PowerPoint Presentation · quality of life, “I don’t know ... Lonely solitary –lonely – ......

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7/5/2019 1 © Teepa Snow, Positive Approach, LLC to be reused only with permission. © Teepa Snow, Positive Approach, LLC to be reused only with permission. For the slides from this presentation, visit: www.teepasnow.com/presentations Slides will be available for 2 weeks © Teepa Snow, Positive Approach, LLC to be reused only with permission. Handouts are intended for personal use only. Any copyrighted materials or DVD content from Positive Approach, LLC (Teepa Snow) may be used for personal educational purposes only. This material may not be copied, sold or commercially exploited, and shall be used solely by the requesting individual. Copyright 2017, All Rights Reserved Teepa Snow and Positive Approach® to Care Any redistribution or duplication, in whole or in part, is strictly prohibited, without the expressed written consent of Teepa Snow and Positive Approach, LLC 1 2 3

Transcript of PowerPoint Presentation · quality of life, “I don’t know ... Lonely solitary –lonely – ......

Page 1: PowerPoint Presentation · quality of life, “I don’t know ... Lonely solitary –lonely – ... -Try a possible solution only once-Try to stop the flow-Reject topics-Try to distract

7/5/2019

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

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

For the slides from this presentation, visit:

www.teepasnow.com/presentations

Slides will be available for 2 weeks

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

Handouts are intended for personal use only. Any copyrighted materials or DVD content from

Positive Approach, LLC (Teepa Snow) may be used for personal educational purposes only. This

material may not be copied, sold or commercially exploited, and shall be used solely by the

requesting individual.

Copyright 2017, All Rights Reserved

Teepa Snow and Positive Approach® to Care

Any redistribution or duplication, in whole or in part, is strictly prohibited,

without the expressed written consent of Teepa Snow and

Positive Approach, LLC

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

How to Communicate

With Someone Who is

Living With Dementia

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

PET Scan of 20-Year-Old Brain PET Scan of 80-Year-Old Brain

PET and Aging:

ADEAR, 2003

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

As we age, we do not lose

function in our brains,

unless…

Something Goes Wrong with

Our Brains

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

Normal vs. Not Normal

Normal Aging:

Slower to think

Slower to do

Hesitates more

More likely to ‘look before

leaping’

Know the person but not the

name

Pause to find words

Reminded of the past

Harder

Not Normal Aging:

Can’t think the same

Can’t do like before

Can’t get started

Can’t seem to move on

Doesn’t think it out at all

Can’t place the person

Words won’t come – even later

Confused about past versus now

Very different

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

Cognitive Changes with Aging:- Normal changes: more forgetful and slower to learn

- MCI: Mild Cognitive Impairment: Immediate recall, word

finding, or complex problem-solving problems

-Half these folks will develop dementia in 5 years

- Dementia: Chronic thinking problems in > 2 areas

- Delirium: Rapid changes in thinking and alertness, seek

medical help immediately

- Depression/anxiety: Chronic unless treated, poor

quality of life, “I don’t know” or “I just can’t”responses, no pleasure, can look like agitation and

confusion

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

Ten Early Warning Signs:

1. Memory loss for recent or new

information, repeats self

frequently

2. Difficulty doing familiar but

difficult tasks: managing money,

medications, driving

3. Problems with word finding,

mis-naming, or misunderstanding

4. Getting confused about time or

place, getting lost while driving,

missing several appointments

5. Worsening judgment, not

thinking thing through like before

6. Difficulty problem-

solving or reasoning

7. Misplacing things or

putting them in ‘odd’ places

8. Changes in mood or

behavior

9. Changes in typical

personality

10. Loss of initiation:

withdraws from normal

patterns of activities and

interests

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© 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-

one related to memory and another part

2. It is chronic – can’t be fixed

3. It is progressive – it gets worse

4. It is terminal – it will kill, eventually

© 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.

Normal Brain Alzheimers BrainUsed with permission from Alzheimers:The Broken Brain, 1999 University of Alabama

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

Dementia

does not equal

Alzheimers

does not equal

Memory Problems

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

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

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How Can We Become Better

Communicators?

Let go of the past to be in the moment

Go with their flow

Be willing to try something new

Be willing to learn something different

Be willing to see it through another’s eyes

Be willing to fail and try again

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

Getting The Person

to Do Something:

Form a relationship first,

then work on task attempt!

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

To Connect:

- Use the Positive Physical Approach™ to

get started

- Make a Visual Connection:

-Look interested and friendly

- Make a Verbal Connection:

-Sound enthusiastic, keep responses short

- Make a Physical Connection:

-Hold Hand-under-Hand®, or use flat open

hand on forearm or knee

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Positive Physical

Approach™:

-Pause at edge of public space (6 feet)

-Gesture and greet by name

-Offer your hand and make eye contact

-Approach slowly within visual range

-Shake hands and then maintain Hand-under-Hand®

-Move to the side

-Get to eye level and respect intimate space

-Wait for acknowledgement

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

Then, Connect Emotionally:

- Make a connection

-Offer your name: “I’m (name) and you

are…?”

-Offer a shared background: “I’m from

(place) and you’re from…?”

-Offer a positive personal comment: “You

look great in that!” or “I love that

color on you.”

