Dementia Horizons™ | Workshop 2 | Communication Changes Video Module [02] Transcript Welcome. It's no surprise that your brain controls how and what you say and understand, but did you know that an area deep within the brain, the amygdala, is responsible for first sensing who is safe to communicate with, and who is not? From the beginning of time, this has been a skill required for survival. Imagine for a moment that someone suddenly walks into the room with a scowl on their face or a look of anger, disgust, or frustration. What is your first reaction? Without them saying a word, you may feel fearful and defensive, not wanting to engage immediately. This core part of your brain is working to protect you without effort on your part. Your brain quickly decides if this person is a friend or foe. Then, if the person starts to talk, your brain tries to figure out the meaning of the person's tone of voice. Do they sound angry, frustrated, kind, respectful, or inviting? Dealing with Communication Changes in Dementia People living with Dementia will respond to or believe what they see and hear. First words have less of an impact. In fact, this is true for all of us. Research indicates that we communicate mostly through our body language. Next comes our tone of voice and lastly, our words. So the first critical lesson is for you to look and sound safe, caring, loving, and respectful. That said, it is also important to be reminded that you are human, and it is not always easy to be loving 24 hours a day. It helps to take at least four slow deep breaths if you become frustrated. This heightened self-awareness of your communication style is particularly impactful as Dementia progresses towards the end of life. It is also essential to understand that the diseases and disorders that manifest as the progressive symptoms which we call Dementia, bring anatomical and cellular changes to various parts of the brain that affect communication differently over time. As the individual enters each stage of their Dementia journey, you may notice some or all of the following changes: Difficulty starting or following conversations, therefore, withdrawing from situations that require social interactions. Repeating the same questions, not having processed your answers. Struggling to find or retrieve words or names of people, places, and common objects. Difficulty juggling a conversation with multiple people in the room. Hearing sounds and talking to people that don't exist. Mixing fragments of words, an inability to follow written or verbal directions, and towards the end of life, language may be limited to just a few responses. So what can you do to help communicate more effectively? There are several guidelines that we recommend. Please note that some may not be intuitive. You are learning a new skill. Now, let's look at a few of the guidelines. First, keep in mind that the individual's brain is changing. Do not take their responses to you personally, if they are accusatory, do not make sense to you, or seem irrational. Pay attention to the environment. Excessive background noise and clutter can interrupt the person's ability to focus and pay attention. So turn off or lower the TV or radio, if possible. Keep the room or space uncluttered. Position yourself at eye level so that the person can see your eyes. It's been said that they are the window to the soul, and they greatly impact our ability to connect with one another. Speak calmly, more slowly, and at an audio level the person can hear. Remember that your tone of voice plays a big part in how your communications are perceived. Avoid stacking questions one on top of the other in rapid succession. Wait for the person to respond to one question at a time. When the individual needs to decide on something, provide simple choices. Instead of saying, what do you want for lunch? Say, would you like a ham and cheese sandwich or a bowl of soup? If there is difficulty understanding your words, then show them the slice of ham, a piece of cheese or a can of soup. The idea is to support their dignity and choice, because the part of the brain that controls rational thinking can become impaired. Avoid trying to convince or argue your point, when their reality is altered in their mind. What they think or believe is very true to them. Arguing will only cause frustration, anger, and more anxiety. For both of you, pause and think. Are these issues we are discussing really that important? Consider going with the flow. Here's an example. A wife who is a retired art teacher and is living with Dementia looks at the sky and says, "What a beautiful purple sky." The husband in return sees the sky as brilliant blue, and corrects her saying, "Honey, don't you see it's blue, not purple? How could you say that, you are an art teacher for gosh sakes?" After that, the wife stops talking. She feels embarrassed and afraid to make a mistake. Mistake . Instead, it would've been more supportive and loving to say, "Yes, it's a beautiful day." Here are a few other ways to foster good communications. Introduce yourself first by name. Don't quiz the person, forcing them to try and come up with your name. That causes frustration. Just like you and me, people living with Dementia don't always perform at their best when they are hungry or tired, memory and communication worsen with these circumstances. Recognize when this is happening so you can respond appropriately. If the person asks the same question repeatedly, respond like it's the first time. You can also shift to another activity or topic or another room to potentially alter their questions and redirect the conversation. Use words that show respect and dignity. For example, use adult words like a napkin instead of a bib, toilet instead of the potty, et cetera. Smile more frequently, and say thank you. Don't focus on what the person may do as wrong. Compliment them for trying. Even if the laundry was folded up in a ball, say, "Thank you so much for helping me." Overall, the main point is to interact and communicate with compassion and empathy. So what is empathy? Empathy is the ability to understand and recognize how someone is feeling. It's your ability to set aside your own thoughts and feelings to see things from someone else's point of view. Understanding how people living with Dementia perceive their world allows you to be more empathetic. Empathy conveys safety and an effort to comprehend. This allows for real connection and trust. And trust encourages cooperation. Without empathy, people may experience increased resistance, and may be less willing to work with you. You can practice using empathy by slowing down and observing the person's feelings through their body language, facial gestures, and tone of voice. Pay attention to see if you can identify confusion, anger, pain, unmet need, or even better, joy or contentment. This practice will give you a deeper, more meaningful connection with others. Empathy is also a statement of reassurance and validation. It says, "I hear you. I recognize how you may be feeling." It may sound like "I sense that you are scared, but you are safe with me", or "You seem upset. I'm so sorry that this is happening to you." As Dementia progresses, rational thoughts and spoken or written words become less effective. When this happens, look for things to do together, that don't require conversation or a right or wrong answer. For example, engage in sensory experiences like listening to or singing to music, drawing or painting, reading poetry, or getting outside for a breath of fresh air. Recognize that your relationship with your loved one is not over. It's just changing. Look for new ways to connect and enjoy your time together. To quote author and family therapist, Virginia Satir, "Life's not the way it's supposed to be. It's the way it is, and the way you respond to life that makes the difference." As you reflect on what was covered in this video, plan to put the following into practice. Focus, take at least four slow, deep breaths to help you keep calm. If the conversation becomes difficult, pay attention to your words, what you may be saying through your physical actions and tone of voice. Ask, what and how am I communicating? Do I appear and sound loving and trustworthy or frustrated and angry? Complete a so-called self scan. Look at your entire being. Your thoughts and feelings influence how you see the situation. In conclusion, I hope you feel more equipped with practical tips to enhance your communication style. By prioritizing how we communicate, we cultivate deeper relationships and build stronger connections with the people that matter most to us. You have taken a great step forward to help yourself and others. Thank you for joining me today. Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.

