For the slides from this presentation, visit: …...5 © Teepa Snow, Positive Approach, LLC –to be...
Transcript of For the slides from this presentation, visit: …...5 © Teepa Snow, Positive Approach, LLC –to be...
1
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
For the slides from this presentation, visit:
www.teepasnow.com/presentations
Slides will be available for 2 weeks
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Handouts are intended for personal use only. Any copyrighted materials
or DVD content from Positive Approach, LLC (Teepa Snow) may be used
for personal educational purposes only. This material may not be copied,
sold or commercially exploited, and shall be used solely by the requesting
individual.
Copyright 2017, All Rights Reserved
Teepa Snow and Positive Approach® to Care
Any redistribution or duplication, in whole or in part, is strictly prohibited,
without the expressed written consent of Teepa Snow and
Positive Approach, LLC
1
2
3
2
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Caring for the
Caregiver:
Tips to Help You and
Your Clients’ Loved
Ones
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Why Do We Care About Care
Partners?
- Care partnering is very hard work!
- The emotional state of care partners affects the person being cared for
- Care partners are just as important as the person with brain change!
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Beliefs:
- People living with brain change are doing the
best they can
- Partners are challenged when learning how
to dance with their person
- We play a key role in making life worth living
- What we choose to do matters for all
- We must be willing to change ourselves
before helping others change
- We must be willing to stop and back off and
try again, if it is not working
4
5
6
3
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Quiz Time!
- What do we know?
- What do we think we know?
- What don’t we know?
- What surprised us most?
- What can we do about it?
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Question #1
Dementia and Alzheimers are two
different words for the same condition
a. True
b. False
c. I don’t know
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Question #2
What is dementia?
a. Problems with memory
b. Another word for Alzheimers
c. Something all older people get
d. Another word for a failing brain
e. I don’t know
7
8
9
4
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Question #3
How long do people live when they get
dementia?
a. Not long, 1-3 years
b. About 3-5 years
c. Anywhere from 6 months to 30 years
d. About 10-15 years
e. I have no idea
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Question #4
What is the first change with dementia?
a. The brain begins to shrink
b. The chemistry of the brain changes
c. The person’s personality changes
d. The person’s behavior changes
e. I don’t know
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Question #5
What parts of your brain will change if
you get dementia?
a. Memory and language centers die
b. Thinking and behavior centers die
c. All areas have some changes at about
the same time
d. All areas have some changes at
different times
e. I really don’t know
10
11
12
5
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Question #6
About how many types, forms, or
causes of dementia are there?
a. 2-3
b. 5-10
c. 20-40
d. Over 100
e. I have no idea
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Question #7
About what percentage of people with
Parkinsons get some form of dementia?
a. About 40-50%
b. About 75-80%
c. About 10-15%
d. About 25%
e. I don’t know
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Question #8
What type of dementia is most common
among people who have Parkinsons?
a. Probably FTD
b. Probably vascular dementia
c. Probably Alzheimers dementia
d. Probably Lewy body disease
e. No one knows
f. I don’t know
13
14
15
6
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Question #9
What is an effective treatment for people with Parkinsons and dementia?
a. How we respond, the settings we create, and the opportunities to continue to life with support that are provided
b. There are pills people can take to slow the disease down
c. There is nothing that really helps
d. Exercise and eating right can keep it from getting worse
e. I don’t know
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Question #10Which message would you prefer if you had
dementia?
a. You seem incompetent, let me help you
b. Hey there, is there something I can offer
to make things better?
c. There is clearly something wrong with
you and I don’t know what to do
d. You are scaring me and I want you out of
here
e. There is clearly something wrong with
you and I am going to call the
authorities for help
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
So, What is Dementia?
- It is NOT part of normal aging! It is a
disease!
- It is more than just forgetfulness, which is
part of normal aging
- It makes independent life impossible,
eventually
16
17
18
7
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Dementia Alzheimers Memory Problems
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
About 90-95% of the general public think
Dementia Alzheimers Memory Problems
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
BETTER ANSWER:
Dementia Alzheimers Memory Problems
19
20
21
8
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
BEST ANSWER:
Dementia Alzheimers Memory Problems
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Having dementia
does not equal and is more
than JUST Alzheimers
does not equal and is more
than JUST Memory Problems
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
How Does it Start?
• Chemical changes happen first
• Then structural changes happen
• Then it spreads OR it might just stay
steady for a while
22
23
24
9
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
How Common are all forms
of Dementia?
The risk goes up
dramatically with
increasing age
America is aging!
