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Lisa Skinner: Hello to all of
you who have tuned in to listen
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to this episode of the truth
lies and Alzheimer's show. I am
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Lisa Skinner, your host, and I'd
like to shout out a very warm
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welcome to all of you who have
joined us today. Thank you so
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much for being here. There are
so many aspects of living with
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dementia that are unexpected and
can surface out of nowhere at
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any time. These are what I call
the hidden or secret faces of
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Alzheimer's disease, and as many
of you know, they show up
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unannounced are completely
unpredictable, and that is the
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reason why it's so important to
be prepared for anything that
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emerges on this journey. And to
be honest with you, I don't
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think there's much doubt that
what makes our relationships and
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caring for those who live with
Alzheimer's and related dementia
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so challenging is the disconnect
that occurs in our ability to
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communicate effectively with one
Another as the progression of
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disease worsens over time, it
clearly becomes more and more
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difficult to know what your
loved one is trying to tell you
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when they are no longer to able
to articulate their wants and
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needs to you. This is the very
reason why I cannot stress the
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importance of arming yourself
with an arsenal of tools and
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strategies so you can be as
prepared as possible when these
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situations arise. And just like
we can count on the sun rising
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each morning, you better be sure
we can count on these situations
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arising unexpectedly every day,
and I want to remind you,
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because I've said this before,
not every strategy works for
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each situation every time. So
the more tools you have
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collected in your toolbox, the
more options you will have to
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use to try to diffuse a
situation from escalating into a
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catastrophic reaction where it
can just really get out of
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control. So what I'm going to
share with you today are some
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triggers and responses to some
of the behaviors that occur as a
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result of this disconnect and
communication, they typically
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manifest as behaviors, and this
is really the way that the
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person you're caring for or your
loved one is trying to tell you
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that there is something
genuinely wrong. They are not
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trying to be difficult. They are
not trying to make your life
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hard. They are not trying to be
spiteful. They honestly can no
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longer tell you what is
bothering them so they will
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behave in a way to get your
attention, trying to relay a
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message to you. And these are
the things that you must learn
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to recognize. That is their way
of communicating with you. You
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learn to recognize the
behaviors, and then you're going
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to have to learn how to identify
what the trigger was for that
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particular behavior. So the tips
and the tools that I share with
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you, you want to just kind of
file them away or collect them
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in your toolbox, as I said. And
if one thing doesn't work, you
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can try another, and the more
tools you have to pull out and
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try, the better equipped you're
going to be for any circumstance
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that will arise. So
environmental issues can create
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behavioral problems in people
with dementia. Examples of
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environmental related issues are
sensory overload. So in other
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words, too much going on around
them, being around unfamiliar
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people, noise, lighting,
something that startles them,
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agitating behaviors of others in
the environment. People with
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dementia pick up other people's
moods and emotions, and they can
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mimic those emotions, and
that's. Other thing I wanted to
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mention, because people lose so
much of their cognitive skills,
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what it really comes down to, at
the end of the day, is
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everything that they are
reacting to is basically comes
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down to raw emotion, because
they no longer have the ability
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to reason things out or to think
things through. So these
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behaviors are raw emotion,
trying to tell you that they
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need or want something. Tasks
presented to a resident with or
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a person with dementia can
create these behavioral
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problems. Here are some of the
task related issues and
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solutions. So in terms of
issues, if a task is
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overwhelming to a person, that
can be a trigger, if they feel
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rushed, if it causes them to
become overstimulated if a task
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is too complicated, if they are
not able to focus on a given
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task, and if they have a poor
attention span. So here are some
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of the solutions to those
issues. Keep things simple, slow
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it down, stay calm and be
gentle. Take one step at a time,
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always make eye contact and
repeat instructions as needed.
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Communication can also
contribute to a person's
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behavioral challenges. Without
effective communication, the
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psychosocial quality of life of
the resident quickly
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deteriorates. Now communication
can be verbal, nonverbal, or
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both. Now verbal communication
is the words we use. Nonverbal
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communication are your actions,
your body language and your
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facial expressions, your tone of
voice, expression of emotion and
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your inflections are also
considered part of nonverbal
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communication. Effective
communication is the key to
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working with people with
dementia. So when communicating
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with people who have dementia,
it helps to face them directly,
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speak slowly, use their name
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and then wait for a response
from them. Don't rush. Repeat it
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if necessary. Use cueing or
modeling behaviors. Smile at
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them at all times, then they
will not absorb feeling a
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sternness coming from you or
that you're mad or upset with
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them, and then praise them
always and reassure them that
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everything is fine and they're
doing great now, according to
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the Alzheimer's Association,
there are three basic steps to
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assist in identifying common
behaviors and causes. Step one,
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identify and examine the
behavior. You should ask
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yourself the following
questions, what was the
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behavior? Was it harmful to the
individual or to others? What
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happened just before the
behavior occurred? Did something
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or someone trigger that
behavior? Other questions you
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may consider in order to examine
the behavior include what
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happened immediately after the
behavior occurred. How did you
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react? The Alzheimer's
Association suggests that you
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should consult your loved one's
physician to identify any causes
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related to medications or an
illness that may be developing.
