Person-Centered Approach to Alzheimer’s Part 2 - Encore

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Hello everybody. Thanks for tuning in to another

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episode of the truth, lies and Alzheimer's show. I am your

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

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to all of you who have joined us again today for a new episode. I

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really appreciate you being here. I hope everybody has had a

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great week, and I've got some really valuable information for

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you again today. So if you remember, if you were tuning in

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to last week's episode, I introduced to you the concept of

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a person centered approach to care, and basically what that

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means is it's a care design that focuses on each individual

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person versus focusing on the disease. Because, as I've

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mentioned before, everybody who develops Alzheimer's disease, or

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one of the other brain diseases that causes dementia will

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experience the process differently, and that is why, as

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you will come to see it is so important to focus on each

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individual person. So I am going to talk about on this week's

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show, reminiscence therapy. What is reminiscence therapy? Well,

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through reminiscence therapy, using photographs, personal

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possessions with emotional connections and much loved

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songs, these can help trigger memories, memorable thoughts of

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the past for individuals living with dementia, for those folks,

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personal identity diminishes as memory reasoning and attention

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continue to slip away, even as your loved ones become less

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aware of their surroundings and current events, reminiscence

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therapy enables them to hold on to long term cherished memories.

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If you remember me explaining to you, especially with Alzheimer's

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disease, the short term memory is what is damaged first in the

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brain and that short term memory switch. Think of it like having

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a switch that flips on and flips off. Sometimes the short term

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memory is on and the person suffering from Alzheimer's

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disease is thinking perfectly rationally and is very lucid.

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When that short term memory switch flips off, they go back

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into a different period of time in their life, so their personal

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identity diminishes. And other aspects of reminiscence therapy

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can include simple activities like conversation sensory

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stimulation to help a loved one become aware of these memories

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that they once fondly held but are tucked away in that long

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term memory bank. The ultimate goal of reminiscence therapy is

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to help a person with dementia reconnect them to their lives,

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as well as help provide closure and the processing of certain

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life events, because people with dementia often feel

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disconnected, reminiscence therapy will help them feel

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valued, connected and heard, as well as help them become more

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engaged, and then they are more likely to open up. Another thing

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I described to you that commonly happens with people who suffer

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from dementia is they withdraw. So reminiscence therapy clearly

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helps open them up and become engaged with you. Now,

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reminiscing is not the same as asking someone to remember

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something from their past. Asking a person with dementia,

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do you remember such and such can be a stressful experience

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for them, especially if they feel pressured or put on the

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spot. However, if you're looking through old photographs, this

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may trigger a sudden and fond memory for them, and when a

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pleasant memory makes its way to the forefront of your loved

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ones. Mind, and they share it with you, it feels really good

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to them, and you know what? That feeling lasts much longer than

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the memory that they just had, and what a great way to bring

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joy into the life of a person living with dementia. Now,

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memories can be associated with different parts of the brain, so

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it's always helpful to offer activities that stimulate the

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different senses. Here are some suggested reminiscence topics

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and activities that you can try with the person you're caring

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for or with your loved one when you're visiting, talk about

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child, their childhood and holidays from their earlier

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life. The more you know about that, the more questions you can

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ask them or stories you can ask them to tell you you can ask

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them favorite playground games or board games to improve

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memory. Now we want to tap into all five senses so we can talk

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about foods and different smells, their likes and

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dislikes. You know, smell is actually a really great way to

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access memories. You can use scent cards or jars using spices

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or essential oils to remind a person with dementia of their

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favorite foods and places, for example, also making a meal that

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your loved one has loved through the years, like a special dish

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from a past holiday celebration could help them recall the

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memories associated with that dish. For me, I that makes me

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think about candied yams that my grandmother used to make for

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Thanksgiving and Christmas holidays with the yams and the

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marshmallows that were roasting on the top. And I, to this day,

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can smell that dish coming out of the oven, and it just brings

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back the fondest memories for me. So like everybody else,

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people relate past memories and fond memories with different

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smells of food. I know chocolate chip cookies are definitely one

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for the books, so whatever you know was maybe a favorite food

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or drink, like mulled cider is always popular during the

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holidays, you could test out that and see if it stimulates

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some fond memories for your loved ones. Some other ideas are

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pets and animals. We call pet therapy. You can either use

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stuffed animals or you can use real animals. People often have

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pets in their younger years and love petting dogs and cats. You

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can talk about their family, their friends and other

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relationships, like tell me about your wedding day and see

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if they remember that day, and start telling you the story.

