Person-Centered Approach to Alzheimer’s Part 1 - Encore

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Hello to all of you who have tuned in to listen

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to this episode of the truth, lies and Alzheimer's show. I'm

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Lisa Skinner, your host, and I'd like to shout out a very warm

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welcome to all of you who have joined us here today. I really

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appreciate you taking the time to listen. The purpose of this

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show is to talk about every aspect of Alzheimer's disease

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and dementia that's going to include the good, the bad and,

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yes, the ugly. My goal is to get to the truth, dispel the lies in

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this and unveil what I call the secret faces of Alzheimer's

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disease. This way you'll have a better understanding of what

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it's truly like to live with a brain disease like Alzheimer's.

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My hope is to zoom outside the paradigm of people believing

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that it's exclusively a memory loss condition, and to shift

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their understanding of just how dramatically this disease

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impacts the lives of those who have it, as well as their

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caregivers and family members. Well, for that matter, anybody

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who is involved in the life of a person living with dementia. My

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story started almost 50 years ago when my grandmother began

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displaying some very strange behaviors. She insisted that

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there were birds living in her mattress, and that they would

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come out at night and peck her face. She insisted that she saw

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rats running along her walls and that they were going to invade

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her house. She talked about the men who were trying to break

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into her home to not only steal her belongings, but they were

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there to harm her. Well, it turned out that this was the

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beginning of our 20 year journey with my grandmother and her

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Alzheimer's disease. So fast forwarding, a few years I became

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a behavioral specialist, and I have spent the last 30 years

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helping family members and caregivers understand the

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devastating effects of this disease so they too, could learn

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how to best live with the unexpected surprises that emerge

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day to day. That way, they can spend time focusing on what

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truly matters, which, of course, is spending quality time with

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their loved ones. And I am here for you now. I've also authored

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several books on the subject, written a training program, and

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believe it or not, have painfully watched eight of my

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own family members fall prey to one of the brain diseases that

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causes dementia. I'm also a certified Dementia Care trainer

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through the Alzheimer's Association, and I'm a certified

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dementia practitioner. I have come to realize, and you

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probably do, too, if you're on this Alzheimer's disease

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journey, that there are so many aspects of living with dementia

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that are unexpected and they surface out of nowhere at any

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time. Well, these are what I call the hidden or secret faces

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of Alzheimer's disease, and as many of you know, they do show

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up unannounced and are completely unpredictable, and

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that's why it's so important to be prepared for anything that

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emerges on this journey. I believe that knowledge is power,

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and I am here to arm you with that knowledge, so you too will

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have the power to negotiate the many challenges you will face

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having a loved one or while caring for someone with

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dementia. You know, living with dementia is unlike anything

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anybody could ever imagine. Think of it like falling into a

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rabbit hole, like Alice in Wonderland, and entering a world

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unlike anything you've ever known, one that is completely

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unfamiliar to you. Well, that said it's equally important to

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not only understand what will occur on a day to day basis, but

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why these things occur, what is happening to the person's

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changing brain as they progress through the various stages of

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Alzheimer's disease, and that is what I'm here. To offer you a

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better understanding about what living with Alzheimer's disease

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is really like, and only then will you be prepared to for what

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challenges lie ahead. And you know what that is the key to

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being prepared and to not being caught off guard. So on today's

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episode, I want to talk to you about what is called the person

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centered approach to care what exactly is it and why is it

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important? I've been practicing the person centered approach to

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care for decades now, and I want to tell you that I feel very,

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very, very fortunate that I was introduced to it and learned

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about it and implemented it early on in my career as an

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elder care counselor. It is so important, and it really, from

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what I've seen and personally witnessed, it has made a huge

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difference in the quality of life that people experience

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living with Alzheimer's disease and related dementia. So relax

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and sit up in your chair, and I am going to explain to you why I

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firmly believe in this approach to care and why it's important

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what I've discovered practicing the person centered approach to

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care. So it means that knowing what is important to an

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individual and working their life and care plan around the

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individual's wants and needs, instead of focusing exclusively

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on the disease, in other words, just to focus exclusively on the

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symptoms that they're displaying, but get to know the

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individual person in a very detailed and personal level.