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So step two is explore potential
solutions. The Alzheimer's
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Association also recommends
identifying the needs of the
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person with dementia and
evaluate if these needs are
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being met. So some of the
questions you may consider in
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your exploration is, Can
adapting the surroundings
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comfort the person? How can you
change your reaction or your
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approach to the behavior? Are
you responding in. Calm and
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supportive way. It is very
important to keep in mind that
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the person with dementia may be
using these behaviors to
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communicate his or her needs in
the only way he or she knows
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how. This is why you as a care
provider or a family member,
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need to be cautious of your
response. It can make all the
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difference in the world. Step
three, try different responses.
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Again, once you attempt new
responses, you should evaluate,
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did your new response help in
this situation, the Alzheimer's
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Association asks, Do you need to
explore other potential causes
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and solutions? If so, what can
you do differently? There are
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many, many resources you can use
to discover positive solutions
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to challenging behaviors. And I
want to also remind you again
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that if your response works at
that time for that given
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situation, and then the same
thing happens again and you try
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that same response, it may not
work this next time. So the more
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responses you have to pull out
of your toolbox, the more
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chances you will have of
diffusing the situation. So
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below, I mean, what I'm going to
share with you now is a list of
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what we call 13 R's, what is
called a solution focused model.
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And the solution focused model
focuses on what you can do right
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now to change the person's
behavior, rather than focusing
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on the problem that made the
person display a difficult
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behavior. Now this approach does
not focus on the past, but
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instead focuses on the present
and the future. The 13 R's are
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number one, remain calm your
voice and your body language.
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Number two, remove the trigger.
You want to eliminate the source
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of agitation, but you have to
figure out what that source of
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agitation is. First, not an easy
task. Number three, redirect the
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person, so guide them to another
task. Number four, reassure them
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by making positive statements.
Number five, Repeat if
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necessary. Number six, revise
present, one step at a time.
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Number seven, respond, which is
listening and paraphrasing their
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words. Number eight, reference,
validate their point of view.
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Number nine, remind, always
encourage reminiscing and
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praising past accomplishments
number 10 reflection, which is
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physically acknowledging
communication. In other words,
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one example would be by nodding
your head to them. Number 11 is
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reinforced. You can do this by
praising positive behaviors
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number 12 reporting incidents,
and what they mean by that is,
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write down, keep a journal of
things that trigger behaviors so
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you will have a reference to
look for in the future, and then
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13 reevaluate, establish the
root cause and assess it for
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controlling the situation. So
next, I'm going to share with
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you some very specific
behavioral responses that you
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may see in people with dementia,
each type of behavior you may
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observe, followed by some
suggestions that you can do to
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help minimize the undesired
behavior when a loved one
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displays anger or agitation.
Here's some tips, do not express
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impatience. Maintain calmness,
smile and reassure. Speak slowly
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and offer comfort. Redirect.
Attached to a quiet area, engage
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with them in a favorite past
time, offer a favorite food or
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beverage and whisper. When the
person becomes aggressive, it
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can help to again remain calm
while you approach them, get
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help, if necessary, use what's
called change of faith
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technique, and what that means
is you get a different person to
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come in and see if that will
make a difference, to diffuse
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the behavior, again, called
change of face. Attempt to
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redirect the person, and when
you do, redirect them to a safe
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area, for example, their room or
a quiet area. Provide a
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distraction. You can use a known
interest to distract them when a
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person with dementia is anxious.
It also helps to identify the
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trigger and time of the
occurrence. It's helpful to keep
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a journal of these things and
reinforce positive behaviors,
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help the resident, help the
person with dementia, reduce
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anxiety, encourage viewing
family photos for discussion,
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that's a great distraction, Keep
them busy and use relaxation
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methods. One of the really
effective ones is give them a
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hand massage. They love that,
and it's very calming. Now, here
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are some things you can do when
the person has increased
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behaviors in the late afternoon
and evening, often referred to
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as sundowning. Prepare for
raised anxiety, turn lights on
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ahead of time. Minimize their
distractions, remove any
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clutter, provide a safe place
for them to rummage. Offer
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favorite items of interest.
Offer snacks and drinks and play
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soft music in the background.
That is very effective.
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When a person is disruptive, you
may seek their attention,
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approach them in a friendly
manner, redirect them to a
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private area, if possible,
inform them of a change in
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routine, encourage an
independent activity, involve
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them in any plans, If possible,
and help them gain their coping
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skills. Here are some things you
can do to help with sleep
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problems. Monitor their sleep
patterns, determine cause such
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as hunger or discomfort, provide
daily exercise, establish
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routine napping, if necessary,
remind them that it's their
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bedtime. Provide security items
such as a favorite picture or
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stuffed animal. Create rituals
such as hand massages, drink,
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prayer, beds, etc, and wind down
activity participation after
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dinner. Unless requiring
exercise, it's always best to do
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more stimulating activities
earlier in the day and wind down
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as the day progresses, on supply
night lights, if they're
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preferred, and reassure them
that you will check on them
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throughout the night. Now, tips
for handling agitation include
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address any chaos in the
environment by reducing noise
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levels and the number of other
people, avoid moving household
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objects around whenever
possible. Familiar object
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located in the same places
provides them with a sense of
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security. Change the immediate
environment. When the person
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with dementia becomes agitated
again, play soothing music. It's
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magical. It's powerful. Safety
proof the environment to allow
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for as much autonomy as possible
with the least number of hazards
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handling communication problems
include giving reassurance. Is
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trying to use a touch if verbal
support isn't working. Again,
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limiting outside distractions.