Video Module [3] Transcript Welcome. Planning ahead for medical, legal and financial concerns helps ensure that wishes are honored, and affairs are well-managed. And in situations that may involve cognitive impairment, preparation is crucial. Planning is essential because having cognitive changes that are out of the normal range for your age, education, and life experiences may impact your decision-making about estate and end-of-life plans down the road. So let's first start with a brief overview, so you can better understand the different types of cognitive issues. When doctors refer to cognitive impairments, they generally categorize them as either minor or major impairments. Major impairments are significant, and often fall under the big umbrella we call Dementia. In addition, there's a point to consider: minor cognitive impairment, often called MCI, is also different from normal age-related cognitive changes. Let's explain. Age-related cognitive changes are considered less severe than minor cognitive impairment, and may involve trouble finding words or remembering names as quickly, taking longer to solve relatively simple math problems, or difficulty juggling multiple appointments in a single day. Examples include: "I can't recall our neighbor's last name. I have to look it up or it comes to me, but like an hour later." "I just can't seem to add the proper tip on a restaurant bill anymore." or "It's harder to go anywhere without my GPS." However, if you or your loved one are experiencing these types of minor cognitive challenges, it is still important to talk with a doctor early on, and consider a cognitive screening to get what's called a baseline assessment. You want to know several things: Is it normal aging, or are the difficulties related to stress, depression, infection, medication, or other common causes of changes in thinking? That said, if a person is diagnosed with a bit more advanced condition, it may be called minor cognitive impairment. So what does that exactly mean? Minor cognitive impairment is the in-between stage between the expected decline in memory and thinking, which usually happens as we age, and the more severe syndrome of Dementia. Although a person can progress from MCI to Dementia with MCI, impairments with memory, language, or judgment, et cetera, are generally not sufficient enough to require assistance with the activities of daily living, like dressing, eating, bathing, running a household, decision-making, and more. MCI may remain stable over time depending on the nature of the cause or causes. So you may be asking yourself, what exactly is Dementia? In brief, Dementia results from biological changes to brain tissue typically caused by one or more neurocognitive diseases or disorders. Dementia is not a disease itself. Instead, it is a syndrome, a group of many progressive symptoms. In medical terms, Dementia is officially labeled as a major neurocognitive disorder, NCD. Generally speaking, the diseases and disorders that underlie the symptoms substantially affect our ability to perform activities of daily living, including rational and reasonable decision-making. Getting Help with Legal and Financial Matters Let me be clear, no matter your age or health status, it's always good to think through your legal, health and financial wishes sooner rather than later, while you can still be considered to have the capacity to make decisions on your own. And that's why you're here to learn about the steps you can take. Different types of legal professionals can assist with creating advanced directives and important estate documents. Most notable are estate planning attorneys and those attorneys specializing in elder law. Now, let's discuss advanced directives . Especially when concerning healthcare aspects of your life, advanced directives are documents allowing individuals to express their preferences, values, and treatment choices, in case of incapacitation. Incapacitation is when an individual lacks the mental capacity to make informed decisions. When someone is incapacitated, they may be unable to understand the nature and consequences of the document they are signing. In the context of Dementia, where cognitive capacities diminish over time, advanced directives become invaluable tools for ensuring that one's wishes are respected, even when the ability to communicate or make decisions is slowly compromised. Next, let's discuss powers of attorney . There are both durable and non-durable powers of attorney, also known as a P-O-A. A non-durable POA is used primarily for singular transactions or purposes like selling property, or opening and closing a bank account. However, when there is a progressive health condition such as Dementia, consider establishing a durable power of attorney for healthcare, sometimes called a healthcare proxy, to ensure continuity in decision-making, even as capacities recede. As the name suggests, it endures and is used for more than one transaction or representation. You may decide to have just one individual represent you in all aspects of your life, or you may elect to have separate individuals focus on particular decision-making. Living wills : a living will allows you to outline medical treatment preferences, life support, and end-of-life care. It permits you to state your choices regarding resuscitation, feeding tubes, and other medical interventions, specify under what circumstances you would want, or not want, certain treatments. Here are some additional suggestions for documents and actions you may wish to consider. Your will : draft or update your will to ensure the assets of your estate are distributed according to your wishes. Trusts : consider creating a trust to manage and distribute assets of the estate equitably, and so that funds are made available to help your beneficiaries, timed to their future financial needs. Guardianship : If you have dependents, consider designating a guardian who will care for them in case you are no longer able to do so. Medical history : gather information for healthcare providers and maintain a comprehensive record of medications, surgeries, allergies, treatments, and next-of-kin and responsible parties' contact information. Include any family medical histories of individuals like parents, siblings, grandparents, aunts, uncles, and cousins, that have had particular conditions or disorders you're aware of. Although sensitive and emotionally complex, include, if able and willing, any knowledge you have of adoptions or familial connections that others may be unaware of . Those insights might provide clues to a diagnosis or guide future healthcare decisions, if you are unable to share that information due to a decline in cognition. In addition, review your finances and insurance coverages , and consult professionals for guidance on managing resources effectively. Take stock of your current financial situation, including assets, debts, income sources, and insurance policies. Also, if you or your loved one is a military veteran, there may be benefits worth exploring. Sooner rather than later, investigate long-term care insurance options, to help cover potential costs associated with Dementia care at home or in a long-term care community. If available, it may be worth considering policies that combine life and long-term care coverage. Periodically review and update your legal insurance and financial plans , especially if there are changes in your health, family structure or financial situation. Openly communicate wishes and plans in the legal documents with family members and the designated individuals. Ensure that those involved know the preferences and have copies of relevant documents , when durable and non-durable powers of attorney documents, as well as other important estate or advanced directive documents are created. Whether for medical, legal, or financial decision making, you should produce several signed copies. Keep them secure, yet make them easy to find for those acting on your behalf, if they don't already have copies. Consider a document pouch that may help protect them from being inadvertently misplaced, consumed by fire or destroyed in a flood, if needed later on, to perform bank transactions or other essential duties. The POA may need to provide an original document, but always make sure they are returned if possible, once viewed for authenticity and confirmation. Today, there may be ways to use an app on a smartphone that can help digitally scan the documents as a backup, but the originals should be closely guarded. In addition, it's relatively common for folks to put a specially marked container or vial inside the refrigerator that provides first responders and others with the basic whereabouts of critical advanced directives , one's medical needs in an emergency, and possible allergies. If you or your care partner are headed to the hospital, having copies of those papers readily found, so that they can be taken with you, may save time, effort, and heartache, should wishes not be followed for lack of clear direction. Lastly, on this point, consider wearing an ID band of some kind on your wrist or placing one on your care partner to help first responders and others obtain more information. Presently, when it comes to advanced directives, many healthcare systems and hospitals are getting proactive and initiating and encouraging them to be created, shared, and stored securely with them beforehand. Check with your trusted professionals and local medical providers to see if such a program exists in your area. In conclusion, when facing the potential for Dementia or other cognitive impairments, it involves thoughtful consideration, clear communication, and guidance from legal, medical, financial, and insurance professionals. Take action today and reach out for help creating or updating your important estate documents and advanced directives. Thank you for joining me, and I hope you found this information helpful. It was my pleasure to be with you. Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.

