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Dementia Horizons™ | Workshop 3 | Legal and Financial 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. 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. MMXXV Copyrighted, Dementia Society, Inc. All rights reserved. This content may be shared or reproduced in whole or in part for educational or informational purposes, provided that proper attribution is given to the Dementia Society of America® along with a link to the original content.

Dementia Horizons™ | Workshop 4 | Distress Responses Video Module [04] Transcript What do we mean by distress? Distress in people living with Dementia can manifest as anger, yelling, swearing, hitting, agitation, pacing, and uncooperative behavior. Yet this distress is not universal. Not everyone living with Dementia will show these behaviors. Understanding these behaviors, sometimes termed challenging behaviors, is crucial to prevent or de-escalate. Let's start with ourselves. Take a moment and think, have you ever sworn at someone? Have you ever, in a fit of anger, had physical contact with someone in your lifetime, or at least contemplated it? What might have been behind this behavior? Were you desperate, over-the-top, frustrated, or acting in self-defense? Perhaps you felt the person was not listening to you; you were feeling ignored. Maybe you felt your emotions were not believed or recognized, or worse, you felt under attack. In other words, you had an unmet need. I am hoping that you are seeing that these unmet needs occur even in people without cognitive impairment or Dementia. Your advantage is that you can more clearly communicate your frustration and argue your point. People with Dementia often struggle with language, reasoning, and rational thinking. They communicate their frustration or unmet needs through their behaviors. Please repeat this mantra: all behavior has meaning. People living with Dementia who feel comfortable, respected, and safe do not moan, rock, yell, punch, and scream. It is critical not to blame the distressed behavior on the individual, as if they are in total control of their actions. Most often, they are not. Importantly, not all people living with Dementia exhibit these behaviors, but when distressed behaviors occur, step back, take a deep breath and consider what the person might be trying to communicate. Distress Triggers The triggers for these behaviors typically fall within one or more categories. One : your approach or the way you communicate. Two : physical discomfort. Three : the environment. Four : emotional discomfort. Five : an underlying mental illness. Your job is to be a detective. If possible, figure out the trigger and work toward eliminating or diminishing the trigger. Trigger One: Your approach or the way you interact. Imagine that you are watching from above. Look and listen to how you come across. Do you look resentful, crabby, angry, or uninterested? If so, it is essential to shift your body language to appear kind, safe, friendly and loving. Avoid arguing or trying to rationalize. Use words and a tone of voice that is encouraging and positive. Then pay attention, if the yelling and lack of cooperation fade away. Trigger Two: physical distress. The brain diseases and disorders that may result in developing Dementia do not generally cause pain. People often receive their Dementia diagnosis while having had preexisting painful conditions such as arthritis, lower back troubles, poor oral health, pressure sores, and discomfort from prolonged sitting. The challenge is that people living with Dementia feel pain similar to others but may have difficulty expressing it. The next step is to determine or call on healthcare providers to help reduce or better manage the pain. Other triggers for physical distress include hunger, fatigue, dehydration, a full bladder, loose bowels, constipation, and infection. Your role is to review this list and find ways to correct them. Trigger Three: environmental factors. People with Dementia also react negatively to loud noises from sources such as the TV and radio, clutter in the room, and too hot or too cold temperatures. If you identify one of these culprits, lower or turn off the TV, declutter the space, and adjust the temperature or clothing items. Trigger Four: emotional triggers. Sometimes a memory may arise, or a person will be reminded of a sad or traumatic event. These may include the death of a spouse, an assault or domestic abuse, or even living through war, famine, or dislocation of one's family. In these situations, you must take special care to create a sense of safety through your words and actions. Start by acknowledging their sadness or fear: "I'm so sorry you feel this way. You are safe with me." There are times like these when you cannot fix it. Acknowledging the underlying emotion and sitting quietly and supportively near their side can be the most soothing. Trigger Five: mental illness. Some people develop Dementia along with a previous history of mental illness, such as depression, schizophrenia, or bipolar disease, but Dementia itself is not considered a mental illness. The underlying mental illness must be managed regularly and consistently; otherwise spikes in anxiety, depression and agitation may