Turn off radios and television.
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Listen for the meaning of the
feelings behind their words.
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Speak clearly and loud enough to
be heard, and then, of course,
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use nonverbal means of
communication, such as body
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language, facial expressions and
touch. Many people with dementia
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have ongoing communication
problems. This is going to
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include forgetting words using
repetitive phrases and other
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things that you will notice now
how to handle delusions,
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hallucinations and paranoia,
along with Anxiety, delusions,
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hallucinations and paranoia are
extremely common behavioral
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issues in people with dementia,
and they may occur as a result
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of changes in physical health of
the brain. So some tips for
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handling delusions,
hallucination and paranoia
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include probably the most
important thing is avoid arguing
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or trying to impose a sense of
truth or reality into the person
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with dementia. Why it absolutely
does not work. Don't feel the
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need to play into the lie. You
can be honest while still
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providing dignity and respect,
and then reassure that person by
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saying things like, I am so
sorry. You are getting upset by
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this. Let me see if I can help
and then redirect the person
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with dementia to divert their
attention to something more
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appropriate tips for handling
sleeplessness and sundowning. So
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insomnia and sleeplessness also
known as sundowning, are again
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common behaviors in people with
dementia. They occur due to a
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combination of factors and can
be worsened by exhaust, by being
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exhausted after a day's events.
So some tips on handling
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sleeplessness and sundowning
include avoid giving your loved
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one alcohol, caffeine or sugar,
considering hiring help at night
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so you as a caregiver can get
enough sleep without having to
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leave your loved one with
dementia unattended. Discourage
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napping during the daytime, talk
to a healthcare provider about
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natural sleep induced medication
such as melatonin, and turn the
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lights on and close the curtains
well before sunset to eliminate
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confusion about the time,
particularly in the winter
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months. And then the last tip I
have for you today is how to
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handle wandering. It's not
always easy to find out why a
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person with dementia is
wandering, but caregivers can
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use these insights to help them
more effectively deal with that
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problem. You can add child safe
plastic covers to doorknobs. You
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can consider having them carry a
GPS tracking device, always have
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a current photo on file, just in
case the person with dementia
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goes missing, register them with
the safe and sound program in
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00:23:55,180 --> 00:24:00,660
your local area. Install door
alarms and set them to go off if
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00:24:00,660 --> 00:24:06,420
the door is opened, and finally,
install locks that require a
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key, keeping safety issues in
mind for all people in the home.
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So those are hopefully some very
helpful and valuable tips for
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you to consider while
encountering some of these
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challenging behaviors that will
occur. So in my segment, what's
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news, I want to share with you
an article that I stumbled upon.
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It was in Fortune, well
presented by CVS Health, and the
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title of the article is called
cognitive decline after
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retirement is a universal trend.
Here are four ways to reverse
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it. The article was written by
Aaron Prater, and it was
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published on May 19, 2023 so.
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And this is what the article
tells us now. It was authored by
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researchers at the University of
Cologne in Germany and the
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00:25:08,700 --> 00:25:13,320
University of California San
Francisco. The researchers
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interviewed nearly 9000 European
retirees, ages 50 and older,
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from 17 countries each completed
six memory assessments over the
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course of 13 years. Their
findings retirement was
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generally associated with a
moderate decrease in Word recall
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and memory decline accelerated
after retirement. This was true
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in all countries involved, even
in those with more generous
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welfare systems and higher
pension benefits, like Germany,
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00:25:52,780 --> 00:25:57,280
Austria, France and Belgium,
versus those with low public
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pensions, like Portugal, Greece,
Israel, Estonia, Poland and
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00:26:02,700 --> 00:26:08,580
Slovenia. The study showed that
postponing retirement can
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protect against cognitive
decline, especially among the
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more highly educated. But let's
face it, the article says life
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is short for those who can and
wish to retire on time, here are
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four tips for staying mentally
sharp during what should be the
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most joyous season of your life.
So keep or get connected. A
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quarter of Americans age 65 and
older, are socially isolated.
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00:26:41,080 --> 00:26:45,760
According to a 2020 report from
the National Academies of
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00:26:45,760 --> 00:26:50,440
Sciences, Engineering and
medicine, while loneliness is
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00:26:50,620 --> 00:26:58,480
miserable, it's also more, it's
also more, it poses a health
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00:26:58,480 --> 00:27:04,080
risk as deadly as smoking a
dozen cigarettes a day the US
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00:27:04,200 --> 00:27:09,300
Surgeon General, Dr Vivek Murthy
recently told attendees of
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Fortune's brainstorm health
conference, retirement often
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00:27:13,620 --> 00:27:18,360
means loss of the community you
worked in perhaps for decades.
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So keep connected to others by
taking classes, volunteering,
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hanging out with friends, or
picking up a sport. The second
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00:27:29,360 --> 00:27:35,480
recommended advice is to keep
active. It's never too late to
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begin an exercise routine, even
if you didn't do it in pre
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00:27:39,920 --> 00:27:44,740
retirement, or if you fell off
the wagon at same point, get up
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and get going again. The third
one, keep your stress to a
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minimum. There are many, many
ways to keep stress at bay. A
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00:27:56,680 --> 00:28:03,540
few of them are get a good
quality sleep and do your best
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not to introduce any new
stressors in your life. And then
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finally, keep working. Ideally,
you're in a situation where you
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00:28:15,840 --> 00:28:19,920
you might not have the financial
need for a typical nine to five
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day like you did when you were
working, free retirement, but
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00:28:24,980 --> 00:28:29,000
you have just as much to
contribute to society as the day
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before you retired. If it brings
you joy, consider volunteering
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contract work or a part time job
in the field you love.