Dementia Horizons™ | Workshop 5 | Gaining Cooperation Video Module [05] Transcript Welcome. How we move, feel, and act: it begins as electrical impulses formed within our brains. Particular parts of the brain control certain functions more than others. When fully engaged, sections of the brain talk to each other, managing our other organs, allowing us to perform day-to-day activities and making us who we are. It can seem like someone is in denial, but in fact, when parts of the brain are not working as they should, asking for help or accepting medical care becomes challenging. These functions are performed throughout the brain, but heavily rely on areas called the frontal lobes and prefrontal cortex. These sections of the brain are located behind the forehead. So, what are executive functions? They are responsible for abilities we take for granted. These include voluntary movement, expressive language, attention span, working memory, planning, self-awareness, judgment, and decision-making. These functions can become increasingly impaired as the result of structural changes in the brain tissue, due to a disease or disorder associated with the syndrome of Dementia. For example, a person exhibiting the cluster of symptoms we call Dementia, especially with impaired executive function, may not be aware they can no longer manage their finances, follow a recipe, recall previous health problems, put clothes on in the proper order, or consciously recognize their decline. Now you can start to appreciate why, from their point of view, they may see no reason to be medically evaluated or tested: "I'm fine. I don't need to see a doctor." How to Improve Cooperation Let's now focus on learning how your approach and different strategies can lessen this type of resistance. Bear in mind that you will need to shift your thinking, even though they may not think an appointment is necessary. Make one anyway. This is not deceptive, it's practical. Given the advanced planning required to get many appointments, start the process sooner rather than later. You are helping by filling in the gaps where they have cognitive deficits. Talking about an appointment too early can cause arguments, agitation, and a flat refusal. Instead, if possible, give the person shorter notice, maybe even the day before or the morning of an appointment, to reduce a buildup of anxiety. When you do talk about the visit, be positive and matter-of-fact. Consider describing it as a routine follow-up for a previous ailment or chronic condition, an annual exam, or a need to discuss medications. You can also focus the reason on the medical provider or insurance coverage. Explain that the doctor must see you face-to-face before refilling or changing any prescriptions. You can also consider saying that you are seeking medical advice for yourself, and want them to come along for support. This is not a lie. Their health can most certainly impact yours. Most care partners want the other person to be healthy, and suggesting that you will benefit from going together may lower their defenses. Keep your emotions in check. Commit to not arguing; it does you no good and escalates the situation. Keep your facial expressions positive. Watch your tone of voice and be soothing no matter their response. If they become upset, use empathy and acknowledge the feeling. This may sound like: "I'm so sorry that you are upset and worried. I will be with you." Sometimes you must change the subject. Get involved in some other activity for a while, and then try again a little later. In addition to your primary care provider, there will likely be different types of appointments, perhaps a specialist, lab work, medical scans, or cognitive testing. We'll explore several scenarios, but first, it's important for privacy reasons and communication difficulties that you want to be present with your care partner throughout their visit, whenever practical. If properly arranged ahead of time, you can act on their behalf, make decisions, and receive information directly from the medical team about your loved one's diagnosis, medications, and care plan. This may require having your care partner agree while they are competent to do so, to allow information to be shared. There can be legal elements to consider, which we will address in other videos. Now, let's look at some tips to help you prepare. Try to schedule an appointment in the middle of the day. Getting out the door earlier in the morning is often more challenging. If the appointment is late in the afternoon or evening, you risk both of you feeling tired, hungry, maybe even hangry. Also, plan to call the office ahead of time on the day of the appointment to see if they are running late. Do something pleasant and brief before the appointment. Stop and smell the roses. Create a fun errand. This is intended to create a positive mood. Pack a bag with a snack, water, medications, change of clothes and briefs if the appointment runs late. Bring a magazine, mobile device, photo album, or other meaningful and portable activity that you can share if the wait is longer than expected. Thankfully, one of the best ways to start a conversation about going to the doctor is around annual wellness screenings. They have become popular and expected. They help normalize honest discussions of concerns or challenges. They enhance a physician's ability to detect early changes in our bodies. This includes the brain. After all, it's the one organ that serves all others. These routine visits can also help create personalized prevention programs or care plans. Cognitive screenings are relatively brief and may include multiple questions, calculations, drawing a clock or various figures, remembering a short list of words or images, and identifying common objects like a banana or bicycle. If cognitive impairment is suspected, the person may be referred to a specialist for a full neuro-cognitive assessment. It is common for testing to take a few hours, and be repeated months later, to determine if there has been a change in cognition, positive or negative. There may be paper and pencil tests, computer-based exams, and physical tests like walking or touching your finger to your nose. All these activities are intended to confirm which aspects of brain function are impaired, if any, and to what extent. Try not to over-describe the testing. Tell them that the doctor wants to check different body parts, including the head, to record your health over time. Indeed, continue to refer to additional testing as routine: "The doctor wanted them to do it just to be on the safe side." There is no need for detailed explanations. As the appointments approach, let the person know that although they may not be fun, they will be worth it, and that you are there for them. If you've had similar experiences, you survived, and they will too. At the appointment, privately describe any new cognitive issues that have arisen since they were last seen, so that they are not surprised at whatever happens. Smile gently, and talk compassionately to the staff about your care partner or loved one and their needs. Be aware that you may be interviewed separately, to obtain a more detailed history and to gather your observations about how thinking and behavior have changed. Medical scans like an X-ray, MRI, CAT, PET, or SPECT may also happen at some point. Additionally, a test may be ordered that requires a bit more preparation. An example would be obtaining a small sample of cerebrospinal fluid. Finally, there might be a desire to perform genetic testing, usually a quick swab on the inside of the cheek. These types of tests can be unnerving and filled with anxiety and fear. Some of the testing machines are imposing or have tight spaces that may be claustrophobic. Some generate loud noises too. Hopefully, medical staff will allow you to accompany your loved one to the area where clothes are changed and stored, before they get into a medical gown in the room where testing is done. Show respect and provide them the dignity they deserve, but also be willing to step in and help no matter how awkward the situation may become. You are there to help them feel more secure. The person within your care may need additional help following directions, so reassure them that everyone is there to keep them safe from harm. You may have to step out during the operation of specific test procedures, so be prepared for anything in advance, including agitation, and ask whether your loved one can wear earplugs, an eye mask and have calming music during the procedure. Lastly, lab appointments bring another set of complexities. Some lab tests require that the person not eat food or drink certain liquids for a period of time beforehand to obtain more accurate results. That said, if the person is having their blood drawn and drinking water ahead of time is allowed, it can make it easier for the technician to find a suitable vein. Give yourself time to prepare everything, and use the same calm matter-of-fact approach. Again, bring a snack to eat immediately after the visit or plan to enjoy a meal together afterward to avoid low blood sugar and unnecessary hunger or thirst. In conclusion, as you navigate these appointments, remember you are learning to care for your loved one differently, and I hope you feel more equipped with practical tips intended to gain cooperation. Thank you for joining me. Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.