occur. It will require the assistance of a mental health specialist to monitor and adjust medications along the way. How to De-Escalate Sometimes, even with your best attempts, a person living with Dementia can become highly distressed. A way to help calm people down is to remember the acronym ACE . This stands for A cknowledging the feeling and their reality, staying C alm, and E mpathizing and engaging appropriately. Acknowledge the feeling : "I can see that you are angry. I'm so sorry. I hope it won't happen again." Remain calm . Use a soothing tone of voice. Stay nearby and give them personal space. Do not hover over, or look threatening. You may need to leave the room for a few minutes, or stop what you are doing. Breathe slowly. Empathize and engage . After a while, see if you can distract by offering a favorite snack, changing the subject, or talking about something pleasant. If the person becomes a danger to you or themselves, leave the immediate vicinity. Call 911 and inform the police that this is a person with a history of Dementia, and that they send an officer who is good at de-escalation skills. Often, people living with Dementia will calm down if they see an officer in uniform. Stay available to answer questions from law enforcement. Under all circumstances, should law enforcement intervene, work with them to ensure that your care partner is not arrested or hauled off to jail without exhaustive attempts to rectify the situation. Often they need hospitalization rather than incarceration. There's no shortage of possible tragic outcomes when someone living with Dementia is put into police custody. After any episode of distress, reflect on triggers and solutions. Share experiences with others and seek their support. Caregiving for individuals with Dementia means practicing patience and bringing a proactive approach to preventing distress. Remember, you are human too, and learning to navigate this information requires you to take good care of yourself over the long haul. Lastly, please consider these suggested next steps. One, keep a log of potential triggers for distress and identify preventive measures. When possible, share this information with others to prevent further distress, and request one or more Aware and Share cards from the Dementia Society of America ® to hand out. They are wallet-sized cards with tips and guidelines to help avoid misunderstandings, and to lower anxiety when communicating with someone living with Dementia. Three, contact the local police or sheriff's department and see if they can enter a note into the 911 system that a person living with Dementia resides at a particular address, advising that any call from the property or the neighbors that involves your loved one should be approached with added caution and understanding. You may have to fill out a form or meet with an officer to verify the information, but it can be well worth the extra effort. Thank you for your love and devotion to your care partner. It was my honor to join you today. Thank you so very much.   MMXXV Copyrighted, Dementia Society, Inc. All rights reserved. This content may be shared or reproduced in whole or in part for educational or informational purposes, provided that proper attribution is given to the Dementia Society of America® along with a link to the original content.

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." 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. MMXXV Copyrighted, Dementia Society, Inc. All rights reserved. This content may be shared or reproduced in whole or in part for educational or informational purposes, provided that proper attribution is given to the Dementia Society of America® along with a link to the original content.

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. MMXXV Copyrighted, Dementia Society, Inc. All rights reserved. This content may be shared or reproduced in whole or in part for educational or informational purposes, provided that proper attribution is given to the Dementia Society of America® along with a link to the original content.

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 We do not endorse or guarantee products, comments, suggestions, links, or other forms of content contained within blog posts that have been provided to us with permission, paid or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Better Brain Nation Magazine | Volume 2 Issue 1 | Crossword Answers Better Brain Busters™ Riddle Answer: CHICAGO (CHI-CA-GO)

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. 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. MMXXV Copyrighted, Dementia Society, Inc. All rights reserved. This content may be shared or reproduced in whole or in part for educational or informational purposes, provided that proper attribution is given to the Dementia Society of America® along with a link to the original content.

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. 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.   MMXXV Copyrighted, Dementia Society, Inc. All rights reserved. This content may be shared or reproduced in whole or in part for educational or informational purposes, provided that proper attribution is given to the Dementia Society of America® along with a link to the original content.