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Regardless of pay, you'll reap
the benefits of connectedness
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and cognitive acuity and
typically accompanying work,
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hopefully without all the
stress. So I think that's some
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pretty good advice. I have known
a lot of people who have retired
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and then just seem to
cognitively decline within years
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of retiring. So I think this is
some really sound advice to
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00:29:06,660 --> 00:29:12,060
follow for those of you who want
to stay sharp even in your
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00:29:12,060 --> 00:29:19,560
retirement years. So that's what
I have for you today. I want to
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00:29:19,560 --> 00:29:24,320
thank you again for listening.
We always have so much to cover
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in our current episode and
upcoming episodes. And as you
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00:29:29,240 --> 00:29:33,980
know, I really it's so important
for me to provide you with
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00:29:33,980 --> 00:29:38,360
information that you will find
helpful and valuable throughout
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00:29:38,720 --> 00:29:44,140
this journey. Remember, and I
can't emphasize this enough,
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00:29:44,800 --> 00:29:51,280
dementia awareness occurs every
day. The kindness is the ability
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to speak with love, listen with
compassion and act with
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00:29:55,960 --> 00:30:01,260
patience. These are all very
necessary. Attributes to have in
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00:30:01,260 --> 00:30:07,380
order to outlast Alzheimer's
disease. This show is all about
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00:30:07,440 --> 00:30:13,740
you and how my experiences,
expertise and strategies can
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00:30:13,740 --> 00:30:17,940
help you and your loved one have
an easier time while struggling
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00:30:17,940 --> 00:30:23,240
through this disease. I know how
difficult it is, therefore I
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00:30:23,240 --> 00:30:26,780
would love it if you would send
me your comments and suggestions
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00:30:26,780 --> 00:30:31,460
on what topics you'd like me to
cover on this weekly show. I
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00:30:31,460 --> 00:30:34,220
genuinely look forward to
receiving your thoughts and
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00:30:34,220 --> 00:30:39,320
ideas, and in the meantime, take
care of you, talk to y'all next
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00:30:39,320 --> 00:30:39,800
week.
00:00:00,240 --> 00:00:03,720
Lisa Skinner: Hello to all of
you who have tuned in to listen
2
00:00:03,720 --> 00:00:08,640
to this episode of the truth
lies and Alzheimer's show. I am
3
00:00:08,640 --> 00:00:13,620
Lisa Skinner, your host, and I'd
like to shout out a very warm
4
00:00:13,620 --> 00:00:18,480
welcome to all of you who have
joined us today. Thank you so
5
00:00:18,480 --> 00:00:24,680
much for being here. There are
so many aspects of living with
6
00:00:24,680 --> 00:00:29,480
dementia that are unexpected and
can surface out of nowhere at
7
00:00:29,480 --> 00:00:35,360
any time. These are what I call
the hidden or secret faces of
8
00:00:35,360 --> 00:00:41,440
Alzheimer's disease, and as many
of you know, they show up
9
00:00:41,560 --> 00:00:48,100
unannounced are completely
unpredictable, and that is the
10
00:00:48,100 --> 00:00:52,300
reason why it's so important to
be prepared for anything that
11
00:00:52,300 --> 00:00:59,080
emerges on this journey. And to
be honest with you, I don't
12
00:00:59,140 --> 00:01:05,280
think there's much doubt that
what makes our relationships and
13
00:01:05,280 --> 00:01:09,060
caring for those who live with
Alzheimer's and related dementia
14
00:01:09,060 --> 00:01:14,460
so challenging is the disconnect
that occurs in our ability to
15
00:01:14,460 --> 00:01:19,860
communicate effectively with one
Another as the progression of
16
00:01:19,860 --> 00:01:25,280
disease worsens over time, it
clearly becomes more and more
17
00:01:25,280 --> 00:01:29,000
difficult to know what your
loved one is trying to tell you
18
00:01:29,240 --> 00:01:32,900
when they are no longer to able
to articulate their wants and
19
00:01:32,900 --> 00:01:38,060
needs to you. This is the very
reason why I cannot stress the
20
00:01:38,060 --> 00:01:42,880
importance of arming yourself
with an arsenal of tools and
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00:01:42,880 --> 00:01:47,740
strategies so you can be as
prepared as possible when these
22
00:01:47,740 --> 00:01:53,080
situations arise. And just like
we can count on the sun rising
23
00:01:53,080 --> 00:01:59,440
each morning, you better be sure
we can count on these situations
24
00:01:59,500 --> 00:02:04,800
arising unexpectedly every day,
and I want to remind you,
25
00:02:04,800 --> 00:02:09,840
because I've said this before,
not every strategy works for
26
00:02:09,900 --> 00:02:15,120
each situation every time. So