Dementia Horizons™ | Workshop 6 | Ambiguous Loss Video Module [06] Transcript I want to welcome you today. Thank you for being here. Caring for a loved one with Dementia can be a challenging and emotional journey. Dementia is a progressive condition that not only affects the individual but also their family members and caregivers. One of the unique challenges of Dementia is dealing with ambiguous loss, which is the feeling of grief and loss that arises when a person is physically present, but mentally and emotionally absent. Our talk today  aims to provide you with practical strategies to adapt to ambiguous loss and navigate the complex emotions that come with caring for someone living with Dementia. Ambiguous Loss Psychotherapist Pauline Boss coined the term ambiguous loss to describe a loss that occurs without closure or clear understanding. The concept evolved while working primarily with military families, whereby women who were married to spouses were missing in action during wartime. They did not know if their spouse was alive or dead. Am I a widow? Not a widow? How do I live my life in this state of limbo? In the context of Dementia, ambiguous loss occurs because the person with Dementia is physically here, and not really or consistently here psychologically. In some situations, one may not even remember being married or the names of one’s spouse or children. This is a hard truth to accept. Understanding that anatomical and cellular changes in the brain are underlying the lack of recognition and emotional disconnect may offer some comfort. Another learning is that fatigue and anxiety can actually bring about more forgetfulness and confusion. Families may experience their loved one with Dementia clearer, or more normal, in the mornings after a good night's rest. Later in the afternoon, they seemed less engaged and more forgetful. Families may erroneously conclude that the person is just trying to get attention. When comparing visits, families may feel like they are experiencing two different people, or whoever visits in the afternoon may find their loved one less able to focus, perhaps more anxious or irritable, because the person with Dementia looks the same on the outside. The changes in thinking and behavior can understandably lead to feelings of grief, frustration, and confusion for family and friends who visit in the evenings in attempting to make sense of these changes. Ambiguous loss is a normal and valid reaction. We hope that by understanding the nature of ambiguous loss, families can better cope with the arising emotions and find ways to adapt to their new reality. Start by acknowledging your feelings. It's normal to feel a range of emotions when caring for someone with Dementia, including sadness, guilt, exasperation, and anger. Acknowledge these feelings and allow yourself to experience them without judgment. Continue educating yourself about Dementia on an ongoing basis. Understanding the progression and symptoms can help you make more sense of your loved one's behavior and reduce frustration. Educating yourself can also help you set realistic expectations for your loved one's abilities. Focus on the present moment. Instead of dwelling on the past or worrying about the future, focus on the present moment with your loved one. Engage in activities that bring you joy and allow you to connect with your loved one in meaningful ways. Seek support. Caring for someone with dementia can be isolating, so it's important to seek support from others who understand what you're going through. Practice self-care. Caring for someone who lives with Dementia can be physically and emotionally draining. Make time for activities that help you relax and recharge, such as exercise, meditation, or spending time with friends. Set realistic expectations. Recognize that you may need to adjust your expectations for your loved one's behavior and abilities as their Dementia progresses. Focus on what they can still do rather than what they have lost. Maintain a sense of humor. Sometimes, finding humor in difficult situations can help lighten the mood and reduce stress. Look for moments of joy and laughter in your interactions with your loved one. Find meaning and purpose. Despite the challenges of Dementia caregiving, many caregivers find meaning and purpose in their role. Focus on the positive aspects of caregiving, such as the opportunity to show love and compassion in ways you did not know possible to your loved one. Seek professional help. If you are struggling to cope with the challenges of Dementia caregiving, don't hesitate to seek help from a mental health professional. If you are feeling persistent anger, resentment, and irritability, it is wise to connect with a therapist for more intense counseling. Therapy can give you the support and coping strategies to navigate this difficult time. In conclusion, practice gratitude. Cultivating a sense of gratitude for the time you have with your loved one, despite the challenges, can help shift your perspective and foster resilience. Caring for someone with Dementia is a challenging and emotional journey, but it's important to remember that you are not alone. By acknowledging your feelings, seeking support, and practicing self-care, you can adapt to the ambiguous loss that comes with Dementia, caregiving, and find meaning and purpose in your role. Thank you for being with me. Ambiguous loss is challenging by its very nature, and yet you choose to join us today to watch, listen, and learn, so that you can deal meaningfully with the grief and undeniable changes. Those are characteristics of a healthy and curious mind, a mind well prepared to take positive steps forward at the most appropriate pace. Thank you again. Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.

Copyrighted Getty Images Always have ROOM FOR DESSERT ? Scientists have discovered that the same nerve cells that tell us we’re full also make us crave sweets.   Parenting is good for brain health. MOMS AND DADS show increased connectivity in areas that typically decline with age.   Artificial intelligence can measure how fast a person’s brain is aging, and may be a POWERFUL NEW TOOL for understanding, preventing, and treating cognitive decline.   Our EYES TELL A STORY — about how we breathe. Research has revealed that our pupils are smallest during inhalation and largest during exhalation.   A study in mice suggests that there are two types of neurons in the brain — OPTIMISTIC AND PESSIMISTIC — and they work together to help us balance risk and reward.   By identifying regions outside the frontal lobe that are involved in THE INTENT TO SPEAK , scientists hope to offer a new treatment option for those with the language disorder Broca’s aphasia. Author:  AI-Assisted Human-Edited Staff Writer Click here to view this issue of Better Brain Nation. Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.

Better Brain Nation Magazine | Volume 2 Issue 1 | Crossword Answers Better Brain Busters™ Riddle Answer: CHICAGO (CHI-CA-GO) Click here to view this issue of Better Brain Nation. Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.