Dementia Horizons™ | Workshop 9 | Brain Health Video Module [09] Transcript Welcome. In this session, we're going to focus on the brain. Yes, that includes your brain and the brains of those around you. Notwithstanding a severe and possibly terminal stage of brain failure, the brain can almost always be learning and emotionally engaged, even when it seems that that's not possible. Over the last few decades, research has now consistently shown that our brains can grow new neurons. When presented with new information, we can add to our cognitive reserve throughout our lives. What is cognitive reserve, you ask? Very simply put, it's the totality of everything you've learned and experienced from birth. Think of cognitive reserve as a dictionary. You can have a thicker dictionary as you age, giving you lots to draw from, to have conversations and be creative, or you can have a thinner dictionary as you enter later years, which may limit the concepts and ideas you can lean on for your day-to-day cognition. Steps to Better Brain Health Let's try to build a better brain by filling our dictionary with more words, ideas, and experiences. This can start at the youngest age and continue to the eldest. It's a chance to encourage the young people in your life to commit to a great education, even if that's not always in the classroom. The other aspect of great brain health is neuroplasticity. In its most basic conceptualization, neuroplasticity leverages cognitive reserve and builds added knowledge or neural connections by using already existing knowledge. It is the ability to do what you've always done, but in a new and novel way. Here is a great example. If able, write your name with a pen or pencil, with whichever is your non-dominant hand. Make it simple. Write your name three times in a row to practice and try to make your writing more legible. As you progress, you might feel very accomplished afterward. I certainly did. Another trick to try is folding your arms. Yes, let's do that now. Fold your arms across your chest if you can. How does that feel? Comfortable? Okay. Now, reverse your folded arms and fold them the opposite way. How does that feel? Awkward at first? Sure, but over time, if you do that more frequently, you'll start to build new muscle memory, like a golfer might try. They swing the club a bit differently for different shots. Folding your arms teaches your brain that you can adapt to change. In a nutshell, these are the two elements of better brain health you can use today, right now: cognitive reserve and neuroplasticity. Well, we are about a quarter of the way through and we have much more to share. We need to dive deeper into what makes the brain tick and how what you do can positively affect your overall brain health. Our brain is like a machine that continuously processes information, stores memories, and regulates our body's functions. To function at its best, it requires care and maintenance. This program explores simple yet effective strategies for maintaining and improving brain health, ensuring that our most vital organ remains in good condition. Our first strategy is to stay active. Regular physical activity increases blood flow to the brain, delivering oxygen and essential nutrients, whether going for a walk, working in the garden, swimming, doing yoga, using simple stretch bands, lifting hand weights, or participating in relatively safe sports like table tennis. Staying active helps promote brain health and cognitive function. This is a true statement: what's good for the heart is good for the brain. Feed your brain like the rest of your body. The brain needs proper nutrition to thrive. A balanced eating plan, rich in fruits, vegetables, whole grains and healthy fats provides the nutrients necessary for brain health. Omega-3 fatty acids, healthy fats that may reduce your odds of cardiovascular disease by lowering your cholesterol, are found in among other things, olive oil, fish, nuts and seeds. If you haven't already, you may want to consider implementing elements of the famous Mediterranean diet, or possibly the brain and heart-healthy version called the MIND Diet. Both can be found online. One important area to note while we're on the subject of nutrition is that diabetes has been closely linked with neurocognitive diseases. The science is still expanding on the subject. The current thinking is around how diabetes affects the vascular system in the brain and may drive other processes that trigger or accelerate pathologies that could result in the expression of Dementia. Please do all you can to reduce the assaults on your brain and eliminate diabetes related risk factors. Trim back highly processed and chemically laden foods and beverages in your diet. Even those with fake sweeteners are reported to mimic similar destructive forces as real sugar. Try local natural honey in limited amounts as a more healthful alternative for added sweetness. Also focus on whole grain food sources and refrain to the degree possible from processed white flour foods and other gluten-rich foods and beverages. Okay, there you have it. That's a lot to think about. Well, we are about halfway through this program and so much great information on brain care has been shared with you, but now I want to suggest you put me on pause. Take a 10 minute break, let your brain process what you've heard so far. Then come back and start up again. There's so much more to know, so I look forward to catching up with you again after the break. Oh, goody, you are back. Thank you for returning. Now let's get restarted and turn our attention to hydration. It's pretty simple overall. Our bodies are made up of 60% water. Indeed, the brain and heart are composed of 73% water, so drink water and other non-sugary beverages throughout the morning and afternoon. Not doing so can impair cognitive performance as the day wears on, and since I know you want to be in tiptop shape at all times, thirst is an easy one to solve. Exercise your mind. Keeping your brain stimulated through mental activities is crucial for maintaining cognitive function. Engage in activities that challenge your brain, such as puzzles, crosswords, reading or learning a new skill or language. Continuous mental stimulation helps strengthen neural connections and can even reduce the risk of cognitive decline as we age. Another way to express exercising your mind, is to stay curious. Get adequate sleep quality. Sleep is essential for brain health and overall well-being. During sleep, the