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This includes offering choices and benefits as well as care

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options and strategies based on a person's personal wants,

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needs, likes and dislikes. This approach has shown to fulfill a

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patient's needs beyond their disability or ailment, as well

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as improve their quality of life, and extremely important

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when caring or communicating with a person living with

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dementia, for them, it demonstrates respect that they

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have their own views on what's best for them, that they have

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their own values and priorities in life, and that maintains

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familiarity that is such a crucial part of their everyday

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lives, these care plans and strategies are adapted to their

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expectations and preferences and not the other way around. By

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doing so, it enables the patients to retain their dignity

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and autonomy during an already challenging time. So these are

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the four principles of person centered care, to treat people

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with dignity, compassion and respect.

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The patients often lose their independence when they enter

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care, which puts their dignity at risk. However, person

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centered care enables a person to maintain their dignity by

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respecting their wishes and treating them with compassion

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and empathy. To fulfill this principle, patients must be

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allowed to own their own thoughts, feelings, opinions,

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beliefs and values, because they don't just suddenly become

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invalidated by their care needs. Respecting their personal

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qualities helps them feel validated and cared for much

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more wholly, both physically and mentally. The second principle

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is providing them with coordinated care, support and

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treatment. So it's very important to record their

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personal information into a journal or care plan and share

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it with other caregivers, the caregivers or family members

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should communicate this information with one another to

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build a shared understanding of how to deliver this person

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centered care. The third principle is to offer

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personalized care, support and treatment. This. This principle

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is truly at the heart of a person centered approach to

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care, and it will enable caregivers to understand what

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works for each individual person based on specific situations.

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You've heard me say in previous episodes that if you've met one

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person with Alzheimer's disease. Guess what? You've met one

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person with Alzheimer's disease, and as I've stated before, it's

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because every single person experiences the stages of the

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disease and progresses through the disease in a little

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different way. So if we have detailed information about the

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people, we can avoid so many stressful situations by being

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prepared with the tools in our toolbox that we will have ready

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based on their personal information. The last principle

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is to enable caregivers to recognize and develop a person's

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strengths and abilities so they can live independent and

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fulfilling lives. And trust me, I have seen this principle do

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exactly that, providing Person Centered Care involved to

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patients in decisions and helps them take action to support

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themselves whenever possible. This helps them to develop their

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own capabilities and an understanding of how to look

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after themselves and to stay as independent as possible through

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each stage of their disease. Now this definitely becomes a

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challenging fine balancing act as they continue to decline, but

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trying to force patients to do more on their own can surely

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cause anxiety and frustration. On the other hand, too much

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involvement makes them feel irrelevant and useless and can

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literally turn them into an invalid so why is this important

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in providing a more meaningful life? Well, the people suffering

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from Alzheimer's disease and related dementia will feel more

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comfortable and confident. They'll have more trust in you

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that you're doing what's best for them, and therefore they

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will be less resistant to your help. This, of course, will make

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any situation easier for both of you. You will meet their

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emotional their social and practical needs, which ensures

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that they maintain a higher quality of life. You can support

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those who may not be able to directly communicate their wants

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and needs. Person Centered Care helps you find suitable ways to

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communicate with them and to help them to communicate with

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you, especially when they can no longer articulate their wants

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and their needs and that will maximize their quality of care.

