's Disease
To feel connected
To feel resected
To feel loved
To be known
To be understood
To experience belonging
To share, give, love
To be helpful, useful
To feel safe

21. How can we find ways to meet these needs for our residents?
Group Discussions and sharing

22. Do’s for Communication
Keep a clear mind and open your heart
Listen Carefully
Help a person fill in the blanks
Read facial expressions and body language and try to respond appropriately
Give compliments
Ask opinions
Ask open ended questions
Give generous praise
Use Common Sense
Enjoy the person in every way possible
Take the blame and apologize
Be sincere
Use the person’s life story frequently
Use positive language
Rely on humor
Keep language simple

23. Do not's for Communication
Argue, confront, correct
Give orders, make demands
Talk down to a person
Talk about a person in his or her presence as if the person were not there
Ask questions that require remembering too many facts
Try to explain or prepare too far in advance
Take negative comments personally
Give too many choices
Take anything for granted

24. Listening as Spiritual Hospitality
Listening is much more than allowing another to talk while waiting for a chance to respond. Listening is pay full attention to others and welcoming them into our very beings.
True listeners no longer have an inner need to make their presence known. They are free to receive, to welcome, to accept.
Listening is a form of spiritual hospitality by which you invite strangers to become friends, to get to know their inner selves more fully, and even dare to be silent with you.

25. Practice
Practice scenarios in groups and group discussion

26. An Alzheimer’s Disease Bill of Rights
Every person diagnosed with Alzheimer’s disease or a related disorder deserves:
To be informed of one’s diagnosis.
To have appropriate, ongoing medical care.
To be productive in work and play as long as possible
To be treated like an adult, not a child.
To have expressed feelings taken seriously.
To be free from psychotropic medications if at all possible.
To live in a safe, structured and predictable environment.
To enjoy meaningful activities to fill each day.
To be out-of-doors on a regular basis.
To have physical contact including hugging, caressing, and hand-holding.
To be with persons who know one’s life story, including cultural and religious traditions.
To be cared for by individuals well-trained in dementia care.
Source: Virginia Bell and David Troxel, The Best Friends Approach to Alzheimer’s Care. Health Professions Press,