brain consolidates memories, processes the day's information, and eliminates toxins. Aim for seven to nine hours of sleep per night to allow your brain the rest it needs to function optimally. Establishing a regular sleep schedule and creating a relaxing bedtime routine can help improve sleep quality and manage stress. Chronic stress can harm the brain and impair memory and cognitive function. Practice stress reduction techniques such as deep breathing, meditation, yoga, or spending time in nature. Do what they call forest bathing. Yes, it's a real thing. Look it up. Engaging in activities that promote relaxation and mindfulness can help mitigate the negative impact of stress on the brain. Stay socially connected. Social interaction is vital for brain health. Engaging in meaningful conversations, spending time with friends and family, and participating in social activities helps stimulate the brain and ward off feelings of loneliness and isolation. Maintaining strong social connections is associated with better cognitive function and a reduced risk of cognitive decline. Protect your head. This is often overlooked, but it's a biggie as they say, because if you think about it, yes, think after all, it's where all the brain activity takes place. Protecting it from assault, injury and infection is job number one. Head trauma can have lasting effects on brain health, so it's essential to take precautions to prevent incidents. Wear helmets when biking or participating in sports. Buckle up in the car and take steps to prevent falls, especially as you age. Moreover, concussions caused by a severe blow to the head, once or multiple times where you might even black out or go unconscious, can have deleterious effects on your short and long-term brain health. You see those who play contact sports, people involved in motor vehicle accidents, cyclists, construction workers, military personnel, and even someone who slips and falls in their home and hits their head on a hard surface, can experience a concussion. Don't play around with a head injury or concussion. Take it seriously. Get medical help and follow their advice for recovery. As Sergeant Phil Esterhaus used to say on the hit TV series "Hill Street Blues": "Be careful out there." Okay, next. Here's something you might not have heard before. Your ears should be protected to help protect your thinking abilities. After all, they are part of your head. In fact, your ears are like direct sensory collectors for your brain. You see, large-scale studies have found possible links between hearing loss and the development of cognitive impairments. The facts behind those findings are still being understood, but suffice it to say that two things we can imagine are happening. One , if you have trouble hearing, you might not register what someone has said, so it looks to the outside world as memory loss. And two, we're not hearing clearly. The brain has to work extra hard to pick out intelligible sounds against the backdrop of surrounding noise. That may take precious cognitive processing power away from one critical brain function or another, and redirect it to less beneficial noise-cancellation efforts. The whole of the experience may cause cognitive stress on your thinking abilities. The bottom line is protect your hearing and consider hearing aids. They may greatly help improve your brain health. Not dissimilar to hearing loss, difficulties with your vision and sense of smell may be linked to the development of cognitive deficits. The takeaways: get your eyes checked regularly and keep up with corrective glasses or contact lens prescriptions if you need them. Plus, use appropriate strength and higher quality reading glasses. Regularly schedule your screenings for cataracts or glaucoma. Likewise, pay attention to one of our more primitive fight or flight senses, your nose and sense of smell. Protect it and don't suffer from endless stuffiness or post-nasal drip. Keep your nose as clean as possible. Along the same lines as taking care of the sense organs already mentioned, your tongue, teeth and gums are also located in your head and provide direct pathways to your brain. They may play a vital role in fermenting infections linked to neuroinflammation in the brain. That condition is similar to the redness and inflammation that occurs when you cut or bruise your hand, for example. So what do you do? Brush and floss your teeth and gums regularly. Consider using a tongue scraper to remove any nasty bits and at the same time, improve your breath. Visit your dentist for regular checkups. Get ahead of any tooth decay, and as an added benefit, have them check for potential signs of mouth cancers. Also, please quit smoking if you do smoke. Apart from the impact on your vascular health, anything you smoke comes into direct contact with your mouth and nose, and most importantly, your lungs. The health of your lungs significantly affects the health of your brain. Why, your lungs take the air you breathe, separate out oxygen, and put that life force into your bloodstream. This oxygen-rich blood then acts as a necessary ingredient for your body, including your brain. After all, your brain begins to fail about four minutes after the loss of oxygen, not to mention the similar effects on oxygen flow to your brain that conditions such as COPD and sleep apnea can have. Lastly, try to limit alcohol and avoid drugs. Excessive alcohol consumption can damage brain cells and impair cognitive function. Limit alcohol intake to moderate levels or avoid it altogether to protect your brain health. Similarly, please avoid the use of recreational drugs as they can have detrimental effects on brain function and overall well-being. In conclusion, by incorporating simple lifestyle changes, you can nurture your brain and ensure that it continues to serve you as best as possible throughout your life. So take care of your brain. It's the only one you'll ever have. You learned, not only about the steps you can take to build a better brain, but you also heard the secrets most people are unaware of: cognitive reserve and neuroplasticity. Well, you are a jolly lot, and being with you has been an absolute pleasure. Thanks so much for joining.    MMXXV Copyrighted, Dementia Society, Inc. All rights reserved. This content may be shared or reproduced in whole or in part for educational or informational purposes, provided that proper attribution is given to the Dementia Society of America® along with a link to the original content.