the more tools you have
27
00:02:15,120 --> 00:02:19,260
collected in your toolbox, the
more options you will have to
28
00:02:19,260 --> 00:02:24,320
use to try to diffuse a
situation from escalating into a
29
00:02:24,380 --> 00:02:28,820
catastrophic reaction where it
can just really get out of
30
00:02:28,820 --> 00:02:33,140
control. So what I'm going to
share with you today are some
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00:02:33,140 --> 00:02:43,060
triggers and responses to some
of the behaviors that occur as a
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00:02:43,060 --> 00:02:48,820
result of this disconnect and
communication, they typically
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00:02:48,820 --> 00:02:55,240
manifest as behaviors, and this
is really the way that the
34
00:02:55,240 --> 00:03:00,040
person you're caring for or your
loved one is trying to tell you
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00:03:00,040 --> 00:03:04,560
that there is something
genuinely wrong. They are not
36
00:03:04,560 --> 00:03:09,420
trying to be difficult. They are
not trying to make your life
37
00:03:09,420 --> 00:03:16,380
hard. They are not trying to be
spiteful. They honestly can no
38
00:03:16,380 --> 00:03:20,900
longer tell you what is
bothering them so they will
39
00:03:20,900 --> 00:03:24,920
behave in a way to get your
attention, trying to relay a
40
00:03:24,920 --> 00:03:29,300
message to you. And these are
the things that you must learn
41
00:03:29,300 --> 00:03:36,200
to recognize. That is their way
of communicating with you. You
42
00:03:36,200 --> 00:03:39,500
learn to recognize the
behaviors, and then you're going
43
00:03:39,500 --> 00:03:45,760
to have to learn how to identify
what the trigger was for that
44
00:03:45,760 --> 00:03:50,560
particular behavior. So the tips
and the tools that I share with
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00:03:50,560 --> 00:03:55,540
you, you want to just kind of
file them away or collect them
46
00:03:55,540 --> 00:04:02,520
in your toolbox, as I said. And
if one thing doesn't work, you
47
00:04:02,520 --> 00:04:08,760
can try another, and the more
tools you have to pull out and
48
00:04:08,760 --> 00:04:14,400
try, the better equipped you're
going to be for any circumstance
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00:04:14,400 --> 00:04:21,380
that will arise. So
environmental issues can create
50
00:04:21,380 --> 00:04:26,900
behavioral problems in people
with dementia. Examples of
51
00:04:26,900 --> 00:04:31,940
environmental related issues are
sensory overload. So in other
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00:04:31,940 --> 00:04:37,280
words, too much going on around
them, being around unfamiliar
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00:04:37,280 --> 00:04:44,860
people, noise, lighting,
something that startles them,
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00:04:45,580 --> 00:04:51,040
agitating behaviors of others in
the environment. People with
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00:04:51,040 --> 00:04:56,800
dementia pick up other people's
moods and emotions, and they can
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00:04:56,800 --> 00:05:01,020
mimic those emotions, and
that's. Other thing I wanted to
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00:05:01,020 --> 00:05:06,660
mention, because people lose so
much of their cognitive skills,
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00:05:06,960 --> 00:05:10,740
what it really comes down to, at
the end of the day, is
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00:05:10,800 --> 00:05:15,180
everything that they are
reacting to is basically comes
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00:05:15,180 --> 00:05:20,420
down to raw emotion, because
they no longer have the ability
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00:05:20,420 --> 00:05:24,680
to reason things out or to think
things through. So these
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00:05:24,680 --> 00:05:30,620
behaviors are raw emotion,
trying to tell you that they
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00:05:30,620 --> 00:05:36,380
need or want something. Tasks
presented to a resident with or
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00:05:36,380 --> 00:05:41,200
a person with dementia can
create these behavioral
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00:05:41,200 --> 00:05:45,880
problems. Here are some of the
task related issues and
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00:05:45,880 --> 00:05:50,980
solutions. So in terms of
issues, if a task is
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00:05:50,980 --> 00:05:56,620
overwhelming to a person, that
can be a trigger, if they feel
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00:05:56,620 --> 00:06:03,900
rushed, if it causes them to
become overstimulated if a task
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00:06:03,900 --> 00:06:10,080
is too complicated, if they are
not able to focus on a given
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00:06:10,080 --> 00:06:16,680
task, and if they have a poor
attention span. So here are some
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00:06:16,680 --> 00:06:22,520
of the solutions to those
issues. Keep things simple, slow
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00:06:22,520 --> 00:06:31,640
it down, stay calm and be
gentle. Take one step at a time,
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00:06:32,660 --> 00:06:39,740
always make eye contact and
repeat instructions as needed.