Various dementias will
increase by 200-300%
over the next 30 years
without medical advances
and life style changes
0
10
20
30
40
50
60
Percent with some degree &
form of dementia
<60
at 60
>85
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Cognitive Changes With Aging:
Normal changes: More forgetful and slower to learn
MCI: Mild Cognitive Impairment: Typically one area
such as immediate recall, word finding, or complex problem
solving, ½ of these folks will develop dementia in 5 years
Dementia: Chronic thinking problems in > 2 areas
Delirium: Rapid changes in thinking and alertness, seek
medical help immediately!
Depression: Chronic unless treated, poor quality of life, “I
don’t know” or “I just can’t” responses, no pleasure, can look
like agitation and confusion
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
The person’s brain is dying
25
26
27
10
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Normal
Brain
Alzheimers Brain
Used with permission from Alzheimers:The Broken Brain, 1999 University of Alabama
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Learning and
Memory
Center:
Hippocampus:
BIG CHANGE
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Understanding Language – BIG CHANGE
28
29
30
11
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Hearing Sound – Not Changed
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Sensory Strip
Motor Strip
White Matter
Connections
BIG CHANGES
Formal Speech
and Language
Center
HUGE CHANGES
Automatic Speech
Rhythm – Music
Expletives
PRESERVED
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Executive
Control
Center:
Emotions
Behavior
Judgment
Reasoning
31
32
33
12
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Vision Center – BIG CHANGES
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
For all that is lost,
some remains!
• 1/3 of brain remains
• Know what still works
• Know how we support in areas of loss
used with permission from Alzheimers:The Broken Brain, 1999
University of Alabama
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
34
35
36
13
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
How to Give Feedback and
Help as a Coach:
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
What is a Coach?
-Supports and encourages
-Helps others learn something new
-Helps others gain skills
-Helps others practice and drill on the skills
-Helps others integrate their skills and
reinforces use until they become ‘automatic’
37
38
39
14
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Option 1:
Focus only on what is wrong or not working:
Say:
-“No”
-“Don’t”
-“That’s not right”
-“You missed”
Do:
-Head shakes
-Sad face
-Grimace
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Option 2:
Focus on positive strokes only:
Say:
-“Good”
-“That’s it”
-“Great”
Do:
-Nods
-Smiles
-Claps
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Option 3:
Ignore the person:
Say:
-Nothing
Do:
-Do other things
-Pay no attention
40
41
42
15
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Option 4:
Take over and do it yourself:
Say:
-“Let me do it”
-“You don’t know what you are doing… here,
let me do it”
Do:
-Take it out of the person’s hand
-Have them sit down and watch
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Option 5:
- Be specific and positive:
Say:
-Give step by step cues
-“Yes”
-Reinforce what was right
Do:
-Show how
-Demonstrate
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
A Good Coach Uses
Learning Cycles:- Do something
- Share what happened and what didn’t
happen
- Think about and consider why?
- Connect this up to what happened and other
situations
- Get a commitment to try something
- Do it again with the change in place
- Offer supportive feedback
43
44
45
16
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Before Coaching:
-Be in control of you
-Decide if this discussion is ‘worth it’
- Pick your place and time for the discussion
- Get connected to the individual using the
Positive Physical Approach
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Five Steps of Coaching for
Change:1. Identify there is a problem: be objective
-“I noticed… “
2. Ask for information and listen
-“Tell me about it….” or “Tell me more…”
3. Ask for help to figure out a solution that will
work: listen, then ask more and help get real
-“What ideas do you have about how to….”
4. Agree on what to do next: assignments, times
5. Check in and provide feedback
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
To Offer Feedback:
- Connect to the partner
- Ask the partner to observe with a goal in mind
- Do something with the person
- Seek the care partner’s perspective on progress
- Reflect what you think you heard (+, 0, -)
- Explore for more: -Ask the partner for two things that seemed to go well for their partner-Ask for one thing they would like to see go differently or better for their partner
- Drill with the person, continuing to seek input from the care partner
46
47
48
17
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Consider Personality Traits:
Who are you?
- Introvert - Extrovert
- Lots of Details - Big Picture Only
- Logical - Emotional
- Planning Ahead - Being in the Moment
Who is the care partner you are trying to help?
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Introvert - Extrovert
Introvert = Controllers
Likes to be alone
Likes to think it out
Likes personal space
Needs alone time
Private
Will focus on the negative – mistakes
Won’t notice what went well
Extrovert = Connectors
Think out loud
Talk it out
Seek out people
Share a lot
Not good with boundaries
Will focus on what was good – great!
Will not notice what could be worked on!