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Now, family members, caregivers and people living with dementia

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deserve to live a fulfilling life and feel positively despite

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the challenges and stresses that accompany living with this

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disease. I want to go over a few things that would be helpful for

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everybody to gather this type of information. It's a behavioral

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history and social assessment. So obtaining this information,

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you can provide very important information. You can design

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activities around what you know they like to do in the past

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about each individual person, the history questions elicit

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information about their history of such behaviors as wandering,

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agitation, assault, sexual behaviors, elopement, and many

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others. The history can be obtained from the resident and

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family at the same time you conduct your social assessment

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and gather requested information from you know, hospitals and

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nursing facilities, daycare caregivers, spouses, family

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members, friends, because every little nugget that you gather

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about a person is going to come. Come in handy when different

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situations arise, and I will explain that in detail over the

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many episodes that we're going to cover this information moving

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forward. So a social assessment provides valuable information

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about a person in their social context, examples of information

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obtained in the social assessment include their customs

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and practices, their beliefs, their fears and joys, their

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family history, things that they may be attached to, and how well

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they socialize and availability of family and friends to provide

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support. Now, obtaining detailed information about the person,

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their background, their personality, their likes, their

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dislikes, etc, helps us provide optimal care. It also helps us

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to design appropriate activities, and it enhances

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communication. So let's take a look in more detail about what

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information you want to try to gather from the social

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assessment. Is the resident outgoing? Are they social? Are

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they quiet? Are they physically active? Do they have a favorite

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food, hobby or sport? How do they respond to stimuli? How do

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they respond to assistance? How does the resident relate to the

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family? Do they have children? Do they practice a religion, and

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if they do, what religion do they practice? How do they like

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to celebrate the various holidays? What do they like to

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wear? Are there any significant life events that the family can

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share that might trigger behaviors at any time. How do

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they respond to stress? How do they display their emotions?

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What is their general demeanor? Or at least, what was their

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general demeanor prior to their brain disease? How do they react

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to discomfort and pain? What type of entertainment Do they

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like? What type of music do they enjoy? What level of education

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did they complete? That's actually an important question.

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How do they respond to animals? I'll give you an example. My

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mother couldn't stand pet so that's one thing I would never

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have introduced to her pet therapy. So that's an important

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piece of information to gather. Would the resident strike in a

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given situation? In other words, become combative and try to hit

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or strike out. And are you aware of whether or not they're able

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to make their needs known? These are just a few of the very

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important information or nuggets for you to gather, have ready in

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your toolbox to you in many, many, many of the situations

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that you will inevitably encounter throughout this

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journey with your loved one.

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And as we continue with these informational episodes, you will

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understand why, in the stories I'm going to tell you and the

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examples I'm going to give you, and in the very detailed

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information that I will provide so you will be able to connect

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all the dots and see the big picture of Just how this disease

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impacts people who suffer from it. Next, I want to just give

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you a little background of how things changed and have changed

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and continue to change since my grandmother's diagnosis 50 years

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ago, back then, when people started displaying the types of

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symptoms that I described to you, that she did with me,

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people were medicated. People were over medicated. That was

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customary, and to the point where they were almost like a

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zombie or in a comatose state. This was very, very common. They

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also used restraints on people who suffered from well at that

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time, I told you, they called it senile dementia, but it is

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synonymous. With today's Alzheimer's disease and the

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other brain diseases that cause dementia, then we move to what

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was called reality therapy, or I'm going to explain to you what

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that means, but it simply did not work. Then a woman by the

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name of Naomi file introduced what is currently called

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validation therapy, also known as joining their reality

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therapy, adapting our world to theirs, and also using

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reminiscence therapy and life stations, and I will explain all

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of these to you between this episode and upcoming episodes.

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So let me start with what is reality orientation therapy?

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Well, reality orientation therapy also known as RO, is a

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treatment strategy. Was a treatment strategy, but it is

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still used. First described in 1966 as a rehabilitation method

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for confused elderly patients. The therapist would present the

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patient with continuous reminders about the date, where

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they are, where they exist, personal details about them,

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about their life, about their likes and dislikes. A therapist

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and a patient would discuss recent events and their daily

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routine. The goal in this was to ground the patient in the

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presence, while also fostering social interaction. For example,

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if they were wondering where their parents are because their

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short term memory switch flipped off, and they're now pulling

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from their lungs to memories and believe that they're a child

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living with their parents, they would be told under reality

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orientation therapy that their parents are no longer living if

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they weren't or that they can't go home because they no longer

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live in that childhood home with reality orientation therapy, the

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goal of the therapist was to reduce confusion and

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disorientation in dementia patients. They believed that the

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patients would gain a stronger understanding of their

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surroundings and their place within them, and would lead to a

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greater sense of control and increased self esteem. But guess

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what? It did not work. What it did do was cause anxiety and

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even scared people, especially if they didn't remember that a

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loved one had passed away. You know, this could be like they

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were hearing it for the first time, and could be sent into a

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panic. Also, arguing with someone who has dementia is

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futile and will often escalate into a more serious situation.