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Don't push them if they don't remember though their school

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days old photographs and family albums, pictures or keepsakes

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that bring back memories are another excellent way to

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reminisce. Photos of families, friends and important events are

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all wonderful choices as well as photos of things that will

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remind your loved one of their favorite hobbies. Music is

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powerful. You can put together a playlist of favorite songs they

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enjoyed when they were younger, maybe in their teenage years or

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in their adult years, you can show them album covers and say,

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Oh, tell me this story.

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Just remember, try to refrain from saying, Do you remember

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this? Ask them in an open ended way, tell me the story about

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this music for people with dementia, helps people relate to

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emotions and past experiences. You can listen to your loved

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one's favorite songs with them. You can have sing along or play

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music on simple instruments like ringing bells, tambourines or

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even tapping on a drum. Activities involving touch, like

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painting pottery, craft, doing things like frosting cupcakes or

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cookies, is really special. Bring in some already made

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cupcakes, have your loved one fry. Sit, and then y'all get to

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eat the cupcakes or the cookies, and it is a memorable

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experience. You know, touch can remind someone of the past,

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including activities like drawing, painting, pottery,

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knitting and sewing, and even if your loved one now finds it

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difficult to do the entire task because maybe they're in the

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later stages of their dementia, still doing things like having

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them touch the paint brushes, swirling watercolors together

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and playing with fabrics can definitely evoke strong

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emotions. Some other topics you can talk about, especially with

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men, would be sports cars, pop culture, especially from their

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younger years, beauty products, looking through magazines. And

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then you can also create memory boxes together. And what are

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memory boxes? Memory boxes contain personal objects from

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the person's past and can be used in several ways, like

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triggering positive memories, helping family members and

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friends stay connected to their life through conversation

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prompts that can provide insight into a person's life story.

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That's what that idea is all about, providing prompts that

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will trigger insight and reconnect them to their lives.

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The idea is that these crops may trigger a memory or a sense of

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identity, and that person then can share their thoughts and

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feelings as they arise again. Open ended questions work best

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as they are more likely to create discussion. Now let me

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tell you a real life, situational story from my book

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whose lies and Alzheimer's its secret faces that illustrates

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this very concept of reminiscence therapy. This story

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is a true story from my days of working with in elder care, and

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I call this story the bedroom litigator Tom had only been in

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the memory care section of the assisted living facility for a

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short time prior to that, he had been living with his daughter

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after his Alzheimer's diagnosis. However, he had declined to the

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point where he needed full time care every day since he was

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placed there, Tom was constantly irritated and anxious and was

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desperately looking for something. What's wrong Tom, one

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of the caregivers, asked him, one day, I can't find my dang

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office. He replied in a panicky voice, Oh, honey, you don't have

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an office anymore. Just go back to the dining room with your

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friends. Tom, clearly agitated, snapped back at her and said,

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Shut up. You don't know what you're talking about. Tom, you

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see, was obsessed with getting to work every weekday morning.

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Since he moved into that memory care unit, the staff tried

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everything they could think of to redirect his attention to

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something else, but nothing worked. He was dogged and

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determined, just as he had been during his career as one of

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Washington DC top litigation attorneys, he was convinced that

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he was needed at his office. Well, the facility's Memory Care

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director, her name was Louise. Had recently attended a

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conference on a new approach to treating neurotic behaviors

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associated with brain disease called reminiscence therapy,

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which is the recreation of a patient's personal environment

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as a scene or object that they would recognize from their past.

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So with the help of Tom's family, Louise recreated a

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section of Tom's bedroom in the dementia unit to look like his

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office did from when he practiced law years earlier.

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Well, the experiment worked like a charm. Every day after

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breakfast, Tom would say, Okay, guys, I've got to get to work

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now. And he'd disappear into his office until the evening. Of

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course, the staff checked on him regularly and were pleased to

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see him working diligently at his desk. His family members

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also visited. Visited him regularly and were relieved to

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see him happy and no longer agitated. The reminiscence

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therapy completely changed his behavior. For those afflicted

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with brain disease, the mental and physical resources they

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relied on before has now robbed them of the ability to make the

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new transition. Reminiscence therapy definitely helps

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alleviate the uncertainty of shedding the skin of their

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former selves and provides a smoother transition into the

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next and often final stage of their lives. Now the story I

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just read to you called the bedroom litigator is a great

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example of common behaviors that can be triggered when a person's

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short term memory is so diminished that they become

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disoriented to time and place and believe they are living in a

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different past period of their life, just like Tom did now. His

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disease also led to personality changes such as irritability,

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anxiety and obsession with an idea that wasn't real, as well

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as becoming easily angered and aggressive, the caregiver

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solution diffused Tom's behaviors and allowed him to

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reengage with his surroundings in a calm and positive way.

