how lifelong personalities traits and · -what helps and what makes it worse/better?-what can we do...

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Positive Approach, LLC


How Lifelong

Personalities Traits and

Preferences Affect

Dementia Care

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Why Is Life So Difficult for

Those Involved in Dementia?Many abilities are affected:• Thoughts

• Words

• Actions

• Feelings

It is variable: • Moment to moment

• Morning to night

• Day to day

• Person to person

• Place to place

Some changes are predictable

but complicated:• Specific brain parts

• Typical spread

• Some parts preserved

If it is progressive:• More brain dies over time

• Different parts get hit

• Constant changing


Understanding and

Responding to Challenges

and Unexpected Behaviors:

- What is happening?

- Why is it happening?

- What helps and what makes it worse/better?

- What can we do about it to make it better?

- How can we not have it happen in the first

place?

- Learning to respond, not react!


I’m Still Me…

But I’m Different!

- Help me to be who and how I am

- Don’t ask me to do or be what I can’t

- Let go, but don’t give up!

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Knowing the Person:

- History

- Values and beliefs

- Habits and routines

- Personality and stress behaviors

- Work and family history

- Leisure and spiritual history

- ‘Hot buttons’ and comforts


What Makes You Click?

What Makes You Tick?

Learn about how you are

and what you like,

so you can help yourself

and the person you are caring for


Lifelong Personality Traits and

Preferences Make a Difference

- We are more of who we have always been

Unless

- We have always been covering up who we really are and we decide to ‘let go’

Or

- Dementia robs us of our ability to be the way we want to be

Or

- Dementia causes us forget ‘how’ we are supposed to be and lets us be ‘free’

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Personal Preferences Matter

- We like what we like!

- With dementia, the ‘likes’ can change

- Old preferences will need to be revisited

- The challenge is to honor what is

important but change what is needed

- Our willingness to meet the person’s

changing needs is essential

- Changes are made harder by our sense

of loss and grief


Some Personal Preferences:

- Appearance

- Behaviors

- Language

- Daily routines

- Foods and drinks

- Music

- Touch, textures, noise, space

- Worship and spiritual practices


How Does Dementia Affect

This?- Memory

- Language: understanding and production

- Self-care skills

- Sensation

- Emotional control

- Reasoning and thinking

- Vision

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Personality Traits:

Who are you?

- Introvert - Extrovert

- Lots of Details - Big Picture Only

- Logical - Emotional

- Planning Ahead - Being in the Moment

Who is the person you are trying to help?


First, How You Do You:

- Come to decisions?

- Get re-energized?

- Feel about ‘boundaries’ and ‘space’?


Introvert - Extrovert

Introvert

Likes to be alone

Likes to think it out

Likes personal space

Needs alone time

Private

Shares little

Decides on own after thinking it through

Extrovert

Thinks out loud

Talks it out

Seeks out people

Shares a lot

Not good with boundaries

Gets opinions before ‘deciding’

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Second, How Do You:

- Like to get information?

- Like to do things?

- Decide whether to do something?

- Approach an unfamiliar task?


Details – Big Picture

Details

Needs to know how

Specifics of what to do

Wants detailed info: to

do it ‘right’

Likes doing the familiar

and routine

Likes a check list and

follows it

Likes to do it

Big Picture

Needs to know why

Likes to ‘fly by the seat of

their pants’

Likes to hear the big plan

Likes to try out new and

different ways of doing

things

Likes to experiment

Likes to talk it out first


Third: What makes ‘sense’?

- How do you ‘judge’ things?

- How do you decide if things are ‘okay’?

- What matters most to you?

- What drives your behavior and actions?

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Logical - Emotional

Logical:

Head First

Fair

Reasonable

Rational

Likes to discuss differences of opinion

How other people ’behave’

Emotional:

Heart First

Nice

Kind

Empathetic

Prefers to avoid disagreements

How other people ‘feel’


Fourth: How You:

- Use time

- Feel about time: the future versus now

- Plan ahead versus like surprises

- Feel about knowing what is expected

- Feel about ‘deadlines’

- Feel about making decisions


Planning Ahead – In the

Moment

Planning Ahead

Aware of the future

Sets priorities - plans

Likes routines

Likes a schedule

Likes to do things as planned

Decide and move on!

Needs to be in control

In the Moment

Being flexible

Go with ‘now’ issues

Not forward thinking

Running late

Putting ‘other’ things off

Considers options

Go with the flow

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Some ‘stuff’ we think/feel people

do on purpose

is really just who they are


Which is Best?

There is no best or better

Just different

Just ranges


What if You Don’t Get

What You Need at Work?

- You still need it!

- You will feel drained and empty if you

don’t get your needs met!

- It’s not about what is ‘better,’ it’s about

recognizing what you prefer and what

you need!

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What About People Living

with Dementia?

- They are at home

- They have needs – how will we help?

- How can we change the environment to

help?

- Who needs to know this?


What About People Living

with Dementia?

Lifelong Patterns:

- Introvert versus Extrovert

-Detail versus Big Picture

-Thinker versus Feeler

-Plan versus Go With The Flow


How Can We Become Better

Care Partners?