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These are what we call catastrophic reactions to them.

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We might as well be calling them a liar and taking away any sense

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of control they may have in telling their story. Keep in

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mind, they believe 100% that what they are telling you is not

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true, even if it doesn't make sense to you, it makes perfect

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sense to them. Reality, orientation, therapy focused on

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presenting patients with the current facts about time, the

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date and their current environment, so patients who

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lived in a dedicated facility, like a memory care unit or

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assisted living or a skilled nursing facility couldn't

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receive this therapy 24 hours a day. So this meant that during

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every interaction, the healthcare workers and

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caregivers, when they were interacting with the residents,

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those workers were emphatic about reinforcing the current

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dates, times, locations and current events with the

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residents. The caregivers would even read the newspaper and

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watch TV with the patients to reinforce their reality. But

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unfortunately, they were reinforcing their. Reality, the

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reality of the caregivers with the healthy brains, not the

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reality of the patients and the residents who had the damage

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changing brain. And that is the difference. There may also be

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signs declaring the date they would have multiple clocks in

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the room, they would emphasize current events, seasonal

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festivals and other ways to do what they considered to be

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grounding social interaction with reality. The second therapy

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that I talked about is called validation therapy, also known

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as join their reality. And that really what it boils down to.

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It's the opposite of reality orientation therapy. It is

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literally adapting the world of the person with the healthy

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brain to the world of the person with the damaged brain. Instead

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of doing what reality orientation therapy tried to do

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was force them to adapt to ours. And as I said, it did not work.

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So validation therapy was developed by Naomi file after

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relocating to Cleveland with her parents from Germany, where her

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father served as an administrator and her mother as

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the head of the social service department at the Montefiore

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home for the aged. Naomi followed in her parents

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footsteps and began working with the elderly after receiving her

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master's degree in social work from Columbia University, after

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experiencing dissatisfaction and frustration with traditional

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treatment methods used with disoriented elderly dementia

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sufferers. File developed what we know today to be validation

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therapy. She's written two books on the subject and about the

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techniques that she uses. The first book was called validation

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the file method, and the second is called the validation

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breakthrough.

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Validation therapy is a method of therapeutic communication

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which can be used to connect with someone who has moderate to

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late stage dementia. It places more emphasis on the emotional

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aspect of a conversation and less on their feelings and

Lisa Skinner: 00:27:47

beliefs. It is a centered approach to care around a

Lisa Skinner: 00:27:54

person's needs by employing empathy and respect validation,

Lisa Skinner: 00:28:00

therapy helps a person with dementia feel supported and

Lisa Skinner: 00:28:04

understood and restores some of the dignity that dementia has

Lisa Skinner: 00:28:09

taken away from them. The practice of embracing the

Lisa Skinner: 00:28:12

reality of a person living with dementia has multiple uses and

Lisa Skinner: 00:28:17

benefits for those living with the disease. It reduces stress.