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Second: How Do You…
- Like to get information
- Like to do things
- Decide whether to do something
- Approach an unfamiliar task
49
50
51
18
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Details – Big Picture
Details
Needs to know how
Specifics of what to do
Wants detailed info to do it ‘right’
Likes doing the familiar and routine
Likes a check list and follows it
Likes to do it
Big Picture
Needs to know why
Likes to ‘fly by the seat…’
Likes to hear the big plan
Likes to try out new and different ways of doing things
Likes to experiment
Likes to talk it out first
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Third: What Makes ‘Sense’?
- How do you ‘judge’ things?
- How do you decide if things are ‘OK’
- What matters most to you?
- What drives your behavior and actions?
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Logical - Emotional
Logical = Think
Head First
Fair
Reasonable
Rational
Likes to discuss differences of opinion
How other people ’behave’
Emotional = Feel
Heart First
Nice
Kind
Empathetic
Prefers to avoid disagreements
How other people ‘feel’
52
53
54
19
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Fourth: How Do You…
- Use time
- Feel about time – the future versus now
- Plan ahead versus like surprises
- Feel about knowing what is expected
- Feel about ‘deadlines’
- Feel about making decisions
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Planning Ahead – In the
Moment
Planning Ahead
Aware of the future
Sets priorities - plans
Likes routines
Likes a schedule
Likes to do things as planned
Decide and move on!
Needs to be in control
In the Moment
Being flexible
Go with now issues
Not forward thinking
Running late
Putting ‘other’ things off
Consider options….
Go with the flow
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Some ‘stuff’ we think/feel
people do on purpose
is really just ‘who’ they are
55
56
57
20
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Which Personality Traits are
Better?- There is no better
- Just different…
- Just ranges…
- Know your self
- Know your person
- Know the Care Partner
- Support each for who they are!
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
How Can We Become Better
Communicators?
Let go of the past to be in the moment
Go with their flow
Be willing to try something new
Be willing to learn something different
Be willing to see it through another’s eyes
Be willing to fail and try again
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
INTENT
I'm sorry I was trying
to help
EMOTION
I'm sorry I made you angry
I’m sorry I disappointed
you
INTELLECTUAL CAPACITY
I'm sorry, I had no right to
make you feel that way
THAT HAPPENED
I'm sorry, it should NOT
have happened
THIS IS HARD
I'm sorry, this is hard, I
hate it for you
58
59
60
21
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Communication Strategies:
1. This or That?
2. Tell Me More About It
3. Show Me How You Use It
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
To Communicate
When They’re Distressed:
First – Connect Emotionally
Then - Use Supportive Communication
Finally - Move Together to a New Location,
Activity, or Conversation
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
To Connect Emotionally:
- Send visual signal of connection:
-Look concerned
-Send a verbal signal of connection:
-Use the right tone of voice
- Send a physical signal of connection:
-Give a light squeeze or sandwich the hand
-Offer a open palm on shoulder or back
-Offer a hug if the person is seeking more
contact
61
62
63
22
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Then, Use Supportive
Communication:• Repeat a few of their words, with a question
• Listen!
• Offer empathy:
•“Sounds like…”
•“Seems like…”
•“Looks like…”
• Go slow
• Avoid confrontational questions
• Use just a few words
• Validate their emotions
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
Be a Detective, Not a Judge!
Try to figure out what is being communicated:
•Words
•Thoughts
•Actions
•Needs
•Beliefs
Don’t assume or presume
Don’t discount the message because of how it
is delivered
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
For All Communication:
If what you are trying is not working:
- Stop!
- Back off
- Think it through, then:
- Re-approach
- Try something slightly different
64
65
66
23
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
The content contained in this presentation is strictly for informational purposes. Therefore, if you wish to
apply concepts or ideas contained from this presentation you are taking full responsibility for your
actions. Neither the creators, nor the copyright holder shall in any event be held liable to any party for
any direct, indirect, implied, punitive, special, incidental or other consequential damages arising directly
or indirectly from any use of this material, which is provided as is, and without warranties.
Any links are for information purposes only and are not warranted for content, accuracy or any other
implied or explicit purpose.
This presentation is copyrighted by Positive Approach to Care and is protected under the US Copyright
Act of 1976 and all other applicable international, federal, state and local laws, with ALL rights reserved.
No part of this may be copied, or changed in any format, sold, or used in any way other than what is
outlined within this under any circumstances without express permission from Positive Approach to Care.
Copyright 2017, All Rights Reserved
Teepa Snow and Positive Approach to Care
DISCLAIMER
© Teepa Snow, Positive Approach, LLC – to be reused only with permission.
To learn more about the
information covered in this
educational presentation,
join our email list.
Text TEEPA to 22828 Resources are provided free of charge.
Message and data rates may apply to text.
67
68