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.     MMXXV Copyrighted, Dementia Society, Inc. All rights reserved. This content may be shared or reproduced in whole or in part for educational or informational purposes, provided that proper attribution is given to the Dementia Society of America® along with a link to the original content.

Dementia Horizons™ | Workshop 12 | Preparing Others Video Module [12] Transcript Hello, my name is Michael. Well, if you can't tell, my roots are from across the pond, as they say. About 40 years ago, I packed up my suitcase, put on my overcoat, and with bumbershoot in hand to ward off the rain, I hopped on an airplane to explore a faraway land. I never planned to stay, but I met this lovely lady, Christina, and I ended up loving America too, its bright sunshine and big skies. In the end, I settled down and made the good old USA my new home with my beautiful wife, Chrissy. I've had a great career, relished being with my family and friends, enjoying romantic candlelit dinners with Tina, and traveling the world, but I always loved coming back to our cozy home. Yet here I am in my seventh decade of life, and something was off a bit. I couldn't add the tip on a restaurant tab, and I was finding it hard to dial the telly. Did I say dial the telly? Well, you know what I mean! I couldn't call the channels up on the TV. I didn't know what was wrong, and my wife and kids, well, you call them kids, but they've got kids of their own. Anyway, something was off. Then late one night as we slept, I felt someone was punching me. I was having an awful nightmare. It felt so real, like I was in danger, but I must have lashed out. I nearly hit my darling birdie. Luckily, she woke up and jumped out of bed. I had no idea. That was the straw that broke her proverbial back. My wife asked me to see a doctor, and I told her that was not in the cards. I was fine and wasn't about to get my head checked. I was having a bad dream. That weekend, I needed a box of those round things. You know, they go into lamps and light the night. Well, anyway, I got lost going to the hardware store. It took me, I don't know, a couple of hours to figure my way back to our flat. Did I say flat? Huh. That's not right. Anyway, I ignored all my other problems until one afternoon, about a month later. That was the day I nearly clobbered a school bus. I was lost. I was frantic, and for some reason, my right leg didn't move fast enough to slam on the brakes. I ran right through a stop sign and bam, I caught the tail end of that double decker. Oh, I did it again. Double decker. That's another story. No one was hurt, no major damage. The little ones had all been dropped off, but I felt so bad I needed to figure out what was going on. Anyway, I confided with my dearest, ah, that woman I'm married to, hmm, sorry, Christina. Anyway, I agreed to see Old Doc Watson, that's what I call him. Sure enough, I didn't do so well on that thing called the memory quiz or whatever. And before long, I needed to get some more tests. Not fun, I'll tell you, but worth it. In fact, good old Doc Watson eventually said it probably wasn't safe for me or others on the road. So I hung up the keys to my old 55. Hey, that's a great Eagles song, isn't it? You probably don't want me to sing a few bars, if you know what I mean. You'd want to hold your ears. So anyway, my kids suggested I wear one of those ID bands on the wrist to let others know who I was and who I belong to, if I couldn't say, and I love it. It makes me feel more secure. And they gave me a handy little card, the Aware and Share card from the Dementia Society of America ® , and I carry it with me everywhere. My wifey carries one too. It's a way to maintain my dignity, but make someone aware that I might say, or act or do something different and unexpected. I share it with people I don't know, and most new places I go, it makes them and me feel better. After that, folks are so kind and understanding. Everyone, my wife, the kids, the doctors, even my old work colleagues came together to help me. I needed it, because I'm still me and able to share my story. So now I volunteer to help others like you, and I love it. Once I decided to tell friends and my golfing buddies about my Dementia diagnosis, I realized that they already had a hunch something was wrong. Well, there was some relief that their concerns had a name to it. I was concerned about being stigmatized, not liked anymore. I was going to prepare my family as best I could, but how was my family, my care partners in life? How were they going to go about preparing others: my friends, neighbors, the Wednesday night study group and the other great people I saw each day, like that nice young woman at the grocery store that I enjoyed so much, or the bank teller who always had a smile and a funny bone story for me? Indeed, I was okay covering up my blunders, but my