Lisa Skinner: 00:28:22

It reduces pain of loss for both the caregiver, the family

Lisa Skinner: 00:28:28

members and the person receiving care. People with dementia do

Lisa Skinner: 00:28:33

not need to be grounded in reality, and it does no good

Lisa Skinner: 00:28:38

anyway, adapting to their reality, versus forcing them to

Lisa Skinner: 00:28:43

adapt to ours makes them feel more safe and secure in the

Lisa Skinner: 00:28:49

moment. You're acknowledging them, you're validating them. It

Lisa Skinner: 00:28:54

has been successful in redirecting them so they are no

Lisa Skinner: 00:28:57

longer concerned about the safety and whereabouts of their

Lisa Skinner: 00:29:01

loved ones, so they can, in turn, enjoy the moments with

Lisa Skinner: 00:29:07

you. When we engage them in their stories of the past, we

Lisa Skinner: 00:29:12

learn and connect with them on their terms, not on ours. You

Lisa Skinner: 00:29:19

know, it's not uncommon for individuals who are living with

Lisa Skinner: 00:29:22

dementia or Alzheimer's to often speak of their younger years as

Lisa Skinner: 00:29:27

if it was their current reality. Think again about that light

Lisa Skinner: 00:29:32

functionality that I've demonstrated to you in a

Lisa Skinner: 00:29:35

previous episode. They often tell stories of their childhood

Lisa Skinner: 00:29:39

home, of their parents, and will even feel the need to go home

Lisa Skinner: 00:29:45

and make dinner for their young children. Sometimes the need for

Lisa Skinner: 00:29:49

this reality is so great that they become anxious and even

Lisa Skinner: 00:29:55

angry when they can't find what in their mind. Should be there.

Lisa Skinner: 00:30:01

So imagine how trapped and powerless they must feel in

Lisa Skinner: 00:30:06

these moments. How would you feel if you woke up one day and

Lisa Skinner: 00:30:11

everything you knew and loved were no longer there, or if your

Lisa Skinner: 00:30:18

once routine and purposeful lives was just a distant memory.

Lisa Skinner: 00:30:25

That's what it's like for them. So understand that going along

Lisa Skinner: 00:30:30

with their current belief offers them comfort, security and peace

Lisa Skinner: 00:30:36

of mind. We know that there is nothing we can say that will

Lisa Skinner: 00:30:40

alter that current belief until that short term memory switch is

Lisa Skinner: 00:30:47

flipped back on. So if they ask you where their mother or father

Lisa Skinner: 00:30:52

is, a suggestion is to tell them they're at the store and we'll

Lisa Skinner: 00:30:57

be right back. If they ask you or tell you that they need to go

Lisa Skinner: 00:31:02

home. Perhaps you can redirect them in that thought by saying

Lisa Skinner: 00:31:06

something like, Well, right now it's too cold to go outside. Or

Lisa Skinner: 00:31:12

you can ask where their children are, and you can tell them that

Lisa Skinner: 00:31:17

they're still at school. Understand that as humans, one

Lisa Skinner: 00:31:23

of our very basic needs is to be loved, accepted and to feel

Lisa Skinner: 00:31:28

validated. It's an innate need that does not diminish with

Lisa Skinner: 00:31:33

dementia. On the contrary, that need for acceptance may be

Lisa Skinner: 00:31:38

increased since their worlds have been turned upside down,

Lisa Skinner: 00:31:43

and validation therapy has been proven to be successful in being

Lisa Skinner: 00:31:48

able to provide a higher quality of life in the lives of those

Lisa Skinner: 00:31:53

living with Alzheimer's disease and dementia. Let me share with

Lisa Skinner: 00:31:58

you now a real life situational story from my book truth, lies

Lisa Skinner: 00:32:04

and Alzheimer's at secret faces that illustrate this concept of

Lisa Skinner: 00:32:09

what I have just explained to you. This is the Mary Ann story.

Lisa Skinner: 00:32:17

Quite often, people with Alzheimer's disease display

Lisa Skinner: 00:32:20

repetitive behavior, such as repeating a word the same

Lisa Skinner: 00:32:25

question, a story or an activity, they repeat it over

Lisa Skinner: 00:32:31

and over and over again, or they'll do something and then

Lisa Skinner: 00:32:39

undo what they just completed and started over and over and

Lisa Skinner: 00:32:44

over again. In most cases, they are more than likely looking for

Lisa Skinner: 00:32:50

comfort, security, familiarity, or they're just plain bored.