Dementia Horizons™ | Workshop 7 | Self-Care Video Module [07] Transcript According to the late former first lady of the United States and mental health advocate, Rosalyn Carter, there are only four kinds of people in the world: those who have been caregivers, those who are caregivers, those who will be caregivers, and those who will need caregivers. Caregiving can be a significant and enriching experience. It can stretch you in positive ways you did not know possible, and it takes energy and work. Caring for a loved one living with Dementia can also last for years. Because of the changes in the brain, your loved one may show less concern or empathy for what you are going through. They may not recognize how hard you are trying. The part of the brain that regulates empathy may not function well, so you may not sense their concern or appreciation for all you do. As frustrating as it may be, the person living with Dementia is not necessarily making hurtful statements, personal attacks, or acting out of character on purpose. When there is a progressive cognitive syndrome like Dementia, more likely than not, many thoughts and actions are out of their control. The onus is on you to be proactive and create options for self-care. Your physical and emotional health serve as tools of the trade to carry out your role as a care partner or caregiver. You can create intentional activities that bring you moments of peace or joy for your physical and mental health to be your best. When this type of self-care is not in place, research indicates a higher risk of developing stress-related conditions such as high blood pressure, obesity, cognitive fogginess, and depression. Therefore, it takes routine maintenance and care of your body and soul. This isn't selfish. This self-care is crucial. Imagine if you rarely change the oil in your car, neglected routine tuneups, or forgot to put gas in the tank. You could run on fumes for only a short while. The same analogy applies to you. We live in a society where independence and self-sufficiency are overrated and can be highly detrimental. When a caregiver feels as if they have to do everything for their loved one or believe they are the only person who can provide care, it is cause for alarm. It is not uncommon to have two patients instead of one. Keep in mind that you are human. Although hard to hear and accept, the reality with Dementia is that despite your best efforts, there will be eventual cognitive and physical decline. You did not cause the Dementia to happen. You cannot control the underlying condition. You can learn how to respond differently, go with the flow and care for your loved one and yourself simultaneously. Tips for Enhancing Your Self Care Okay. I think it would be essential to start by having you write down all the activities that bring you comfort or joy. But before you get your pen out to make your personal list, consider the following list starters. Might you enjoy listening to Sinatra or Glen Campbell or maybe putting on the Beatles' classic "Let It Be" album or clapping your hands and singing out loud with a local gospel choir? How about reading a juicy romance novel or digging into a good biography? Maybe picking up a great magazine and reading about the latest fashions? Taking the dog out for a walk around a park or strolling along the lake or beach? Doing some yoga exercises in the backyard? Stepping into the garden to tend to the soil, smell some flowers or pick some vegetables? Taking a break for spiritual renewal and contemplation? Having breakfast with old high school buddies or a girl's night out at a local hotspot? Getting some alone time with a soothing bubble bath, smooth jazz, and soft flickering candles? Now, please pause this program and take five minutes to reflect and capture your comfortable or joyful activities. What did your list have on it? Was it long with 10 or 20 things you love to do, or short with one, maybe two or three? Do all you can to keep this list visible as a tangible reminder, and schedule 30 to 60 minutes of "me time" daily. Before the time arrives when your loved one cannot be left alone unsupervised, enlist the help of neighbors, family, and friends. Now is the time to expand your circle of care and open up your umbrella of protection. Another strategy is a quick self-evaluation to see if you show signs of compassion, fatigue, or burnout. Are you experiencing any of the following: increased irritability, sudden increase or decrease in weight, emotional numbing through alcohol, recreational drugs, or overdoing prescription drug use, lack of concentration, forgetfulness, or do you catch yourself saying, I'm losing it? Apathy, a simple numbness; you are easily triggered and lash out, unpredictable, emotional outbursts, headaches, shortness of breath, or tightness or pain in the chest or abdomen. Please do not wait until you feel yourself drowning in stress or overwhelmed. If you are experiencing a pattern or upward trend in any of these feelings, behaviors, or physical manifestations, please talk to a health professional. Another reason to take good care of yourself is that your loved one living with Dementia can pick up or absorb your irritability, annoyance, anger, et cetera, without saying a word. They will sense these feelings through your facial expressions, body language, and tone of voice. This, in turn, creates a scenario whereby they will be less engaged, cooperative, or trusting. Please know that it is normal to be a great caregiver, love the person you care for, and sometimes feel resentment, frustration, and anger. You are not a robot. Give yourself some slack when it becomes concerning, you feel these things more consistently and perhaps feel trapped or unable to shake these distressed emotions. Take time to care for yourself daily, as an essential plan to be a better care partner or caregiver. Here's another self-care tip: Throughout the day, when you sense you are feeling more frustrated, try box breathing. Imagine seeing a box for the count of four. Take one, slow deep breath. As you move up one side of the box, hold your breath for a count of four. As you visualize moving across the top of the box, exhale for a count of four, as you move down the other side, and hold your exhale across the bottom of the box. Then repeat this pattern of breathing four times. Notice how you feel before and after. It's free, requires no pre-planning, and a tool that is available as needed. Now, in conclusion, let us close this program by sharing a few lines from the caregiver Bill of Rights. I have the right to take care of myself. This is not an act of selfishness. It will allow me to take better care of my loved one. I have the right to seek help from others because I recognize the limits of my endurance and strength. I have the right to maintain facets of my life that do not include the person I care for, just as I would if they were healthy. I do everything I reasonably can for this person and have the right to do some things for myself. Self-care is not selfish. Start making a plan for yourself. This is a journey and not a race. Thank you for being with me today. I wish you peace and give you grace. Thank you again. Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.

Dementia Horizons™ | Workshop 8 | Life Enrichment Video Module [08] Transcript I am excited to have you join me today. Thank you for taking the time to learn about one of the most exciting and satisfying areas of Dementia care: music and the arts. Non-medical interventions and experiences can profoundly impact people living with Dementia, offering life enrichment, and a means to communicate, express emotions, and connect with others. This video aims to provide practical strategies for family caregivers to use music and the arts to support connection, and improve the quality of life for individuals at different stages of Dementia. The Benefits of Life Enrichment Activities As background information, music engages multiple brain areas, including those involved in emotion, memory, and motor functions. This widespread activation can help maintain neural connections that might otherwise deteriorate. Music can also promote neuroplasticity, the brain's ability to reorganize itself by forming new neural connections. This is particularly beneficial in compensating for lost functions. Music has also been shown to reduce cortisol levels, thereby lowering stress and anxiety. A calmer state can improve overall cognitive function and quality of life. Artistic activities such as painting, drawing, and sculpting often engage multiple senses: visual, tactile, and auditory, which can stimulate different brain areas, helping to maintain neural connections and promote brain plasticity. The arts provide a medium for expressing emotions that may be difficult to communicate verbally, fostering emotional release and reducing stress. Any of these activities require focus, planning, and problem solving, which can help slow down the decline in some cognitive functions. In addition, participating in group art activities encourages social interaction and can reduce feelings of isolation and depression. With this new learning, caregivers can now see why it is important to integrate the arts and music throughout the person's Dementia experience. In the early stage of Dementia, individuals often maintain many of their abilities and can still engage in various activities. Here are some ways to use music and the arts effectively during this stage. Compile a playlist of favorite songs from different periods of their life. These songs can evoke positive memories and emotions. Take them to live music events, which can be stimulating and enjoyable. Engage in singing sessions at home or in group settings. Singing familiar songs can be a joyful activity and promote social interaction. Encourage participation in art classes. Painting, drawing, and sculpting help maintain fine motor skills and provide an outlet for self-expression. Visiting art museums can be both stimulating and relaxing. Many museums offer special tours for people with Dementia. Set up a space at home for joint art projects. Collaborative art making can strengthen bonds and provide a sense of accomplishment. As Dementia progresses to the middle stage. Individuals may experience greater difficulty with memory and cognition, but they can still find joy and connection through music and the arts. Establish regular times for listening to music. Consistent routines can be comforting and provide structure to the day. Consider professional music therapy sessions. Music therapists are trained to use music to achieve therapeutic goals tailored to the individual's needs. Simple instruments like tambourines, shakers or drums can be used for active participation. The rhythmic activity can be both soothing and engaging. Provide step-by-step instructions for art projects to accommodate cognitive changes. Simple repetitive tasks can be very satisfying. Continue to enjoy looking at art together. Discussing colors, shapes, and scenes and paintings can stimulate conversation and memory. Introduce tactile art activities such as working with clay or finger painting, which can be enjoyable and stimulating for the senses. In the late and final stages of Dementia, individuals may have severe cognitive and motor impairments, but they can still respond positively to sensory stimulation from music and the arts. Play soft soothing music to create a peaceful environment. This can help reduce agitation and anxiety. Familiar lullabies and hymns can be comforting and may evoke emotional responses. You may be surprised that people can recall the second or third verses, or the entire song, even in the final stages of Dementia. Gentle movement to music like swaying or rocking, can provide comfort and a sense of connection. Add a gentle hand massage while singing, "You Are My Sunshine", or "Take Me Out to the Ball Game" and enjoy the experience together. Offer easy art activities like coloring with large crayons or using textured materials. The goal is to provide sensory engagement rather than focus on the final product. Use brightly colored objects or pictures to capture attention and provide visual stimulation. When necessary. hold onto the pencil or crayon, and have them guide your hand to help with art activities, ensuring they can still participate meaningfully. Overall, be patient and flexible. Adapt activities to the individual's current abilities and interests. Be patient and willing to try different approaches. Ensure the setting is comfortable and free of distractions. Positive reinforcement and encouragement can go a long way. The process of engaging with music and art is more important than the outcome. Celebrate the moments of connection and joy that these activities can bring. Using music and the arts to support individuals with Dementia can enhance their quality of life, providing opportunities for expression, connection, and joy. By tailoring activities to the stage of Dementia and the individual's preferences, family caregivers can create meaningful experiences that enrich their lives and those of their loved ones. Thank you for being here. I hope you've learned some great ways to enrich the care experience through music, art, movement, and touch, all of which are the wellsprings of the human experience. Best wishes as you continue your journey. Thank you.   Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.

