Transcript Dementia Friendly Communities working in partnership

Dementia friendly communities:
working in partnership
Victoria Macleod, Dementia Advisor
Scotland's national
organisation helping
people with dementia,
their families & carers
We aim …
• to be the national and local voice
• to improve public policies
• to provide and secure high quality services
…for people with dementia and their partners, families and
carers
We operate in:
Argyll & Clyde
Dumfries & Galloway and Ayrshire
Glasgow, E. Dunbartonshire & Lanarkshire
Grampian, Tayside & Shetland
Highland, Western Isles & Orkney
South East Central (Lothian, Borders, Fife &
Forth Valley)
Role of the Dementia Advisor
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local point of contact
help with planning ahead
navigating through maze of services
information on dementia
signposting to other services
linking in with other local services
supporting local communities
What is dementia?
An illness that causes damage to the
brain
There are different types of dementia
Dementia is progressive, so it will
affect you more as time goes on
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
People with dementia will have …
Good days and bad days – tiredness,
depression, emotional state & other health
problems will have impact on coping with
dementia
Can even depend on time of day
Alzheimer’s Disease (AD)
Changes in the brain
Brain cells are gradually damaged one by
one, causing brain shrinkage
Temporal lobes most damaged – important
in storing recent memories
Alzheimer’s Disease (AD)
• In over 95% of cases, cause is not fully
understood
Only few, rare families where Alzheimer’s
is definitely inherited by passing on of
faulty gene (less than 5% of all people with
AD)
Vascular dementia
Second most common cause of dementia
– caused by impaired blood supply to
brain
Most common type is multi-infarct
dementia (MID) where brain is damaged
by small strokes
Arteriosclerotic dementia - reduced
oxygen supply to the brain (chronic
ischaemia).
Communication
Speaking
Choose words
Put words in right
order
Put sentences in right
order
Listening
We hear
Brain recognises and
‘decodes’
We have to understand
then react and formulate
an appropriate reply
Communication difficulties
Repeats things already said
Asks the same question again & again
Says things which aren’t real or true
Slowness at responding
Mispronounces words
Communication difficulties
Difficulty writing
Difficulty following television & reading
Conversation wanders
Insensitive to other peoples’ conversation
needs
Unable to explain things
Avoid ‘vague’ questions
What would
you like?
???!
Avoid saying too much at once
After this
we’ll go to
that new
place I
mentioned
earlier, then
we’ll get
something to
eat. Have
you got your
scarf as it’s
cold outside
and it’s a bit
of a walk?
Eh?!
Respond to the emotion
You are 80!
What age
would your
mother be!?
I need to find
my mother!
Some useful communication tips
• Be calm and patient
• Face the person. Speak clearly and slowly
• Use short simple sentences and say exactly
what you mean
• Try to get one idea across at a time
• Allow plenty of time for the person to take in
what you say and to reply
• Try not to confuse or embarrass the person by
correcting them bluntly
• Use questions which ask for a simple answer
• Don’t ask questions which test their memory
• Use facial expressions and hand gestures to
make yourself understood
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?
Misunderstanding events
Disorientation
Fear or
alarm
Stress
Separation
anxiety
Feelings of
incompetence
Loss of
goal
recognition
Communication
difficulties
Memory
loss
Pain or
discomfort
Disinhibition
Searching
Reality confrontation
Behaviour – making things worse
• Using tricks, lies or
deception
• Disempowering
• Talking as you might
to a child
• Labelling
• Making threats
• Outpacing
• Rejecting the person
• Dismissing feelings
• Emphasising
disabilities
• Ignoring the person
Alexander McCall Smith
“Being alone in the face of
suffering is not an easy thing. Not
having a name for the cause of
the suffering and not knowing how
widely it is shared is not easy
either. And worst of all must be the
thought that nobody cares very
much.”