1. Dementia Awareness An introduction to supporting people with dementia

2. Aim: To provide you with a basic understanding of dementia and introduce approaches that will help you be supportive to people with dementia

3. Learning Objectives Increased understanding of the experience of dementia Increased understanding of communication and behaviour relating to dementia Increased understanding of the potential effects of the environment on a person with dementia Increased understanding and confidence in using enabling and person-centred approaches

4. Dementia Care in Scotland Dementia Strategy Standards of Care for Dementia in Scotland Promoting Excellence Framework

5. Understanding the experience of dementia PERSON DEMENTIA ENVIRONMENT

6. What is dementia? Dementia is a broad term indicating loss of intellectual functions (such as thinking, remembering, reasoning) of sufficient severity to interfere with a person’s ability to carry out day to day activities and often affecting social behaviour

7. Understanding dementia Dementia is not a disease itself but a collection of features or symptoms accompanying certain conditions What all these conditions have in common is that they damage and kill brain cells, so that the brain cannot work as well as it should

8. Who is affected? Dementia affects both men and women and exists worldwide It is most common in older people but can affect people in their 40s or 50s or even younger Research shows that many factors affect the risk of developing dementia

9. Types of dementia Many different conditions bring about the features of dementia, the most common are: Alzheimer’s disease Vascular dementia Dementia with Lewy bodies It is also possible to have more than one type of dementia; for example Alzheimer’s disease and vascular dementia

10. What happens? In most types of dementia, the illness is progressive and therefore the person will experience many different difficulties over time There is no cure at this point in time although some medications are available that help some people with some types of dementia for a period of time

11. Disabilities in dementia This person may experience difficulties with… Communication A sense of time and place Finding his way around Coping with unfamiliar places, people or activities Social/spatial/visual awareness Memory

12. Possible difficulties… Planning and calculating Reasoning and judgment Controlling emotional responses Recognising people and objects Coping with everyday activities - including his personal care Learning, concentration and motivation

13. Important points… Every person with dementia is different and may experience dementia differently Not everyone will have same symptoms and they do not necessarily appear in any particular order Good days and bad days – tiredness, depression, emotional state and other health problems will have impact on coping with dementia Can even depend on time of day

14. DVD Through our eyes A life with dementia

15. EXPERIENCE OF DEMENTIA ENVIRONMENT THE KIND OF PERSON YOU ARE PERSONAL LIFE EXPERIENCES AND WAYS OF COPING PHYSICAL HEALTH/ PSYCHOLOGY CHANGES TO THE BRAIN AND FUNCTION

16. Dementia circle of support and resources Our home Family & Friends Our hobbies Care Team

17. Normal communication: a complex process Speech Hearing Touch Sight Understanding Expressing Words 7% Tone of voice 38% Facial expression 55%

18. Communication difficulties for people with dementia Understanding what is being said Finding appropriate words Repeats things Asks the same question again & again Says things which aren’t real or true Slowness at responding Mispronounces words Naming objects and people Difficulty writing Difficulty following television & reading Conversation wanders Insensitive to other peoples’ conversation needs Unable to explain things Ashdeane House

20. How can I help? Use name at beginning Check aids Minimise distractions Consider who is the best person to impart information Avoid the use or overuse of questions Consider echoing

21. How can I help? Take time – give time Be calm and patient Speak slowly and clearly in a respectful, adult manner Face the person and maintain good eye contact Give the person your full attention and address him/her – not accompanying helper Look interested in what is being said even if it is difficult to understand

22. How can I help? Ensure the person is able to hear and see you clearly Be aware of the tone of your voice Focus on the person’s emotions and feelings Make suggestions if the person seems to be struggling to find words Be aware of the individual’s facial expressions, body posture or mannerisms – what are they telling you?

23. How can I help? Be aware of your own facial expressions and body language Provide clues and visual/verbal prompts to assist understanding Try providing information in a variety of formats Be prepared to repeat information and instructions calmly Try a range of approaches to ensure information is understood

24. Making connections Music Singing Touch Smell

25. Everyone is Different! Person Dementia Environment Challenging behaviour often relates to a failure in normal communication

26. Communication and Dementia Ashdeane House26

27. Behaviour in Dementia Aggression/irritability Uncooperativeness Apathy Shouting/swearing Repetition/questioning Catastrophic reaction Separation anxiety ‘ Wandering’ Hallucinations Delusions Disinhibition Sundowning Continence problems Accusations

28. What can cause challenging behaviour? Challenging Behaviour Boredom Over Stimulation Separation Anxiety Loneliness Reality confrontation Feelings of incompetence Stress Fear or alarm Disorientation Misunderstanding events Disinhibition Pain or discomfort Memory Loss Loss of goal recognition Communication Difficulties

29. A,B,C Approach to understanding behaviour we find challenging Activation – what was happening immediately prior to the behaviour? Who was there? Where were they? Behaviour – what was the behaviour you actually observed? Be clear, specific and descriptive. Consequence – What happened after the behaviour? Who was involved? How was it resolved 29

30. Things to avoid Using tricks lies or deception Disempowering Talking as you might to a child Labelling Outpacing Rejecting the person Dismissing feelings Emphasising disabilities Ignoring the person

31. The environment can help or hinder a person with dementia Once you understand some basic rules, you can help improve communication, behaviour and understanding Environmental challenges

32. Issues to consider Help people with dementia to make sense of their surroundings Colour and design Lighting Noise Mirrors & Reflections

33. ‘See Me’ - Who has dementia? ©Alzheimer Scotland

34. Aids and resources

35. www.alzscot.org