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Tom's short term memory was almost completely erased at this

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stage of his disease. There was absolutely nothing anyone could

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have done to convince him that he was now living in a dementia

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care facility and that he no longer had a career as an

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attorney or an office to go to every day he believed that he

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did and trying to change his reality would have been futile

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for his caregivers, and it would have continued to exacerbate The

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situation

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with an overall prevalence of about 30% agitation is the third

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most common neuro psychiatric symptom in dementia, after

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apathy and depression. Confusion is one of the leading causes of

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anger and aggression in Alzheimer's and dementia

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sufferers, as we heard in the story the bedroom litigator.

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Confusion can be triggered by lost trains of thought, mixed up

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memories, or a sudden change in the environment, such as a

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change from one caregiver to another, believe it or not, as

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we heard in Tom's story, treatments like reminiscence

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therapy help patients cope with the loss of their core cells.

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For Alzheimer's patients like Tom the best thing we can do is

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to keep them safe, keep them engaged and keep them

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comfortable in the last years of their lives. You see, it's our

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memories that keep us plugged into the work and play of our

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lives, what we do and how we do it. It also allows us to

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understand how we fit into the social fabric, because it's our

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memories that store the key habits, beliefs and values that

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makes each one of us unique and vital. Now, unfortunately,

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dementia profoundly affects a person's ability to keep their

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world in order, and therefore impacts the way they live in

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that world and how they get along with other people in it,

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most people become confused when situations go beyond the limits

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of their thinking ability, and as this disease progresses, the

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mind's ability to avoid confusion declines because they

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lose the normal filters and protections that they once had

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when their brains were healthy. Success in Tom's story was about

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finding a creative way to join his reality. You remember I

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talked about that on last week's episode, and your loved one may

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have a different preoccupation than Tom had, but the lesson

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here is that with a little insight into what's driving the

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preoccupation and a little creative troubleshooting, you

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too, can find a way to put your loved one at ease. For most

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people living with Alzheimer's disease, their recent. Memories

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are the first to fade away by sharing memories from the past

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through reminiscence therapy, people with dementia can feel

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more positive and less stressed or agitated through basic

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activities and a little prompting, including asking

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simple questions, looking at photos, singing, playing songs,

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talking about a family anecdote, your loved one may be able to

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recall memories from their childhood and beyond.

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Reminiscing about these memories can definitely help people with

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dementia feel more confident and even a lot happier. So engaging

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with them in a conversation surrounding these memories can

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also help relieve boredom, as well as feelings of loneliness,

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depression and despair. Research has shown that reminiscence

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therapy can actually help with depression by focusing on the

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positive and rewarding aspects of their past and support

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uplifting thoughts. Now I just want to mention one caveat to

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reminiscence therapy. You never know which memories might

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surface when reminiscing about the past, if an unhappy memory

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emerges through the conversation or through the prompts and cues

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that we have been talking about, just remember to respond with

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kindness and understanding to ensure that your loved one

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remains safe, calm and at ease if something negative does come

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up, use your judgment as to whether it's best to listen and

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offer support or to gently steer them Towards a happier memory.

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So I think we are just about out of time for today's episode. So

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I'm going to introduce to you what life skill stations are on

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next week's episode, and I have a true life situational story to

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share with you at that time that reflects on a life skill

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situation, story. One last note, I can't emphasize enough how

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much it means to me for y'all to know that this show is about you

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and how my experiences, expertise and strategies will

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hopefully be able to help you and your loved one have an

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easier time while struggling through this disease. I know how

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difficult it is for everybody, therefore, I would love it if

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you would send me your comments and suggestions on what topics

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you'd like me to cover on this weekly show, you can send them

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to my email at dementia whisperer one@gmail.com Also, if

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you're listening to this on YouTube, or if you Got here

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through our social media page, please leave your comments or

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

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certainly look forward to receiving your thoughts and

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ideas. And in the meantime, I want to say, take care of you.

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Talk to you all next week, bye, bye. You.