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00:06:40,700 --> 00:06:44,080
Communication can also
contribute to a person's
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00:06:44,080 --> 00:06:48,520
behavioral challenges. Without
effective communication, the
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00:06:48,520 --> 00:06:51,940
psychosocial quality of life of
the resident quickly
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00:06:51,940 --> 00:06:57,940
deteriorates. Now communication
can be verbal, nonverbal, or
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00:06:57,940 --> 00:07:05,580
both. Now verbal communication
is the words we use. Nonverbal
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00:07:05,580 --> 00:07:10,500
communication are your actions,
your body language and your
80
00:07:10,500 --> 00:07:18,300
facial expressions, your tone of
voice, expression of emotion and
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00:07:18,300 --> 00:07:23,240
your inflections are also
considered part of nonverbal
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00:07:23,240 --> 00:07:29,360
communication. Effective
communication is the key to
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00:07:29,360 --> 00:07:33,860
working with people with
dementia. So when communicating
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00:07:33,860 --> 00:07:39,560
with people who have dementia,
it helps to face them directly,
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00:07:40,760 --> 00:07:45,100
speak slowly, use their name
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00:07:46,180 --> 00:07:52,000
and then wait for a response
from them. Don't rush. Repeat it
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00:07:52,180 --> 00:07:59,980
if necessary. Use cueing or
modeling behaviors. Smile at
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00:07:59,980 --> 00:08:06,960
them at all times, then they
will not absorb feeling a
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00:08:06,960 --> 00:08:10,800
sternness coming from you or
that you're mad or upset with
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00:08:10,800 --> 00:08:16,620
them, and then praise them
always and reassure them that
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00:08:16,620 --> 00:08:21,560
everything is fine and they're
doing great now, according to
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00:08:21,560 --> 00:08:26,480
the Alzheimer's Association,
there are three basic steps to
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00:08:26,480 --> 00:08:32,060
assist in identifying common
behaviors and causes. Step one,
94
00:08:33,200 --> 00:08:37,700
identify and examine the
behavior. You should ask
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00:08:37,700 --> 00:08:40,840
yourself the following
questions, what was the
96
00:08:40,840 --> 00:08:46,780
behavior? Was it harmful to the
individual or to others? What
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00:08:46,780 --> 00:08:51,880
happened just before the
behavior occurred? Did something
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00:08:51,880 --> 00:08:56,860
or someone trigger that
behavior? Other questions you
99
00:08:56,860 --> 00:09:01,680
may consider in order to examine
the behavior include what
100
00:09:01,680 --> 00:09:07,140
happened immediately after the
behavior occurred. How did you
101
00:09:07,140 --> 00:09:12,060
react? The Alzheimer's
Association suggests that you
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00:09:12,060 --> 00:09:17,640
should consult your loved one's
physician to identify any causes
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00:09:17,640 --> 00:09:23,540
related to medications or an
illness that may be developing.
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00:09:24,320 --> 00:09:30,800
So step two is explore potential
solutions. The Alzheimer's
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00:09:30,800 --> 00:09:35,480
Association also recommends
identifying the needs of the
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00:09:35,480 --> 00:09:39,380
person with dementia and
evaluate if these needs are
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00:09:39,380 --> 00:09:43,600
being met. So some of the
questions you may consider in
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00:09:43,600 --> 00:09:48,760
your exploration is, Can
adapting the surroundings
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comfort the person? How can you
change your reaction or your
110
00:09:55,300 --> 00:10:01,020
approach to the behavior? Are
you responding in. Calm and
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00:10:01,020 --> 00:10:06,060
supportive way. It is very
important to keep in mind that
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00:10:06,060 --> 00:10:10,080
the person with dementia may be
using these behaviors to
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00:10:10,080 --> 00:10:15,540
communicate his or her needs in
the only way he or she knows
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00:10:15,540 --> 00:10:21,500
how. This is why you as a care
provider or a family member,
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00:10:21,680 --> 00:10:26,060
need to be cautious of your
response. It can make all the
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difference in the world. Step
three, try different responses.
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Again, once you attempt new
responses, you should evaluate,
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did your new response help in
this situation, the Alzheimer's
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Association asks, Do you need to
explore other potential causes
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and solutions? If so, what can
you do differently? There are
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many, many resources you can use
to discover positive solutions
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to challenging behaviors. And I
want to also remind you again
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that if your response works at
that time for that given
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situation, and then the same
thing happens again and you try
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that same response, it may not
work this next time. So the more
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responses you have to pull out
of your toolbox, the more
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chances you will have of
diffusing the situation. So
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below, I mean, what I'm going to
share with you now is a list of
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what we call 13 R's, what is
called a solution focused model.
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And the solution focused model
focuses on what you can do right
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now to change the person's
behavior, rather than focusing
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on the problem that made the
person display a difficult
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behavior. Now this approach does
not focus on the past, but
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instead focuses on the present
and the future. The 13 R's are
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number one, remain calm your
voice and your body language.
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Number two, remove the trigger.
You want to eliminate the source
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of agitation, but you have to
figure out what that source of
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agitation is. First, not an easy
task. Number three, redirect the
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person, so guide them to another
task. Number four, reassure them
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by making positive statements.
Number five, Repeat if
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necessary. Number six, revise
present, one step at a time.
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Number seven, respond, which is
listening and paraphrasing their
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words. Number eight, reference,
validate their point of view.
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Number nine, remind, always
encourage reminiscing and
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praising past accomplishments
number 10 reflection, which is
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physically acknowledging
communication. In other words,
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one example would be by nodding
your head to them. Number 11 is
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reinforced. You can do this by
praising positive behaviors
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number 12 reporting incidents,
and what they mean by that is,
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write down, keep a journal of
things that trigger behaviors so
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you will have a reference to
look for in the future, and then
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13 reevaluate, establish the
root cause and assess it for
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controlling the situation. So
next, I'm going to share with
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you some very specific
behavioral responses that you
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may see in people with dementia,
each type of behavior you may
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observe, followed by some
suggestions that you can do to
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help minimize the undesired
behavior when a loved one
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displays anger or agitation.
Here's some tips, do not express
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impatience. Maintain calmness,
smile and reassure. Speak slowly
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and offer comfort. Redirect.
