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Dementia during the Holidays: Diamonds

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:

  1. Dementia is progressive, without a known cure, and leads to death. However, medications and engagement can slow the progression of the disease.
  2. 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.
  3. 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.)
  4. A person living with dementia will loose various skills and abilities as the disease progresses, not just their cognitive capacity.

Diamond

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.

Let’s talk

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.

Dementia during the Holidays: Sapphires

Brain Change Model

NursePartners’ approach to Alzheimer’s and dementia care is based on The GEMS™: Brain Change Model created by Teepa Snow. NursePartners recognizes the Teepa’s Positive Approach™ to Care as an effective method to provide care for loved ones affected by dementia. This approach categorizes dementia stages with six different gemstones, defined by unique characteristics.

This approach to care serves as an effective method for understanding and meeting the needs of individuals affected by Alzheimer’s Disease and other forms of dementia.  To learn about all the GEM levels, explore here.

Other methods of dementia classification might use numbers or levels of severity to describe the progression of dementia. However, we at NursePartners speak in GEMTM levels. It is not enough to simply describe the stage of dementia, we need to emphasize how to connect with your loved one, wherever they are in the disease process.

During the holiday season, you may see changes in an older adult. This article series is meant to help you reconnect with them.

Sapphire

The first GEMTM level is Sapphire, the only level that describes the absence of dementia. This is included because we must remember to always investigate other possible causes for forgetfulness, confusion, poor concentration, personality changes, apathy, and inability to do everyday tasks.

Depression can share many of the same side effects as dementia. Older adults can feel isolated, especially during the winter months. They may struggle to fill their days with meaningful activity and social interaction. The Sapphire level is “a true blue” color for this reason.

Depression severity varies and may require pharmacological and psychotherapeutic intervention, but we can do little things to help our loved one, even if it is in conjunction with these other treatments. Even if we are pursuing other solutions simultaneously, the causes of depression are often complicated and persistent. It helps to make real and consistent changes to our daily life in order to combat the effects of depression.

Three Ways to Combat Depression

  1. Fill their world with meaningful activity
    • If they do not have a schedule, make one. The schedule does not have to be arduous, but there should be a reason to get out of bed each morning, dressed, showered, and out in the world.
    • Choose activities that are aligned with their interests and personality. Just because someone is an introvert, does not mean they cannot visit the craft store or volunteer at the local animal shelter.
    • All activities should make the person feel loved and needed. When someone feels as a contributing member in society, mood generally improves.
    • Involve them in the decision making. If they cannot decide, switch up your approach. Try presenting a few options versus proposing open-ended questions.
    • Ask them to help you. Do you need help wrapping presents, meal prep, or picking up the kids from the bus stop? Request their assistance. This helps them feel needed while helping you get everything done.
    • Don’t forget to schedule time for your visits! As you help build their schedule, do not be surprised if they become “too busy” for your visits.
  2. Exercise
    • Start with moving more around the house and then take it outside, weather permitting.
    • If your loved one benefited from a program designed by a physical therapist, continue those exercises even when the physical therapist sessions end. The adage “move it or lose it” applies here.
  3. Boost their Diet
    • What are they eating? Sometimes vitamin deficiencies are the culprit. Try enriching their diet and involving them in the process. Start slowly, by adding a few new options each week.
    • You can teach them how to use these new ingredients but bringing them a freshly baked meal instead might persuade them quicker. They may be surprised that eating well can also taste good.

Bring in an ally

You can enlist the help of professionals to kickstart a change in lifestyle.  The advantage of working with a certified nursing assistant is that they can be your eyes and ears on the ground.  While you are at work or with your family, they are helping mom or dad out of bed and into the world.

There are additional benefits you might not have expected:

  • Constant and ongoing fall risk mitigation
  • Light housekeeping
  • Meal preparation and socialization
  • Performing and assisting with personal care activities
  • Home exercise program support
  • Detailed family updates
  • Familiarity and rapport
  • Coordinate grocery purchases and deliveries
  • Medication management

Older adults are not children.  They have lived a life rich in experiences.  It is unrealistic to think that one adult can take care of all the needs of another.  Enlist help to optimize the results for both you and your loved one.

Want to talk more or schedule a wellness assessment?

Call us at 610-323-9800.  Expect you call to be answered by a member of our administrative team, never a call center or third party.  Mention this article and receive the wellness assessment completed by a registered nurse, free of charge.

How to know when its time for home care

Give your thanks by showing them you care

 

This day each year, we gather to give thanks for another year. We are seeing some relatives for the first time in a while. At these reunions we usually put our best face forward. This is no exception for older adults.

 

The Positive Approach to CareTM classifies dementia by six gemstones (click here to learn more). The first two are sapphire and diamond. The sapphire symbolizes normal aging and forgetfulness, which is not dementia. The diamond, however, is the first stage of dementia.

 

A diamond is highly functioning and may not be aware of its own cognitive decline. It can cover up forgetfulness and other warning signs for periods of time, such as during your reunion.

 

We should spend extended periods of time with our loved ones to truly understand their needs. Although casual conversation throughout the reunion will not paint a perfect picture, it can help us understand if we should investigate further.

 

As you talk, test their short-term memory. Alzheimer’s disease inhibits our ability to form new memories first. Discuss something new and bring up the same topic a few hours later. See if they remember having this discussion.

 

During conversion, do they appear frustrated or fixated in a train of thought? Are they unable to “shift gears”?

 

Even if your loved one is not experiencing a cognitive decline, they are still a sapphire. How is their mobility, hygiene, and nutritional intake? Would they be happier or healthier if these basic needs are met? How about socialization? Have they been getting out of the house and trying new things?

 

GEM care for dementia or traditional home care can help your loved one operate at their best. Old age or a progressive disease does not need to prevent them from enjoying their time with us. Have questions about how GEM care or traditional home care can best support your loved one?

 

Call us to learn more or to schedule a complementary wellness assessment by a

Registered Nurse and Certified Dementia Practitioner: 610-323-9800.

 

NursePartners is open 24 hours a day, 365 days a week: 610-323-9800