Brain Change Model
This is the continuation of our series about connecting with a loved one, living with dementia, during the holiday season.
In the previous article about Sapphires, we discussed someone exhibiting signs of dementia, but not actually suffering from the disease. Depression, as well as other possible culprits, are mostly curable. Dementia is different.
What is Dementia?
In this article, we will discuss the first stage of dementia: Diamond.
If you are looking for a three-minute explanation of dementia, here is a great video.
Here are a few important statements to keep in mind:
- Dementia is progressive, without a known cure, and leads to death. However, medications and engagement can slow the progression of the disease.
- There are over 80 known types of dementia, and sometimes some can exhibit multiple types. The most common type of dementia is Alzheimer’s disease.
- Many people are only officially diagnosed further in the disease progression, if at all. (There are many Diamonds that do not know they have the disease, nor do their family members.)
- A person living with dementia will loose various skills and abilities as the disease progresses, not just their cognitive capacity.
The first stage of dementia is a Diamond because this gem is “clear and sharp”. Diagnosis is tricky because sometimes picking up on changes requires a long visit.
Diamonds can be successful at established habits and routines. They can engage in small talk and appear pleasant. This is because the first skill to be compromised, in Alzheimer’s type dementia, is short-term memory. In other types of dementia, such as frontotemporal, the person loses the ability to control their impulses.
Established habits and social mannerisms continue, because they were usually adopted at a younger age. These memories and skills are preserved are stored differently in the brain.
Interactions become more difficult as they become more substantive. During conversation difficulties can arise if you reference recently learned information. The person living with dementia becomes less flexible at changing habits and behaviors in response to new information. In conversation, the person will begin to appear overly rigid and are prone to snap if they cannot follow the conversation.
Recommendations for engaging with Diamonds
For those living with dementia and are operating as a Diamond, here are some recommendations:
- Throw out the phrase “Do you remember?” and anything similar. They do not remember and you quizzing them will leave no one feeling better. Instead, try to focus on what they remember, resorting to more distant memories.
- Involve them in the process as much as possible. They will feel frustrated by being unable to accomplish certain tasks, but your job is to find out the ones they still can do with you or on their own. If they can participate, they will feel competent and valued. Best activities will vary depending on physical abilities and past hobbies, but here are some ideas:
- Ask them to help you sort or organize, preferably a task that you are not highly prioritizing, but would be nice if complete.
- Have them paint or color certain objects.
- Request they tell you a favorite childhood story.
- Enlist their help watching a pet dog or cat.
- Try a simpler version of a task they used to enjoy. For example, if they used to complete 1,000-piece puzzles, try a 100-piece puzzle.
- Do not rationalize or try to occupy the moral high ground. Meet them where they are in their moment. If you seek to stop or prevent a certain activity, offer them an alternative. Substitute, then subtract.
GEM levels can fluctuate based on the person’s energy level, stress, and nutrition. For example, a fatigued or sick Diamond, can operate more like an Emerald for periods of time, before the Emerald stage become their modus operandi. Learn when and how your loved one operates best and use these moments to maximize a connection. Remember, always connect before providing care.
Build your team
It is important to build your care team at this stage before you reach a state of desperation. As the disease progresses, the person will become increasingly dependent on the people who are currently fulfilling the role as caregiver. If this person is you, it will be more difficult to introduce outside help effectively. Your loved one living with dementia may develop abnormal sleep patterns and become less considerate of your needs until theirs are met.
Providing hands on care is more effective after a connection is established. It is recommended that you introduce care early, on a regular weekly schedule, to get the person comfortable with the idea of help before someone needs to actively assist with hygiene and other more private care needs. In this way, you can gradually build your team and establish coverage with a reputable care provider.
NursePartners is happy to complete a wellness assessment, at no cost, if referencing this article. All assessments are completed by a registered nurse and certified dementia practitioner. Your call is answered by a member of the admin team, at any time around the clock: 610-323-9800.