Lisa Skinner: 00:32:59

Repetitive behaviors are demonstrated by people with

Lisa Skinner: 00:33:02

dementia because they may be unable to remember recent events

Lisa Skinner: 00:33:08

or actions due to their short term memory loss. Remember the

Lisa Skinner: 00:33:12

short term memory switch is either flipped on or flipped

Lisa Skinner: 00:33:16

off. They may also repeat words or gestures as a means to soothe

Lisa Skinner: 00:33:22

themselves. The behaviors that you see may also be an attempt

Lisa Skinner: 00:33:28

to communicate an unmet need or alert you to a physical

Lisa Skinner: 00:33:33

discomfort. Well, Mary Ann happened to be my mother in law,

Lisa Skinner: 00:33:38

and she loved to fidget with tissues. She would meticulously

Lisa Skinner: 00:33:44

fold those tissues into neat little squares and then put them

Lisa Skinner: 00:33:49

in her purse, and then she'd close her purse. Moments later,

Lisa Skinner: 00:33:54

she would take out the folded tissue. She would unravel it,

Lisa Skinner: 00:33:59

fold it again, and tuck it back into her purse. Fold, tuck,

Lisa Skinner: 00:34:04

repeat, fold, tuck, repeat, over and over again. But this

Lisa Skinner: 00:34:13

activity would keep her occupied for hours, and she seemed

Lisa Skinner: 00:34:17

perfectly content doing it, but one weekend, when it was our

Lisa Skinner: 00:34:23

turn to look after my mother in law, she was sitting on the sofa

Lisa Skinner: 00:34:26

with me in our living room, and we were watching the nostalgic

Lisa Skinner: 00:34:31

Andy Griffith Show. She looked peaceful for a time, folding her

Lisa Skinner: 00:34:36

tissues and tucking them away into her purse. But then all of

Lisa Skinner: 00:34:43

a sudden, on the turn of a dime, her whole entire demeanor

Lisa Skinner: 00:34:48

changed. All of a sudden, she anxiously stood up from her

Lisa Skinner: 00:34:53

seated position on the sofa and demanded that I take her home.

Lisa Skinner: 00:34:58

She asked me Stern. Me, does Marty know where I am? He's

Lisa Skinner: 00:35:02

going to want his dinner. I've got to get home to him. I'm

Lisa Skinner: 00:35:07

thinking in my head, did she really just ask me where Marty

Lisa Skinner: 00:35:12

was? Oh, my goodness, you see, Marty had passed away four years

Lisa Skinner: 00:35:19

earlier. Well, my initial knee jerk response was that I wanted

Lisa Skinner: 00:35:24

to remind her that Marty had passed away, and to pull her

Lisa Skinner: 00:35:29

back into my reality. After all, she was my mother in law, and I

Lisa Skinner: 00:35:34

wanted to correct her false belief because I wanted to make

Lisa Skinner: 00:35:38

her better, but I knew better than to react that way. So

Lisa Skinner: 00:35:44

joining her reality was really my only option in this scenario.