Dementia Horizons™ | Workshop 10 | Dementia Emotions Video Module [10] Transcript Welcome. Let's start by saying that all of us change as we age. Our thinking speed may slow a bit, and what we remember may fade slightly. This is normal. However, if you or your loved ones sees or experiences several clues, signs and symptoms that may seem unusual, inappropriate, or excessive, then it's worth making an appointment with a healthcare provider. As you will learn, Dementia is much more than memory loss alone. What follows is a short list. There may be issues with planning, organizing, and decision making, as well as changes in how one walks and talks, not to mention increased anxiety, possible hallucinations, trouble with sleep, tremors, visual disturbances, and much more. There is no universal journey of Dementia. Each person's path is unique, but they share common experiences. Some symptoms may be treatable, but at a minimum, many are manageable. It is important to note that Dementia is a syndrome and not a disease. That means that Dementia is a word we use to describe a group of symptoms that often occur together. Dementia Emotions Severe and progressive cognitive changes are usually caused by one or more underlying diseases or disorders. Cellular changes happen within the brain tissue itself. The brain often shrinks. Most people are unaware of these microscopic changes. While others may experience more noticeable physical symptoms such as tremors, urinary incontinence, falls, or headaches, there may be a vague sense that something is wrong with their ability to think clearly. There may also be feelings of frustration, trouble recalling names quickly, worrying about getting lost in familiar places and anxiety about these changes. Because of this, the individual often becomes more withdrawn and less engaged in their normal interests, routines, and activities. Fears of making a mistake or not fitting in may develop. On the other hand, there may be no personal insight or awareness of their changes in memory, behavior, or personal hygiene. Imagine for a moment the frustration of struggling with everyday activities like grocery shopping, paying bills, or remembering what you had just eaten or read. These are day-to-day activities, once done on autopilot, that are now challenging. Author, psychologist, and international Dementia community advocate, Dr. Richard Taylor, who had been diagnosed with younger onset Dementia at the age of 61, once wrote retrospectively: "Sometimes I am clear in my vision and memory. Sometimes I'm disconnected. There is an unpredictable shift." To better understand this unpredictable shifting, think of the brain as a loose light bulb. Sometimes the connections in the brain are stronger than others. Sometimes they are not. This uncertainty can confuse those observing, leading to questions about whether the person really has Dementia or is getting better. Are they acting on purpose, faking it, or simply seeking attention? It is important to realize that these alterations in cognition are likely the result of a degenerative disease process within the brain. A person living with Dementia cannot control what is happening inside their brain. Their outside appearances and their physical abilities may not have changed. So detecting these subtle clues is particularly challenging for those who don't live with them, like a doctor or a family member who only checks in by phone. It is easy to forget or have a lack of appreciation for what is happening on the inside. So how can you be intentional and show support despite these changes that they are loved, cared for, and valued? Dr. Taylor eloquently shares what it might feel like to be living with Dementia: "I am still me, perhaps a different me from what I have ever been before." There are other practical ways to help individuals living with Dementia feel respected. For starters, if you are conversing with them, look and speak to them directly at eye level as best as possible. Do not direct your conversation with them at someone else. They may feel unimportant and less valued. Refrain to the degree possible from speaking frankly about their situation in the third person, as if they were not there. If needed, remove yourself from the conversation and indicate that you'd like to talk with that other person separately. Secondly, allow time and space for the person living with Dementia to vent, express how they feel and even grieve when there has been a loss. Another learning is to realize that while you may worry about them, they are also worried about you. They may be concerned about becoming a burden or that you will tire of them. Reassure the person that they are safe in your presence. Smile, speak at a slower pace. Speak clearly, enunciate and speak loud enough based on hearing abilities. When having difficulty communicating, you can use different words, images, or body language, but pay attention to the most fleeting facial expressions so you can hopefully pick up on any hidden pain, discomfort, or anxiety. You can also look for joy, happiness, and contentment. Introduce yourself by name and use their first name. Often, a simple touch of the arm or shoulder can be meaningful, and a positive statement about how they look will always win you bonus points. Avoid asking "Do you know who I am, or don't you?" Remember, ask the person's opinion or preference, and give them a couple of simple choices or, if necessary, suggestions. It also helps to keep a sense of humor. It can ease anxiety and perhaps frustration for everyone involved. Everybody loves to laugh. Plus, it lowers stress hormones as we see a loved one experience changes in behavior and thinking. It's not uncommon to unintentionally change how we treat them. Let's look at a few other common ways people hurt others without realizing it. As the relationship changes, it may harm the person's ego or confidence by consistently pointing out their faults. Instead, work on supporting the person's remaining abilities. Unfortunately, negative stereotypes exist and people may be treated like a child. This is demeaning and disrespectful, causing further withdrawal and anxiety. Even for conversations and decisions that are difficult, it is essential to treat the person as an adult, and whenever possible, encourage independence and inclusivity when making decisions. Also, try not to jump in and complete their thought or task automatically. Instead, be patient. Allow more time for them to think of a word or take an action, and if warranted, ask if they want some assistance. Hopefully, you now have a better understanding of what it may feel like to live with Dementia emotions, what may help and what may hurt. The bottom line is that a person living with Dementia needs to feel safe, valued, and loved. In conclusion, as you embark on this journey, anticipate that there will be good days and bad. Bear in mind that brain cells are being altered on a microscopic level, resulting in cognitive changes in thinking, behavior, movement, and more. Avoid blaming the person or taking their actions and words personally going forward. Remember, this is not a race, but a journey. Thank you for joining me, and I hope you found it enlightening and instructive. I wish you all the wellness in the world. Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.