poor lady, this was all starting to fall on her shoulders, and God knows she has enough challenges with her job, the grandkids, and looking after me. I felt alone in the midst of everyone who loved me, and I knew that even Christina felt a bit embarrassed. However, one way to bust through the myths and the fears and help us cope is to share a few new understandings. First, my experience is my experience. You may know a relative or neighbor with Dementia and want to compare me to them. Please don't. Each journey is unique and everyone experiences things differently. I'm learning that communication is really important. The way I communicate will change over time. I tell that lady I'm living with that she'll need to be patient with me, and recognize my brain is changing and give me grace when this happens. I don't think she'll give up on me. I still want to spend time with her. We can still do fun things together, like taking walks in the woods, listening to the Rat Pack, Hank Williams or even the Beatles, or share a lobster down at the dock. We're all headed to that great glory someday. But while I'm here, I'm living with my Dementia, not suffering or hiding out of sight. Dementia is like anything else that can come our way. Cancer, heart disease, lung disease, accidents, and so much more. Oh, yes, it's not a good thing I have a disease that's causing my Dementia symptoms, but I count my blessings and plan to stay strong. So here are a few things that I'd ask. Give me more time to answer a question and please speak more slowly. Look me in the eyes and don't talk about me as if I weren't there. Gosh, that feels awful. As my challenges become more ducky, become, I mean harder, introduce yourself when you walk into the room, I can tell you I won't want to try to guess your name right now, so please don't ask me to. And as hard as it may be, please try to avoid correcting me. I probably will think of things differently or lose a word every once in a while, but that's okay. If I do something that doesn't make sense (after all, I did put the laundry in the icebox one day), just go along to get along. I won't feel as anxious. If you can avoid starting a sentence with "Do you remember?" That's only going to frustrate me when I can't. Instead, say "I remember when..." and share the experience. That way I can be part of your memory. I hope you won't be offended when I want to take some breaks. I'm going to tire more easily. You see, it may not show, but it takes a lot of energy for me to process information throughout the day. It is possible I will see people and hear sounds that you can't. It can be frightening, but please, as my parents told me, they had placards all over the city during the Big War that read, "Stay calm and carry on." Yes, that's what they used to say and I feel it's kind of my motto these days. But we'll get through it, with your help and steadiness in the eye of the storm. But gosh, above all, let's make time to laugh together. If you are my long lost friend I've known forever, or a new old stranger, and I swear like a sailor, or call you names and get angry, I might even accuse you of stealing my girl or taking stuff out of my dorm room, I want you to know I love you. Even if it's harder for me to show it, my actions are probably not something I can control, but I will never stop loving you. If you are a care partner now, it's a two-way street. You help me and I'll do my best to help you, but over time, you become more of a caregiver than a care partner. With that said, you play a vital role in preparing, sharing, and widening your circle to include extended family members and old and new acquaintances. Share with them how you cope, what your needs are and what you have learned to make it a tad easier on everyone. As you start to share this information, others will want to help. Don't go it alone. There are many practical ways folks can assist you. Make a list of your daily and weekly to-dos, other tasks someone else can take on to lessen your load or free up more time for your self-care. We all need self care. It feels so good. What might you need, help with grocery shopping? Good. Jolly good. You know, you could ask your neighbor every once in a blue moon to run an errand for you, or take your loved one living with Dementia on a stroll down the promenade, or a trip to see old what's his name, the barber. How about odd jobs around the flat? I mean the house or the apartment. Can one of the kids down the block mow the lawn, clean up the basement, sweep the sidewalk and the stoop, or pick berries from the backyard for your morning oatmeal? Don't forget, huh? That phrase sounds funny coming from me. Okay? Yes. Remember that maybe your sister-in-law is a great cook and could whip up a roast, roast beef, and some yummy Yorkshire pudding. If you don't know that old British recipe, look it up. I guess I should mention that if you