Lisa Skinner: 00:35:51

Yes, he knows you're here. I told her. I just called him, and

Lisa Skinner: 00:35:56

he knows I'll bring be bringing you home very soon. Are you

Lisa Skinner: 00:36:00

sure? She replied, Yes, Mary Ann, I'm certain. Well, okay, if

Lisa Skinner: 00:36:09

you're sure, I just don't want them to be worried about me or

Lisa Skinner: 00:36:14

to be hungry. So she sat back down on the sofa, refocused her

Lisa Skinner: 00:36:20

attention on the Andy Griffith Show, and within a few minutes,

Lisa Skinner: 00:36:25

she was back to

Lisa Skinner: 00:36:27

fold, tuck, repeat, fold, tuck, repeat, opening and closing that

Lisa Skinner: 00:36:33

purse. But she looked very calm and peaceful again, and although

Lisa Skinner: 00:36:39

I felt conflicted by joining her reality and feeling compelled to

Lisa Skinner: 00:36:44

reassure her that Marty was okay and waiting for her at home, I

Lisa Skinner: 00:36:50

knew that correcting her could have caused her a lot more pain

Lisa Skinner: 00:36:54

and grief in her mind, knowing that her husband was okay with

Lisa Skinner: 00:36:59

her being over at our house, relieved her concern at the

Lisa Skinner: 00:37:03

moment and brought her the relief that she desperately

Lisa Skinner: 00:37:07

needed to hear. After all, she believed that what she was

Lisa Skinner: 00:37:14

telling me was true at that moment in time, and there was

Lisa Skinner: 00:37:20

nothing I could have done that would have relieved that anxiety

Lisa Skinner: 00:37:25

she was feeling in response to the false belief she was having

Lisa Skinner: 00:37:30

of him still being alive and well and waiting for her at

Lisa Skinner: 00:37:34

their home, choosing the other option of trying to correct her

Lisa Skinner: 00:37:39

false belief surely could have backfired. And hearing me tell

Lisa Skinner: 00:37:45

her that he was no longer living could have shocked her. It could

Lisa Skinner: 00:37:50

have been like he didn't know that he had passed on and that

Lisa Skinner: 00:37:54

nobody had told her and they had kept it from her. I mean, just

Lisa Skinner: 00:37:58

all these ideas going through her mind and creating a panic

Lisa Skinner: 00:38:03

for her, seeing her calmness after telling her what I did,

Lisa Skinner: 00:38:09

definitely reassured me that I did the right thing. Well, I

Lisa Skinner: 00:38:15

knew Mary Ann would never be her normal self again, but at least

Lisa Skinner: 00:38:19

the way I knew her before her Alzheimer's disease, this was

Lisa Skinner: 00:38:25

her new normal, but somehow I did find comfort in knowing that

Lisa Skinner: 00:38:31

she'd never be normal again, but that she would be Okay, as we

Lisa Skinner: 00:38:39

heard in our story. Mary Ann, people with dementia can seem

Lisa Skinner: 00:38:44

perfectly fine one moment and in the next out of nowhere, they

Lisa Skinner: 00:38:51

can be anxious and detached from reality. This can be one of the

Lisa Skinner: 00:38:57

most troubling behaviors for families and caregivers to deal,

Lisa Skinner: 00:39:01

to deal with. The difficulty stems in part, from not wanting

Lisa Skinner: 00:39:06

to see our loved ones uncomfortable, from not knowing

Lisa Skinner: 00:39:09

how to handle a problem that only exists in their mind,

Lisa Skinner: 00:39:13

watching them lose touch with reality that is a normal

Lisa Skinner: 00:39:19

progression of the disease, and again, this is due to the short

Lisa Skinner: 00:39:24

term memory diminishing throughout the course of the

Lisa Skinner: 00:39:27

illness. Mary Ann believed that her husband was still alive.

Lisa Skinner: 00:39:32

Your loved one will likely have a different false belief.

Lisa Skinner: 00:39:36

Remember that no matter what you cannot dissuade the person from

Lisa Skinner: 00:39:45

the belief that they're having in that moment, therefore,

Lisa Skinner: 00:39:50

exploring joining their reality is the most effective approach

Lisa Skinner: 00:39:56

to that occurrence. Right? The essence of the approach is to

Lisa Skinner: 00:40:03

acknowledge their reality and then divert their concern. In

Lisa Skinner: 00:40:09

Mary Ann's case, this meant acknowledging that her husband

Lisa Skinner: 00:40:12

was at home, but explaining why there was no reason for her to

Lisa Skinner: 00:40:17

be worried. The situation with your loved one may be different,

Lisa Skinner: 00:40:22

but you can use the acknowledge and divert approach for many

Lisa Skinner: 00:40:26

similar situations. Additionally, what you heard was

Lisa Skinner: 00:40:33

Mary Ann exhibited repetitive behaviors, which are also

Lisa Skinner: 00:40:39

extremely common with dementia. Hers was fold, tuck and repeat.