Dementia Horizons™ | Workshop 14 | Enhanced Hygiene Video Module [14] Transcript Hello and welcome. Ensuring enhanced hygiene for people living with Dementia can be challenging, especially when they resist bathing or showering. Resistance to these activities is often rooted in fear, discomfort, or confusion. However, with thoughtful preparation, patience, and the proper techniques, caregivers can help make the experience more pleasant and manageable. We will explore practical strategies to overcome resistance to showering for individuals with Dementia, emphasizing the importance of a compassionate and person-centered approach. Key Elements of Enhancing Hygiene in Dementia Before attempting a shower or any bathroom task, spend time creating a safe and comfortable atmosphere. Provide a shower or bath seat for times when the person needs to sit, and pre-install grab bars or other handholds so you, or they, can grab on if needed. Lay down rubber-backed bathroom mats to prevent accidental slips and falls, and to soak up excess water. If your care partner thinks they see someone else in a mirror while using the bathroom, place a sheer curtain over the mirror. Even if you are their long-term care partner, each time you work together, approach the experience with a new appreciation for their current situation. Clearly and confidently communicate each step you're taking, before you begin any new task. This allows the person to prepare themselves, be less fearful and not be surprised. Building a rapport that feels safe and trusting is critical. Start by engaging in a friendly conversation. Talking about one of their favorite topics like a sports team, their days at summer camp, or music they loved in their teens, can help make the interaction more personal and engaging. Please focus on the person before the task, and give them a fun reason to clean up, such as getting ready for an outing, or visiting a friend. In general, when someone is in the middle to later stages of Dementia, they may not think they need a shower or bath. In their mind, it may seem to them like they just took one. Also, the ability to smell odors can become less acute. And so, they may believe that there is no reason to shower or bathe. If using the word shower triggers anxiety, substitute phrases like "wash up", "clean up", or "Let's have a spa day." Addressing toileting needs before showering can prevent accidents and make the process smoother. Ensuring the individual has used the bathroom can reduce anxiety and make them more comfortable. Before entering the bathroom, ensure it is at a comfortable temperature and that all your toiletries are within reach. A warm and inviting environment can make a significant difference. Ensure that the shower room or bedroom has all the necessary supplies, such as towels, soap, and washcloths are readily available. This preparation can help create a sense of security and comfort for the individual. Then focus on their privacy, dignity, and warmth by keeping a large towel over their shoulders while verbally encouraging or assisting with removing their clothes. Sometimes you'll be challenged to do so, but keep the mood as upbeat and fun as possible. Consider playing soft music in the background. Soft, calming music can create a soothing atmosphere. Music has been shown to have a positive impact on mood and can help reduce agitation and anxiety in individuals with Dementia. Providing a soft, colorful sponge, a rubber ducky, or other water-safe object can serve as a distraction and reduce anxiety. These items can be soothing and fun, helping direct an individual's attention during bathing. Hum, or sing a familiar tune to brighten the atmosphere and create a bond between you and your care partner through music. Have the individual within your care start the washing process. It can promote independence and reduce resistance. Guide them through the process and assist as needed. Begin washing with less sensitive areas, such as the feet, legs, and arms. This approach can help the person gradually become more comfortable. Move to the middle of the body, and when appropriate, gently wash the perineal area. This is an area that lies between the genitals and the anus. I'd suggest using a handheld shower wand with a medium-pressure spray, if possible, to clean all the nooks and crannies. Maintain hygiene and comfort, and use fresh washcloths as often as necessary, especially for the face. Offer compliments if resistance develops. Stop, pause, and re-engage differently. Alternatives to consider: One: If the individual is uncomfortable with undressing, consider leaving their gown on and washing it underneath. This can help maintain their dignity and comfort. Two: If a bed bath is necessary, ensure the person is covered with blankets to maintain their dignity and warmth. Three: An under-the-clothes bath can be a more comfortable and less invasive option for individuals who are resistant to undressing. Four: Divide the bath: upper body in the morning and lower body in the evening may make the process less overwhelming. Five: A towel bath, where warm, moist towels are used to cleanse the body, can be a gentle and non-intrusive alternative to traditional bathing methods. No matter how you accomplish the cleanup, a gentle massage with scented lotion can be relaxing and comforting afterward. Focus on the lower back, feet, and hands to help the individual feel pampered and cared for. Expressing gratitude can have a positive impact. Thank the person for their cooperation and participation, reinforcing their sense of autonomy and dignity. Offer compliments to boost their self-esteem and reinforce positive behavior, acknowledge their efforts and cooperation. Share with family or paid caregivers what worked, and what did not, and document those experiences. Incorporating individuals' preferences and experiences into their care plan ensures that their needs are met consistently and compassionately. Showering and bathing should be enjoyable activities for the person, not just tasks to be completed. In conclusion, overcoming resistance to showering and bathing in people living with Dementia requires a patient and person-centered approach. By preparing thoroughly engaging the individual positively and using creative alternatives, caregivers can help make the experience more pleasant and manageable. Prioritizing individual's comfort, dignity, and preferences is essential to providing effective and respectful care. Bathing, showering, brushing teeth, and other daily acts of hygiene that were once normal and even enjoyed are now the subject of anguish, anger, and fear. You've taken on a considerable task that many would avoid. Don't give up. Thank you for being here. Thank you for learning all you can. Every day and every way, seek to be kind, helpful, and loving.         Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.