- Be willing to try something new

- Be willing to learn something different

- Be willing to see it through another’s eyes

- Be willing to fail and try again

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We think They may

we are: perceive us as:

Logical

Honest

Clear

Concerned

Uncaring

Deceitful

Confusing

Insulting


Think…whose brain is

working better?We can understand

another’s perspective

We can change our

behaviors and actions

We can decide to do

things differently

We can ask for help

They may understand

things from only one side

They may react, not

respond

They may be at the mercy

of old ‘relationships’

They may ask for help

through actions, not words


With Dementia,

It’s All About Finding the

Balance!

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Balance:

Like Good for you

Want Tolerate

Pleasant Unpleasant

Comforting Annoying

Stimulating Frightening

Calming Boring

Nothing Too much

Familiar Novel – New


Sensation:

A common stimulus

that causes an individual experience


The Stimulus:

- Single mode versus multi-modal

- Constant versus intermittent

- Subtle versus extreme

- Still versus moving

- Gradual versus sudden

- Sought out versus given

- Controlled by me versus by you

- Expected versus unexpected

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With Dementia All Senses

Are Affected:- Miss information

- Misunderstand information

- Over-react to information

- Under-react to information

- Get stuck on a sensation

- Can’t stand a sensation

- Variable abilities

- Can’t adjust or adapt to sensation


Vision Changes:

Peripheral awareness

Visual field

Depth perception

Light-dark accommodation

Tracking

Blink

Organized scanning

Saccadic eye movements

Color discrimination

Figure ground perception

Near-far accommodation

Near acuity

Night vision

Object recognition

Facial recognition

Protective: Discriminatory:


Hearing-Comprehension

Changes:

Direction

Emergency signals

Alerting communication

Localization

Comprehension

Sound recognition

Voice recognition

Foreground-background

Tracking

Following a conversation

Interpreting meaning

Multi-step information


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Touch and Movement

Changes:- This one is both complicated and important!

- Sensation, processing, reactions, and

responses happen fast! Almost automatic

due to habits and procedural memories –

looping once started

- Active versus passive: different


Touch:

Balance

Coordination

Speed

Accuracy

Strength

Bilateral and unilateral

Gross motor

Fine motor

Reflexes

Pressure

Temperature

Moving touch

Texture

Shapes

Movement: Sensations:


Touch:

Extreme Temperature

Sharp – Cutting

High velocity impact

Sustained pressure

Friction

Variation in temperature

Variable textures

Massage

Wet/dry

Manipulation

Grasp


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Movement:

Balance against

gravity

Block incoming

Avoid contact

Catch balance

Maintain upright

Voluntary movements

to meet goals

Tool use

Object manipulation

Construction



Olfactory – Smell Changes:

Smoke

Chemicals or gas

Spoiled food

Body odor

Urine or feces

Emotional memories

Emotional reaction

Pleasant-unpleasant

Smell identification

Stimulate hunger or thirst

Stimulate nausea

Localization/tracking



Gustatory – Taste Changes:

-Less able to pick up on sweet and salty so

they want more

-Still keep bitter and sour so they may not

like things they used to

-Things may taste ‘wrong’

-May order something, then refuse to eat it

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Create a Sensory Preference

List for You:

- Visual likes: stimulating and calming

- Auditory likes: stimulating and calming

- Touch likes: stimulating and calming

- Movement likes: stimulating and calming

- Smell likes: stimulating and calming

- Taste likes: stimulating and calming


Create a Sensory Intolerance

List for You:

- Visual Irritants

- Auditory Irritants

- Touch Irritants

- Movement Irritants

- Smell Irritants

- Taste Irritants


Now Think About These for

the Person(s) for Which You

are Caring!

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GEMS® Sensory Changes:

- Sapphires: you and me, as is

- Diamonds: more vocal and rigid

- Emerald: visual and auditory most

- Amber: all senses critical

- Ruby: touch, movement, personal and

intimate space awareness

- Pearl: touch, movement, intimate space

are key!


Consider Sensory

Preferences:

- Visual likes: stimulating and calming

- Auditory likes: stimulating and calming

- Touch likes: stimulating and calming

- Movement likes: stimulating and calming

- Smell likes: stimulating and calming

- Taste likes: stimulating and calming


Consider Sensory

Intolerances:

- Visual Irritants

- Auditory Irritants

- Touch Irritants

- Movement Irritants

- Smell Irritants

- Taste Irritants

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Realize:

It Takes Two to Tango…

or

Two to Tangle!


Being ‘right’ doesn’t

necessarily translate into a

good outcome for both of you


It’s the relationship that is

most critical

Not the outcome of any one

encounter

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Any links are for information purposes only and are not warranted for content, accuracy or any other implied or explicit purpose.

This presentation is copyrighted by Positive Approach to Care and is protected under the US Copyright Act of 1976 and all other applicable international, federal, state and

local laws, with ALL rights reserved. No part of this may be copied, or changed in any format, sold, or used in any way other than what is outlined within this under any

circumstances without express permission from Positive Approach to Care.

Copyright 2017, All Rights Reserved

Teepa Snow and Positive Approach to Care

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how lifelong personalities traits and · -what helps and what makes it worse/better?-what can we do...

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