Lisa Skinner: 00:40:45

Now your loved one may repeat words, activities, questions or

Lisa Skinner: 00:40:51

stories in the same conversation. They may also pace

Lisa Skinner: 00:40:56

around a room. These types of behaviors are often a coping

Lisa Skinner: 00:41:00

mechanism for dealing with stress or fear, but it certainly

Lisa Skinner: 00:41:06

can be annoying for caregivers and family members, so do what

Lisa Skinner: 00:41:11

you can to redirect them, but as long as the behavior is safe,

Lisa Skinner: 00:41:16

eliminating it is not mission critical. Our brains process

Lisa Skinner: 00:41:22

information in different ways. We do this through abstract

Lisa Skinner: 00:41:27

thought or through concrete thought, and we rely on these

Lisa Skinner: 00:41:32

thought processes every day. Now this ability is lost in this

Lisa Skinner: 00:41:38

Alzheimer's disease and other related dementia. This means

Lisa Skinner: 00:41:44

that the many concepts that we rely on to live in this world no

Lisa Skinner: 00:41:49

longer have meaning for a person living with dementia. So in

Lisa Skinner: 00:41:55

future episodes, I'm going to discuss ways in which we as

Lisa Skinner: 00:42:00

caregivers and family members can help our loved ones make

Lisa Skinner: 00:42:04

better sense of the world that they are living in. According to

Lisa Skinner: 00:42:09

the Alzheimer's Association, the past and the future are held in

Lisa Skinner: 00:42:15

order by the power of abstraction. Time is abstract,

Lisa Skinner: 00:42:20

being able to think about the what ifs in our lives relies on

Lisa Skinner: 00:42:25

abstraction. How much is a part of abstraction and the

Lisa Skinner: 00:42:29

connection among family members and friends are abstract. Like

Lisa Skinner: 00:42:34

the other powers of thought, abstraction declines with the

Lisa Skinner: 00:42:38

progression of the dementing disease, disability is lost

Lisa Skinner: 00:42:44

early in the disease. So this means that many of the concepts

Lisa Skinner: 00:42:49

we rely on to live in this world no longer have any meaning for a

Lisa Skinner: 00:42:54

person living with dementia. I sure hope you've enjoyed the

Lisa Skinner: 00:42:59

information that I've shared with you today, I want to thank

Lisa Skinner: 00:43:03

you again for listening. We have so much to cover in our upcoming

Lisa Skinner: 00:43:08

episodes, and I do want to provide you with information

Lisa Skinner: 00:43:12

that you will find helpful and valuable throughout your

Lisa Skinner: 00:43:16

journey. Remember, dementia awareness is every day, and

Lisa Skinner: 00:43:22

kindness is the ability to speak with love, listen with

Lisa Skinner: 00:43:26

compassion and act with patience. These are all very

Lisa Skinner: 00:43:32

necessary attributes to have in order to outlash Alzheimer's

Lisa Skinner: 00:43:37

disease. One last note, this show is about you and how my

Lisa Skinner: 00:43:44

experiences, expertise and strategies will be able to help

Lisa Skinner: 00:43:49

you and your loved one have an easier time while struggling

Lisa Skinner: 00:43:53

through this disease. I know how difficult it is, therefore, I'd

Lisa Skinner: 00:43:58

love it if you would send me your comments and suggestions on

Lisa Skinner: 00:44:02

what topics you'd like me to cover on this weekly show. You

Lisa Skinner: 00:44:06

can send them to dementia whisperer one@gmail.com if

Lisa Skinner: 00:44:15

you're listening to this on YouTube or if you got here

Lisa Skinner: 00:44:18

through our social media page, please leave your comments or

Lisa Skinner: 00:44:21

questions, and I promise I will do my best to address them. I

Lisa Skinner: 00:44:27

genuinely look forward to receiving your thoughts and

Lisa Skinner: 00:44:29

ideas, and in the meantime, always take care of you. Talk to

Lisa Skinner: 00:44:35

you next week.