are so inclined, ask friends or a local service club that does good deeds to take you both to your place of worship for spiritual renewal. You might just want to sing, be social, or find solitude and soak in the scent of dusty pine floorboards, or, I don't know, sit and rejoice in the bands of color streaming through the stained glass windows. In conclusion, help spread Dementia awareness in your faith community, or civic and fraternal organization, at work, in the neighborhood, and over the internet. Share valuable resources and supportive programs with your family and friends, such as the educational information that comes from noteworthy non-profits like the Dementia Society of America ® and others. Knowledge is empowering. While the news of a loved one living with Dementia can be difficult at times, it can also be an opportunity to strengthen connections, keep the communication open and support one another. Accepting help from family and friends is not only beneficial for the person with Dementia, but also for you. Jolly good. I've thoroughly enjoyed our time. I hope you did too. Let's face this journey together. Thank you, and please take good care of each other, won't you?       MMXXV Copyrighted, Dementia Society, Inc. All rights reserved. This content may be shared or reproduced in whole or in part for educational or informational purposes, provided that proper attribution is given to the Dementia Society of America® along with a link to the original content.

Dementia Horizons™ | Workshop 11 | Home Safety Video Module [11] Transcript Home. What does that mean to you? Are you surrounded by pictures and mementos that have a story or bring you joy? Does home mean safety, peace, and familiarity? When you come home, do you love a particular scent or smell? Our job today is to learn how to adapt a home for someone whose brain and senses are changing over time, due to progressive cognitive impairments that we call Dementia. That way, you can better understand why modifications to create a safer home environment are necessary in the first place. It is also essential to know how the underlying diseases or disorders that can cause Dementia may impact the senses. Let's start with vision or eyesight. Peripheral vision narrows, meaning that the person sees primarily what is directly in front of them, like looking through a tunnel, with less ability to see what is happening on the sides. Because of this, people living with Dementia may then bump into objects if pathways are narrow or cluttered. Also, identifying shapes and objects can be difficult if the lighting is dim. For example, the vacuum can look like a small child in the distance. Shadows can be misinterpreted, especially at night, looking like strangers entering the room. The shape, purpose, or function of an object can be misconstrued, so a TV remote control and a cell phone can look the same. Because of changes in the brain, which keeps track of what does what and how, managing devices can become overwhelming. Depth perception changes over time. It may be more difficult to safely walk up or down stairs, or know how to step into or out of a bathtub. As you can anticipate, there is a higher risk of slips, falls, and injuries. The brain also controls our ability to move our legs and maintain balance while walking. As Dementia progresses, steps shorten, people may shuffle their feet; and reflexes slow, creating another reason why the risk of trips and falls is a common concern. The sense of smell may diminish, making it problematic to identify smoke, foul odors, or spoiled food. It is also common for hearing to become impaired with age. Therefore, older people living with Dementia can have more difficulty deciphering sounds and voices. This is especially true when there is too much background noise or people are talking simultaneously. Although this may not happen to everyone with Dementia, hallucinations can occur. Hallucinations are perceptions of having touched, heard, seen, tasted, or smelled something that does not exist. Given this wide range of potential changes, I hope you can see why creating a home environment that supports safety and thriving is wise and loving. Hearing all of this may be overwhelming to absorb. Take four deep breaths. By anticipating challenges and making proactive adjustments inside and outside the home, care partners and caregivers can significantly enhance the quality of life for those living with Dementia and provide reassurance for themselves. You can do hard things, and I am here to help you get started. Let's start by imagining yourself walking into the kitchen. Objects might look different to a person living with Dementia. Now, scan the room. Take inventory of what is inside the cabinets and drawers, and consider the following recommendations. Remove knives and other sharp utensils. Purchase kitchen appliances, such as coffee makers, with automatic