Dementia Care Specialist Level 1 Training 2019-05-24¢  seeing GEMS Sapphires ¢â‚¬â€œTrue Blue ¢â‚¬â€œSlower

  • View
    0

  • Download
    0

Embed Size (px)

Text of Dementia Care Specialist Level 1 Training 2019-05-24¢  seeing GEMS Sapphires...

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Welcome “It’s all about You”

    Provincial Long Term & Continuing Care Conference

    May 14, 2019

    Charleen Phelps, R.N. Teepa Snow, Positive Approach, LLC

    Gems®

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Seeing more than loss

    The Living Gems®

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    ..

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    What is

    Dementia?

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    The person’s brain is dying

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Four Truths About Dementia

    1. At least 2 parts of the brain are dying

    2. It is chronic and can’t be fixed 3. It is progressive and will get worse 4. It is terminal

    Teepa Snow, Positive Approach, LLC - to be re-used

    only with permission

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Tab 1

    Page 6

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    How we Take in Information

    1. What you see

    2. What you hear

    3. What you feel/ touch

    4. What you smell

    5. What you taste

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    How We Give Information

    Visual – How we look

    Verbal – What we say

    Touch - What we do

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Visual Cue Options:

    Signs

    Pictures

    Props or Objects

    Gestures

    Facial Expressions

    Demonstrations

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Normal Brain Brain with Alzheimers

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Positron Emission Tomography (PET) Alzheimers Disease Progression vs. Normal Brains

    G. Small, UCLA School of Medicine.

    Primitive

    Brain

    Primitive

    Brain

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Primitive Brain is in Charge of: •Survival:

    •Autonomic protective – fright, flight, fight + hide or seek •Pleasure seeking – meeting survival needs and finding joy

    •Thriving – Running the Engine: •Maintain vital systems: BP, BS, O2sat, Temp, pain •Breathe, suck, swallow, digest, void, defecate •Circadian rhythm • Infection control

    •Learning New and Remembering: • Information •Places: spatial orientation •Passage of Time: Time awareness

    Tab 1

    Page 10

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Hippocampus BIG CHANGE

    Learning & Memory Center • Way finding • Learning &

    Memory • Time Awarness

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Amygdalae:

    Dangerous Need

    Risky Want

    Dislike Alert/Aware Like

    Tab 1

    Page 10

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    • Impulse Control • Be Logical • Make Choices • Start-Sequence-

    Complete-Move On

    • Self Awareness • See Others’

    Point of View

    LeftRight

    LeftRight

    Executive

    Control

    Center

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Vision Center – BIG CHANGES

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    1. Less Peripheral Awareness

    2. Tunnel Vision

    3. Binocular Vision

    4. Object to Use Confusion

    5. Monocular Vision

    6. Limited Visual Regard

    Changes in Visual Regard With each new level of vision change, there is a

    decrease in safety awareness.

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Understanding Language – BIG CHANGE

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Hearing Sound – Not Changed

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Sensory Strip Motor Strip

    White Matter Connections

    BIG CHANGES

    Formal Speech & Language

    Center HUGE CHANGES

    Automatic Speech

    Rhythm – Music

    Expletives

    PRESERVED

    LeftRight

    LeftRight

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Positron Emission Tomography (PET) Alzheimers Disease Progression vs. Normal Brains

    G. Small, UCLA School of Medicine.

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Progression of Dementia

    Alzheimer scale: Early - Middle - Late

    Global Deterioration Scale 1 - 7

    Allen Cognitive Levels 0 - 6

    The Gems®

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Seeing more than loss

    The Living Gems®

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    A Positive Framework… seeing GEMS

    Sapphires – True Blue – Slower BUT Fine

    Diamonds – Repeats & Routines, Cutting

    Emeralds – Going – Time Travel – Where?

    Ambers – In the moment - Sensations

    Rubies – Stop & Go – No Fine Control

    Pearls – Hidden in a Shell - Immobile

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Dynamic Assessment

    Visual regard

    Ability to speak and understand

    Skill in movement

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    •True Blue

    •Optimal Cognition,

    •Healthy Brain

    Sapphires

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Sapphire

    True Blue

    •Optimal Cognition Aging normally

    •Slowing down: needs more time to process

    •True to self: likes/dislikes are same

    •Able to learn: takes practice

    •Stress, fatigue or pain can induce Diamond moments

    •Time to recharge or heal can restore to Sapphire

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Clear and Sharp

    Routines and Rituals Rule

    Diamonds

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Diamond

    Clear and Sharp

    •Routines and Rituals Rule: likes familiar •May resist change or won’t let things go •Rigid under pressure: limited perspective •Becoming protective: may be territorial •Repeats self: hard to integrate new information •Can cover mistakes in social interaction •Symptoms may or may not be dementia related

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Emeralds

    Green and

    On the Go with a Purpose

    Naturally Flawed

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Emerald

    •Green and On the Go with a Purpose

    •Naturally Flawed

    •Desires independence: noticeable ability change

    •Vocabulary and comprehension diminishing

    •Communication becoming vague

    •May neglect personal care routines

    •On the go: needs guidance and structure

    •Difficulty finding way to and from places

    •May be lost in time

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Ambers

    •Caught in a Moment of Time

    •Caution Required

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Amber

    Caught in a Moment of Time

    •Caution Required

    •Focused on sensation

    •Will react to how things: look, sound, feel, smell or taste

    •Lives in the moment: not socially aware

    •No safety awareness: typically very busy

    •Difficulty understanding and expressing needs

    •No ability to delay needs or wants

    •Needs help with tasks: may resist

    •Hard to connect with: may exhaust care partners

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Rubies

    Deep and Strong

    Others Stop Seeing What

    Is Possible

  • © Teepa Snow, Positive Approach, LLC – to be reused only with permission.

    Rubies •Deep and Strong

    •Others stop seeing what is Possible

    •Retains