Attached to a quiet area, engage
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with them in a favorite past
time, offer a favorite food or
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beverage and whisper. When the
person becomes aggressive, it
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can help to again remain calm
while you approach them, get
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help, if necessary, use what's
called change of faith
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technique, and what that means
is you get a different person to
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come in and see if that will
make a difference, to diffuse
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the behavior, again, called
change of face. Attempt to
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redirect the person, and when
you do, redirect them to a safe
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area, for example, their room or
a quiet area. Provide a
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distraction. You can use a known
interest to distract them when a
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person with dementia is anxious.
It also helps to identify the
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trigger and time of the
occurrence. It's helpful to keep
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a journal of these things and
reinforce positive behaviors,
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help the resident, help the
person with dementia, reduce
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anxiety, encourage viewing
family photos for discussion,
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that's a great distraction, Keep
them busy and use relaxation
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methods. One of the really
effective ones is give them a
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hand massage. They love that,
and it's very calming. Now, here
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are some things you can do when
the person has increased
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behaviors in the late afternoon
and evening, often referred to
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as sundowning. Prepare for
raised anxiety, turn lights on
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ahead of time. Minimize their
distractions, remove any
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clutter, provide a safe place
for them to rummage. Offer
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favorite items of interest.
Offer snacks and drinks and play
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soft music in the background.
That is very effective.
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When a person is disruptive, you
may seek their attention,
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approach them in a friendly
manner, redirect them to a
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private area, if possible,
inform them of a change in
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routine, encourage an
independent activity, involve
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them in any plans, If possible,
and help them gain their coping
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skills. Here are some things you
can do to help with sleep
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problems. Monitor their sleep
patterns, determine cause such
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as hunger or discomfort, provide
daily exercise, establish
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routine napping, if necessary,
remind them that it's their
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bedtime. Provide security items
such as a favorite picture or
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stuffed animal. Create rituals
such as hand massages, drink,
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prayer, beds, etc, and wind down
activity participation after
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dinner. Unless requiring
exercise, it's always best to do
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more stimulating activities
earlier in the day and wind down
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as the day progresses, on supply
night lights, if they're
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preferred, and reassure them
that you will check on them
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throughout the night. Now, tips
for handling agitation include
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address any chaos in the
environment by reducing noise
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levels and the number of other
people, avoid moving household
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objects around whenever
possible. Familiar object
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located in the same places
provides them with a sense of
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security. Change the immediate
environment. When the person
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with dementia becomes agitated
again, play soothing music. It's
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magical. It's powerful. Safety
proof the environment to allow
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for as much autonomy as possible
with the least number of hazards
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handling communication problems
include giving reassurance. Is
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trying to use a touch if verbal
support isn't working. Again,
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limiting outside distractions.
Turn off radios and television.
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Listen for the meaning of the
feelings behind their words.
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Speak clearly and loud enough to
be heard, and then, of course,
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use nonverbal means of
communication, such as body
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language, facial expressions and
touch. Many people with dementia
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have ongoing communication
problems. This is going to
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include forgetting words using
repetitive phrases and other
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things that you will notice now
how to handle delusions,
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hallucinations and paranoia,
along with Anxiety, delusions,
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hallucinations and paranoia are
extremely common behavioral
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issues in people with dementia,
and they may occur as a result
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of changes in physical health of
the brain. So some tips for
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handling delusions,
hallucination and paranoia
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include probably the most
important thing is avoid arguing
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or trying to impose a sense of
truth or reality into the person
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with dementia. Why it absolutely
does not work. Don't feel the
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need to play into the lie. You
can be honest while still
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providing dignity and respect,
and then reassure that person by
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saying things like, I am so
sorry. You are getting upset by
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this. Let me see if I can help
and then redirect the person
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with dementia to divert their
attention to something more
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appropriate tips for handling
sleeplessness and sundowning. So
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insomnia and sleeplessness also
known as sundowning, are again
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common behaviors in people with
dementia. They occur due to a
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combination of factors and can
be worsened by exhaust, by being
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exhausted after a day's events.
So some tips on handling
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sleeplessness and sundowning
include avoid giving your loved
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one alcohol, caffeine or sugar,
considering hiring help at night
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so you as a caregiver can get
enough sleep without having to
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leave your loved one with
dementia unattended. Discourage
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napping during the daytime, talk
to a healthcare provider about
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natural sleep induced medication
such as melatonin, and turn the
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lights on and close the curtains
well before sunset to eliminate
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confusion about the time,
particularly in the winter
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months. And then the last tip I
have for you today is how to
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handle wandering. It's not
always easy to find out why a
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person with dementia is
wandering, but caregivers can
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use these insights to help them
more effectively deal with that
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problem. You can add child safe
plastic covers to doorknobs. You
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can consider having them carry a
GPS tracking device, always have
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a current photo on file, just in
case the person with dementia
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goes missing, register them with
the safe and sound program in
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your local area. Install door
alarms and set them to go off if
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00:24:00,660 --> 00:24:06,420
the door is opened, and finally,
install locks that require a
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key, keeping safety issues in
mind for all people in the home.
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So those are hopefully some very
helpful and valuable tips for
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you to consider while
encountering some of these
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challenging behaviors that will
occur. So in my segment, what's
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news, I want to share with you
an article that I stumbled upon.
