Dementia Awareness

An introduction to supporting people with dementia

Aim:

To provide you with a basic understanding of dementia and introduce approaches that will help you be supportive to people with dementia

Learning Objectives

• Increased understanding of the experience of dementia

• Increased understanding of communication and behaviour relating to dementia

• Increased understanding of the potential effects of the environment on a person with dementia

• Increased understanding and confidence in using enabling and person-centred approaches

Dementia Care in Scotland

• Dementia Strategy

• Standards of Care for Dementia in Scotland

• Promoting Excellence Framework

Understanding the experience of dementia

• PERSON• DEMENTIA• ENVIRONMENT

What is dementia?

• Dementia is a broad term indicating loss of intellectual functions (such as thinking, remembering, reasoning) of sufficient severity to interfere with a person’s ability to carry out day to day activities and often affecting social behaviour

Understanding dementia

• Dementia is not a disease itself but a collection of features or symptoms accompanying certain conditions

• What all these conditions have in common is that they damage and kill brain cells, so that the brain cannot work as well as it should

Who is affected?

• Dementia affects both men and women and exists worldwide

• It is most common in older people but can affect people in their 40s or 50s or even younger

• Research shows that many factors affect the risk of developing dementia

Types of dementia

Many different conditions bring about the features of dementia, the most common are:• Alzheimer’s disease• Vascular dementia• Dementia with Lewy bodies

It is also possible to have more than one type of dementia; for example Alzheimer’s disease and vascular dementia

What happens?

• In most types of dementia, the illness is progressive and therefore the person will experience many different difficulties over time

• There is no cure at this point in time although some medications are available that help some people with some types of dementia for a period of time

Disabilities in dementiaThis person may experiencedifficulties with…

• Communication• A sense of time and place• Finding his way around • Coping with unfamiliar places, people

or activities• Social/spatial/visual awareness• Memory

Possible difficulties…

• Planning and calculating • Reasoning and judgment • Controlling emotional responses• Recognising people and objects• Coping with everyday activities - including his

personal care• Learning, concentration and motivation

Important points…

• Every person with dementia is different and may experience dementia differently

• Not everyone will have same symptoms and they do not necessarily appear in any particular order

• Good days and bad days – tiredness, depression, emotional state and other health problems will have impact on coping with dementia

• Can even depend on time of day

DVD

• Through our eyes • A life with dementia

EXPERIENCE OFDEMENTIA

ENVIRONMENT

THE KIND OF PERSON YOU

ARE

PERSONAL LIFEEXPERIENCES AND WAYS OF

COPING

PHYSICALHEALTH/

PSYCHOLOGY

CHANGES TO THE BRAIN

AND FUNCTION

Dementia circle of support and resources

Our home

Family & Friends

Our hobbies

Care Team

Normal communication:a complex process

• Speech• Hearing• Touch• Sight• Understanding• Expressing

• Words 7%• Tone of voice 38%• Facial expression 55%

Communication difficulties for people with dementia

• Understanding what is being said

• Finding appropriate words • Repeats things • Asks the same question

again & again • Says things which aren’t real or

true• Slowness at responding• Mispronounces words

• Naming objects and people • Difficulty writing• Difficulty following television &

reading• Conversation wanders• Insensitive to other peoples’

conversation needs• Unable to explain things

Ashdeane House

How can I help?

• Use name at beginning• Check aids• Minimise distractions• Consider who is the best person to impart information• Avoid the use or overuse of questions• Consider echoing

How can I help?

• Take time – give time• Be calm and patient• Speak slowly and clearly in a respectful, adult manner• Face the person and maintain good eye contact• Give the person your full attention and address him/her – not

accompanying helper• Look interested in what is being said even if it is difficult to

understand

How can I help?

• Ensure the person is able to hear and see you clearly• Be aware of the tone of your voice• Focus on the person’s emotions and feelings• Make suggestions if the person seems to be struggling to find

words• Be aware of the individual’s facial expressions, body posture

or mannerisms – what are they telling you?

How can I help?

• Be aware of your own facial expressions and body language• Provide clues and visual/verbal prompts to assist

understanding• Try providing information in a variety of formats • Be prepared to repeat information and instructions calmly• Try a range of approaches to ensure information is

understood

Making connections

• Music• Singing • Touch• Smell

Everyone is Different!

• Person • Dementia• Environment

Challenging behaviour often relates to a failure in normal communication

•Communication and Dementia

Ashdeane House 26

Behaviour in Dementia

• Aggression/irritability• Uncooperativeness• Apathy• Shouting/swearing• Repetition/questioning• Catastrophic reaction• Separation anxiety

• ‘Wandering’• Hallucinations• Delusions• Disinhibition• Sundowning• Continence problems • Accusations

What can cause challenging behaviour?

Challenging Behaviour Boredom

Over Stimulation

SeparationAnxiety

Loneliness

Reality confrontation

Feelings of incompetence

Stress

Fear or alarm

Disorientation

Misunderstanding events

Disinhibition

Pain or

discomfort

Memory Loss

Loss of goal

recognition

Communication Difficulties

A,B,C Approach to understanding behaviour we find challenging

Activation – what was happening immediately prior to the behaviour? Who was there? Where were they?

Behaviour – what was the behaviour you actually observed? Be clear, specific and descriptive.

Consequence – What happened after the behaviour? Who was involved? How was it resolved

29

Things to avoid

• Using tricks lies or deception

• Disempowering• Talking as you might to

a child• Labelling• Outpacing

• Rejecting the person • Dismissing feelings• Emphasising

disabilities• Ignoring the person

The environment can help or hinder a person with

dementia

Once you understand some basic rules, you can help

improve communication, behaviour and understanding

Environmental challenges

Issues to consider

Help people with dementia to make sense of their surroundings

• Colour and design

• Lighting

• Noise

• Mirrors & Reflections

‘See Me’ - Who has dementia?

©Alzheimer Scotland

Aids and resources

www.alzscot.org