Dementia Horizons™ | Workshop 16 | Meaningful Activities Video Module [16] Transcript Welcome. Thank you for joining me today. Dementia is a progressive condition that affects memory, thinking, behavior, and the ability to perform everyday activities. It is divided into three stages, early, middle, and late. Each stage presents unique challenges and requires different approaches to care and engagement. Meaningful activities can enhance the quality of life for individuals living with Dementia, providing a sense of purpose, reducing distress, and improving overall well-being. This video offers practical tips and ideas for creating meaningful activities tailored to each stage of Dementia. Engage in Meaningful Activities at All Stages In the early stage of Dementia, individuals may experience mild memory loss and changes in cognitive function, but can still participate in many activities with minimal assistance. This stage focuses on maintaining independence, stimulating the mind, and encouraging social interaction. This can include puzzles and games, word searches, crosswords, Sudoku, and jigsaw puzzles. Encourage reading books, newspapers, or magazines, and writing letters or journaling. Introduce new hobbies such as painting, playing a musical instrument, or learning a new language. The key is to work on learning something new and different to challenge the brain. Physical exercise is crucial for overall health, improving mood and reducing anxiety. Consider regular walks in the park or around the neighborhood, or exercise classes, yoga, tai chi, or dance classes and gardening. Planting flowers or vegetables provides a sense of accomplishment. Maintaining social connections can be described as a meaningful activity, and can help prevent feelings of isolation and depression. This can be accomplished by joining a book club, participating in senior center activities, attending faith-based services or joining hobby groups. Consider volunteering, participating in community service, or helping at local organizations. Regular visits and outings with family and friends are wonderful ways to sustain relationships. Encourage regular, shorter visits to prevent fatigue. Be sure to share how best to communicate or engage differently, as language skills and the ability to initiate conversation or activities can be altered. Include creative and therapeutic modes of expression. Many people with Dementia enjoy arts and crafts, such as drawing, painting, knitting, or scrapbooking. Music is another important way to spend time. You can play an instrument, sing or listen to your favorite songs, take photos or create albums or scrapbooks. As Dementia progresses to the middle stage, individuals may require more assistance with daily activities, and experience increased confusion and memory loss. Activities should be simplified, and focus on familiar tasks that provide comfort and enjoyment. It is important to adapt activities to match the person's abilities. This means simpler puzzles and games, such as larger pieces of jigsaw puzzles, matching games and picture-based activities, short stories, audio books, and magazines with lots of pictures. Consider looking at old photos, discussing past experiences, and creating a memory box with cherished items. Also, physical activities such as chair exercises, stretching, seated yoga, or gentle movements should be modified to ensure they are safe and enjoyable. Enjoy playing balloon volleyball: a fun, low impact way to stay active. Try nature walks: short walks in familiar, safe environments. It may be appropriate to investigate adult day programs designed for individuals with Dementia. Continue to support creative activities focusing on enjoyment, rather than the end result or the finished product. Simple projects like coloring, collage-making, or decorating items. Listen to music, sing along to familiar songs, or play simple instruments like maracas, or encourage the person to tell stories from their past. In the late stage of Dementia, individuals often have severe cognitive and physical impairments and need full-time care. Activities should focus on sensory stimulation, and maintaining comfort and dignity. Focus on engaging the senses to evoke positive emotions and memories. Use soft fabrics, textured objects and hand massages. Engage familiar scents like lavender, baking cookies or flowers. Offer favorite foods and drinks that evoke pleasant memories. Listen to calming music and nature sounds, or read aloud. Watch videos of nature, family photo slideshows, or light displays. Even during the later stages of Dementia, gentle movement can be beneficial: guided movements to maintain flexibility and circulation, to promote relaxation and reduce discomfort. Assist with short walks in safe, familiar environments. Don't forget to provide comfort and emotional support at this stage. Engage in gentle conversation, holding hands and providing reassurance. Play recordings of family members or friends. Minimize noise to maintain a peaceful setting. A sense of security can be created by caring for a soft doll or stuffed animal. Caregivers can also offer quilts with various textures and attachments to keep hands busy. Caregivers, be patient and flexible. Understand that abilities and preferences may change from day to day. Be willing to adapt activities accordingly. Allow the person to do as much as possible independently, offering support only when necessary. Offer praise and encouragement to boost confidence and motivation. Focus on the process, not the outcome. The enjoyment and engagement in the activity are more important than completing it perfectly. Enjoy the moments together. It is an invaluable life skill to learn. Creating meaningful activities for individuals with Dementia requires understanding their abilities, preferences, and the stage of their condition. By focusing on activities that promote cognitive stimulation, physical movement, social interaction, and creative expression, a caregiver can significantly enhance the quality of their loved one's remaining life. Remember, the goal is to provide joy, comfort, and a sense of purpose, helping individuals living with Dementia to live their lives to the fullest. Once again, you've taken the time to consider all the wonderful ways you can help your loved one. As discussed today, non-medical therapies can have the greatest impact on both you and the one you care for. You are the light and sunshine that make all things possible. Thank you for joining me today to learn more about how to create meaningful activities.         Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.

Caring for someone living with Dementia can be a tough job. It's a role filled with emotional highs and lows, requiring considerable patience and strength. Finding ways to manage stress and emotions is crucial for caregivers. One effective method may be Cognitive Behavioral Therapy (CBT). Let's explore how CBT can help Dementia caregivers lead a healthier and more balanced life.   Understanding Cognitive Behavioral Therapy   First, what exactly is Cognitive Behavioral Therapy? CBT is a type of talk therapy in which you sit with a therapist and talk through your feelings and thoughts. The key idea behind CBT is that our thoughts, feelings, and actions are connected, and changing negative thoughts can help improve our emotions and behaviors.   Stress Reduction   Caregiving can often feel like a 24/7 job with no breaks. This continuous stress can lead to burnout, where a person feels extremely tired and unable to cope. CBT comes into play by teaching care partners techniques to manage their stress more effectively. For example, a therapist might help a caregiver identify and work on changing stressful thoughts. Instead of thinking, "I can't do this anymore," CBT would help them think, "This is hard, but I can handle it."   Better Emotional Management   It's normal for caregivers to experience a range of emotions, from sadness and frustration to guilt and anger. These feelings are natural, but they can be overwhelming. CBT helps by offering tools to manage these emotions more effectively. Caregivers learn to recognize their emotional triggers and understand how to calm themselves when faced with challenging situations.   Improved Relationships   CBT can also enhance caregivers' interactions with the person they're caring for. Sometimes, misunderstandings or communication gaps can create additional stress. CBT techniques help caregivers communicate more effectively by teaching them to express their needs and feelings clearly, without becoming upset or angry, thereby easing the situation and strengthening their relationship with the person they care for.   Coping with Change   As Dementia progresses, the person's abilities and behaviors can change dramatically, which can be challenging for caregivers to handle. Often, at the beginning, the relationship is relatively balanced, resembling a type of partnership. We prefer to refer to someone acting as a "care partner" in this situation. However, over time, the burden of caring usually shifts to the person who is not living with Dementia, and their role evolves to giving care. In other words, they are now a "caregiver." In these cases, CBT typically helps them adapt to these changes by setting realistic expectations and learning to accept things they cannot change. It teaches them to focus on what they can control: their reaction and attitude towards the situation.   Encouraging Positive Thinking   One of the core parts of CBT is cultivating a habit of positive thinking. Caregivers are often so focused on the needs of the person they are caring for that they forget to appreciate the good moments. CBT encourages them to notice and appreciate these joyous times, which can boost their morale.   Enhancing Self-Care   Finally, CBT emphasizes the importance of self-care. For caregivers, taking care of themselves is often at the bottom of their to-do list. CBT sessions can include setting goals for self-care activities, such as regular exercise, hobbies, or spending time with friends and family. These activities help reduce stress and prevent caregiver fatigue.   Conclusion   Caring for someone with Dementia is no easy task, and caregivers need to have support systems in place. Cognitive Behavioral Therapy is a valuable tool that offers this support. It helps caregivers manage stress, handle emotional ups and downs, improve communication, cope with changes, and appreciate the positive aspects of caregiving.   If you're a caregiver feeling overwhelmed, consider cognitive behavioral therapy (CBT). It could be a step towards better managing your duties and enjoying them more. Remember, taking care of your mental health is just as important as the physical care you provide. Contact the Association for Behavioral and Cognitive Therapies here to find a CBT therapist. Author: AI-Assisted Human-Edited Staff Writer Disclaimer: Dementia Society of America (DSA) provides educational content only and does not offer medical advice. Always consult a qualified healthcare professional before making changes to your medical care. DSA content is created by both human and computer-generated means and is reviewed for accuracy; however, errors may occur. Views expressed by third-party contributors do not necessarily reflect those of DSA. Unless expressly stated, DSA does not endorse or guarantee any third-party products, services, organizations, or external content. All DSA content is copyrighted and/or trademarked and may not be used without written permission.