Further knowledge in dementia part 1

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South West Dementia Partnership
Further knowledge in dementia part 1
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Welcome

• Introductions
• Group Agreement
• What will be achieved from this session?

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Main Talking Points

• How the brain is affected when a person has
  dementia
• Person centred care and positive communication
• How physical health is important to a person with
  dementia

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Changes in dementia

• Difficulties with
• Getting lost
• Forgetting losing things
• Finding the right words
• Expressing strong feelings in an appropriate way
• Making decisions and judgements
• Managing social situations
• Managing money and finances

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The different types of dementia

• Alzheimers disease
• Vascular dementia
• Lewy Body dementia
• Frontal temporal dementia
• Parkinsons Disease
• Korsakoffs Syndrome
• CJD

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Alzheimers disease

• Most common form of dementia
• Progresses gradually over time
• The damage to the brain cells usually starts in
  the temporal lobe of the brain which results in a
  person having problems with short term memory and
  new learning
• Damage to all areas of the lobes of the brain is
  common as the disease progresses

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Vascular dementia

• Sometimes referred to as stroke related
  dementia
• multi infarct / single infarct dementia
• The damage to the brain cells are dependent on
  where the blood vessel damage occurs
• Sometimes it is described as stepwise in the
  way the changes occur
• The way the disease progresses is very variable
  from person to person

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Lewy Body dementia

• This dementia shares similarities with both
  Alzheimers and Parkinsons diseases
• Lewy bodies are tiny round deposits found in the
  nerve cells which disrupt the brains normal
  functioning
• Hallucinations and delusions are commonly
  experienced
• The person with Lewy body dementia may react
  badly to anti-psychotic medications

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Person centred care and positive communication

• Tom Kitwood and psychological needs of people
  with dementia
• Person centred care in practice
• Positive communication in distressing situations

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Tom Kitwood
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• Think of ways you might uphold a persons
  well being in each of these areas

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Person centred care in practice

• Key difficulties and responses
• When the person is confused by past memories
• Positive and effective communication in
  distressing situations

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When the person is confused by past memories

• Consider is it possible to orientate the person
  to reality?
• Validating/ agreeing with the persons feelings
• Explore past memories that the person is
  experiencing
• Provide reassurance and comfort

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Positive communication in distressing situations

• Responding to distress and frustration
• Do not argue with the person focus less on the
  factual content of what is being said and more on
  how the person is feeling
• Do not blame the person for being distressed
• Try not to take it personally if the person
  displays angry behaviour towards you
• It may help to try and distract the person with
  everyday routines such as meals /walks

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Responding to distress and frustration

• Consider the persons sense of reality and
  respond to this - using reminiscence to link to
  past stories in the persons life and asking
  questions to engage the person.
• Look to identify how the person is feeling and
  respond to this.
• Identify themes and plan accordingly.

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Verbal communication

• Speak in a calm way notice the tone of your
  voice
• Use short sentences giving small amounts of
  information
• Make time for the person to answer
• Dont argue about facts or try to correct the
  person

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• Identify the non verbal skills that are being
  used in this communication

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Non-Verbal Communication

• Move to the persons level
• Gain eye contact where possible
• Use gestures, objects or signals as well as words
  e.g. show the person an object that relates to
  what you are saying

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General health and well being

• Exercise does the person have opportunities to
  move around?
• Good diet is the person getting enough to eat,
  is this a balanced diet and nutritional?
• Having enough fluids is the person getting
  enough to drink?
• Being free from pain and infection
• Environment is the room warm/cool enough?

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Focus on physical health in order to

• Reduce the risk of delirium
• Reduce potential communication difficulties where
  a person is trying to express these needs
• Increase an individuals wellbeing

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Main Talking Points re-visited Any questions?

• How the brain is affected when a person has
  dementia
• Person centred care and positive communication
• How physical health is important to a person with
  dementia