shut-off. Disconnect the garbage disposal, or make it very difficult to turn on. If possible, remove the knobs from the stove. Lock up cleaning supplies. People may misinterpret cleaning solutions for juice. Be especially sure to secure dishwasher soap pods. They are poisonous and commonly mistaken for candy. Remove anything mistaken for food, such as fake fruit in a bowl. Clear the refrigerator of expired food regularly. Some cabinets may require safety locks to keep items hidden and secure. Keep the fire extinguisher or fire blanket within easy reach. Label cabinets so that things are easier to find. This will also help support a sense of independence. Use chairs that are sturdy, with armrests that make it easier to get in and out of. As you walk through the hallways, clear the pathways. Remove throw rugs that can be tripping hazards, and add additional lighting where necessary. Consider using non-skid wax on floors. If not, be sure the person wears non-skid shoes or slippers when walking on wooden or tile surfaces. Some people with Dementia find it easier to locate rooms in the house if way-finding signs are in place. These signs usually have the room's name in large print and a picture. Use brightly colored tape or paint to mark the edges of steps, or changes in the flooring. Install or secure handrails on stairs. If steps become too challenging, the person may need to remain on one main floor. If clear glass doors or partitions are present in your home, use decals to prevent people from bumping into them. Now, let's imagine going into the bedroom or bedrooms. I would encourage you to decorate the bed with a color that contrasts with the rug or floor so that it can be easily identified. For example, a blue bedspread and a cream colored carpet. Install motion detector nightlights for times when someone wakes up and needs to find the restroom. Again, be sure to remove throw rugs. Listen for low battery chirps from smoke alarms, and don't wait to change them. Supervise the use of heating pads or electric blankets. Remove clutter, and label drawers and cabinets. Moving into the bathroom. This is an area that requires particular attention: Remove or secure prescription or over-the-counter medications from cabinets, and place mouthwash and colognes where they can be supervised during use. Replace door locks with non-locking levers. Install grab bars in shower and bathtubs. Use a non-slip bath mat. Install non-slip toilet seats that contrast with the color of the floor, making them easier to see. Set water temperature to avoid scalding. Use overflow valves or flood sensors to avoid or detect flooding. Find yourself now in the living room: Remove throw rugs, and use non-slip surfaces if possible. Do your best to declutter. It's easier to pay attention when there is less overstimulation. Remove long cords to avoid tripping. Perhaps in the living room or somewhere else, create a calm and inviting space for the person living with Dementia to relax and have access to meaningful activities such as books, magazines, simple puzzles, paper and pencils for drawing, and music for listening. If guns or a knife collection exists, secure and disable them. Safety, autonomy, and comfort also apply to the backyard and garage: Secure the keys to the snowblower or lawnmower and car. Place power tools out of reach. Disconnect the gas or electric source for the grill. Adjust uneven pathways. Create a space for gardening, walking, sitting and spending time in the fresh air and sunshine. Consider adding a bird feeder or gentle wind chime. Now, you may be wondering, how do I make these changes when the person with Dementia may resist? Start gradually, one slight modification at a time. Have a friend or family member take the person out for a meal or for the day, while the remodeling happens. Do not say anything in advance. Wait to see if the person recognizes the changes. Be matter of fact. Avoid saying you needed this "because...". Instead, say "We needed to make a slight improvement." Creating a safe home environment for individuals living with Dementia requires a combination of understanding, empathy, creativity, and practical adjustments. It's a journey, but ultimately, it can significantly improve the quality of life for both the individuals living with Dementia and their loved ones. Consider these adaptations as a way of loving your spouse, parent, or sibling differently. There we have it: home sweet home. Thank you for joining me today. There was a lot to take in, but use our support material to review and help you implement changes over time. Thank you again. Be well.      MMXXV Copyrighted, Dementia Society, Inc. All rights reserved. This content may be shared or reproduced in whole or in part for educational or informational purposes, provided that proper attribution is given to the Dementia Society of America® along with a link to the original content.