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

Connecting Emotionally:

-Identify common interest

-Say something nice about the person or

their place

-Share something about yourself and

encourage the person to share back

-Follow their lead and listen actively

-Use some of their words back to keep

the flow going

-Remember it’s often the ‘first time’ for

them, so expect repeats

-Use the phrase “Tell me about…”

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

To Communicate:

Just Having a Conversation-The more you know, the better it will go

-Take it slow and go with the flow

-Later in the disease:

-Use props or objects

-Consider parallel engagement at first: look at the

‘thing,’ be interested, share it

-Talk less, wait longer, take turns

-Cover, don’t confront when you aren’t getting

their words and just enjoy the exchange

-Use automatic speech and social patterns to

start interactions

-Keep words short and emphasize the visual

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

Then, Get it Going!

- Give Simple and short information

- Offer concrete choices

- Ask for help

- Ask the person just to try

- Break the task down to single steps at a time

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

Give Simple Information:

- Use Visual Cue (gesture/point) combined

with a Verbal Cue:

-“Its about time for… “-“Lets go this way…”-“Here are your socks…”

- Don’t ask questions you don’t want to hear

the answer to!

- Acknowledge the response/reaction to your

information

- Limit your words and keep it simple

- Wait!!!!

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

To Communicate

When They’re Distressed:

First - Connect

Then - Use Supportive Communication

Finally - Move Together to Something New

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Be a Detective, Not a Judge!

Try to figure out what is being communicated:

•Words

•Thoughts

•Actions

•Needs

•Beliefs

Don’t assume or presume

Don’t discount the message because of how it

is delivered

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

Top Five Human Needs and

Emotional Indicators of

DistressFive Human Needs:

IntakeHydration, nourishment, meds

Energy Flowtired or revved up

directed inward or outward

OutputUrine, feces, sweat, saliva,

tears

Comfort4 Fs and 4 Ss

PAIN Free!!!Physical, emotional, spiritual

Five Expressions of Emotional Distress:

Angryirritated – angry – furious

Saddissatisfied – sad – hopeless

Lonelysolitary – lonely –

abandoned/trapped

Scaredanxious – scared – terrified

Lacking Purposedisengaged – bored – useless

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

To Communicate and Figure

It Out:Connect:

•Visually

•Verbally

•Physically

•Emotionally

•Spiritually

How?

•PPA™

•Supportive Communication

Supportive Communication:

•Empathy

•Validation

•Exploration

•Acknowledgement

Move Forward:

•New words

•New place

•New Activity/Focus

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

To Connect When They’re

Distressed:

- Send Visual Signal of connection:

-Look concerned

- Send a Verbal Signal of connection:

-Use the right tone of voice

- Send a physical signal of connection:

-Give a light squeeze or sandwich the hand

-Offer an open palm on shoulder or back

-Offer a hug if the person is seeking more

contact

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

What is Supportive

Communication?• Repeat a few of their words with a question at

the end

• Avoid confrontational questions

• Use just a few words

• Go slow

• Use examples

• Fill in the blanks

• Listen, then offer empathy:

“Sounds like…” or “Seems like…” or “Looks

like…”

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

More Supportive

Communication:• Validate their emotions

• Early Stage: “It’s really (label emotion) to

have this happen” or “I’m so sorry this is

happening to you!”

• Mid Stage: Repeat their words with emotion:

-Listen for added information, ideas, thoughts

-Explore the new info by watching and listening

-Late Stage: Check out the whole body:

-Face, posture, movement, gestures, touching,

looking

-Look for the need under the words or actions

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

Once You’re Connected and

Communicating:

Move Forward:

•Add new words

•Move to a new place

or location

•Add a new activity

Early Stage: Redirection

•Same subject, different

focus

Later Stage: Distraction

•Different subject,

unrelated but

enjoyed

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

For All Communication:

If what you are trying is not working:

- Stop!

- Back off

- Think it through, then:

- Re-approach

- Try something slightly different

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

Use empathy

and

go with the flow!

Reality

OrientationTelling

Lies

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

Do:- Go with the flow

- Use supportive communication techniques

-Use objects and the environment

-Give examples

-Use gestures and pointing

-Acknowledge and accept emotions

-Use empathy and validation

-Use familiar phrases or known interests

-Respect values and beliefs and avoid the negative

-Offer info if asked, monitoring the emotional state

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

Don’t:- Try to control the flow

- Argue with them or correct their errors

- Ignore problem behaviors

-Use reality orientation and big lies

-Try a possible solution only once

- Try to stop the flow

-Reject topics

-Try to distract until you are well-connected

-Use negative visual cues

-Give up

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

So What Should We Do???

Remember

who

has the healthy brain!

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

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contained from this presentation you are taking full responsibility for your actions. Neither the creators, nor the copyright holder

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Any links are for information purposes only and are not warranted for content, accuracy or any other implied or explicit purpose.

This presentation is copyrighted by Positive Approach to Care and is protected under the US Copyright Act of 1976 and all other

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format, sold, or used in any way other than what is outlined within this under any circumstances without express permission from

Positive Approach to Care.

Copyright 2017, All Rights Reserved

Teepa Snow and Positive Approach to Care

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