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It was in Fortune, well
presented by CVS Health, and the
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title of the article is called
cognitive decline after
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retirement is a universal trend.
Here are four ways to reverse
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it. The article was written by
Aaron Prater, and it was
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published on May 19, 2023 so.
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And this is what the article
tells us now. It was authored by
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researchers at the University of
Cologne in Germany and the
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University of California San
Francisco. The researchers
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interviewed nearly 9000 European
retirees, ages 50 and older,
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from 17 countries each completed
six memory assessments over the
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course of 13 years. Their
findings retirement was
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generally associated with a
moderate decrease in Word recall
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and memory decline accelerated
after retirement. This was true
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in all countries involved, even
in those with more generous
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welfare systems and higher
pension benefits, like Germany,
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00:25:52,780 --> 00:25:57,280
Austria, France and Belgium,
versus those with low public
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pensions, like Portugal, Greece,
Israel, Estonia, Poland and
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00:26:02,700 --> 00:26:08,580
Slovenia. The study showed that
postponing retirement can
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protect against cognitive
decline, especially among the
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more highly educated. But let's
face it, the article says life
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is short for those who can and
wish to retire on time, here are
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four tips for staying mentally
sharp during what should be the
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most joyous season of your life.
So keep or get connected. A
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quarter of Americans age 65 and
older, are socially isolated.
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00:26:41,080 --> 00:26:45,760
According to a 2020 report from
the National Academies of
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00:26:45,760 --> 00:26:50,440
Sciences, Engineering and
medicine, while loneliness is
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00:26:50,620 --> 00:26:58,480
miserable, it's also more, it's
also more, it poses a health
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00:26:58,480 --> 00:27:04,080
risk as deadly as smoking a
dozen cigarettes a day the US
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00:27:04,200 --> 00:27:09,300
Surgeon General, Dr Vivek Murthy
recently told attendees of
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00:27:09,300 --> 00:27:13,620
Fortune's brainstorm health
conference, retirement often
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00:27:13,620 --> 00:27:18,360
means loss of the community you
worked in perhaps for decades.
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So keep connected to others by
taking classes, volunteering,
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hanging out with friends, or
picking up a sport. The second
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00:27:29,360 --> 00:27:35,480
recommended advice is to keep
active. It's never too late to
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begin an exercise routine, even
if you didn't do it in pre
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00:27:39,920 --> 00:27:44,740
retirement, or if you fell off
the wagon at same point, get up
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and get going again. The third
one, keep your stress to a
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minimum. There are many, many
ways to keep stress at bay. A
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few of them are get a good
quality sleep and do your best
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not to introduce any new
stressors in your life. And then
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finally, keep working. Ideally,
you're in a situation where you
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00:28:15,840 --> 00:28:19,920
you might not have the financial
need for a typical nine to five
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00:28:19,920 --> 00:28:24,740
day like you did when you were
working, free retirement, but
305
00:28:24,980 --> 00:28:29,000
you have just as much to
contribute to society as the day
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00:28:29,000 --> 00:28:34,880
before you retired. If it brings
you joy, consider volunteering
307
00:28:35,180 --> 00:28:39,680
contract work or a part time job
in the field you love.
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Regardless of pay, you'll reap
the benefits of connectedness
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and cognitive acuity and
typically accompanying work,
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hopefully without all the
stress. So I think that's some
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pretty good advice. I have known
a lot of people who have retired
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00:28:58,480 --> 00:29:02,640
and then just seem to
cognitively decline within years
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00:29:02,640 --> 00:29:06,660
of retiring. So I think this is
some really sound advice to
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follow for those of you who want
to stay sharp even in your
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00:29:12,060 --> 00:29:19,560
retirement years. So that's what
I have for you today. I want to
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00:29:19,560 --> 00:29:24,320
thank you again for listening.
We always have so much to cover
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in our current episode and
upcoming episodes. And as you
318
00:29:29,240 --> 00:29:33,980
know, I really it's so important
for me to provide you with
319
00:29:33,980 --> 00:29:38,360
information that you will find
helpful and valuable throughout
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00:29:38,720 --> 00:29:44,140
this journey. Remember, and I
can't emphasize this enough,
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00:29:44,800 --> 00:29:51,280
dementia awareness occurs every
day. The kindness is the ability
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00:29:51,280 --> 00:29:55,960
to speak with love, listen with
compassion and act with
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00:29:55,960 --> 00:30:01,260
patience. These are all very
necessary. Attributes to have in
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00:30:01,260 --> 00:30:07,380
order to outlast Alzheimer's
disease. This show is all about
325
00:30:07,440 --> 00:30:13,740
you and how my experiences,
expertise and strategies can
326
00:30:13,740 --> 00:30:17,940
help you and your loved one have
an easier time while struggling
327
00:30:17,940 --> 00:30:23,240
through this disease. I know how
difficult it is, therefore I
328
00:30:23,240 --> 00:30:26,780
would love it if you would send
me your comments and suggestions
329
00:30:26,780 --> 00:30:31,460
on what topics you'd like me to
cover on this weekly show. I
330
00:30:31,460 --> 00:30:34,220
genuinely look forward to
receiving your thoughts and
331
00:30:34,220 --> 00:30:39,320
ideas, and in the meantime, take
care of you, talk to y'all next
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00:30:39,320 --> 00:30:39,800
week.
