© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

People Living with Dementia Need Care Partners To Wonder About

What They Want, Need, or Think

Watch and Observe

• What they show you- how they look

• What they say – how they sound

• What they do – physical reactions

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

Abilities are ever-changing Use what you see,

hear, and experience to help determine where the

person is functioning in that moment or during a

specific interaction to adjust your expectations,

support, and behavior to match what is happening

for them.

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

As the person is faced with different settings, task, and people,

their ability to cope and respond may change regularly or

unexpectedly. The existence and impact of other medical,

emotional, and sensory conditions (vision, hearing, touch,

balance, pain) can also have a great impact.

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

None of us perform the same when we are tried, stressed out, distracted, or in pain, as we do when we are rested, focused, and alert.

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

There are day and night people, the

brain get tired as they are up and

fades faster when stressed.

Realize where you are in the day

and their natural rhythm.

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

So, we need to learn to

use the support that seems

to best match most of skills

the person has that your

working with. Ask yourself

how is it working? Modify

as needed.

5 Senses How Humans Take In Data

1. What you see

2. What you hear

3. What you feel/ touch

4. What you smell

5. What you taste

Visual Data

• The most powerful sensory input.

People with dementia pay more attention to what they see than what they hear.

Remember scuba vision and monocular vison? BIG CHANGES IN

VISION

Auditory Data

• What do we often do wrong?

Care partners like to talk.

The person with dementia is focused on how we look visually and they are not processing the content.

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

ACTIVITY

Role playing with

hands.

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

Have them hold up one hand with the 3

skill fingers- this is the person with

dementia. We want to know about them,

but we can’t fix them. Because this is what

they are losing. They are losing skills.

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

Now have them hold up the other hand with 3 skill fingers- this represents caregiver. We have the skill and have power over them. However, we are not using them correct with the person we are working with.

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

Match your skills with theirskills.

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

Pitfalls & Causes for distress

1) We talk too much.

2) Our expectation is too high.

3) We are looking at what they can’t do. Instead of looking at

what they can do.

4) We need to realize that they’re not the same person. Grief for

the person they used to be. Then learn to accept, love and

work with the person you have in front of you. Something to

into mind is this person is going to change again. So, you must

be able to modify your skills with them as they change.

5) Take care of yourself. Find a good support early in the disease.

Take breaks.

6) Always stop what you our doing if its not working. Take a step

back and reproach.

Relationship• It is not about the task to get done, it is

about the relationship.

• Hide your agenda, do not give push back.

• Work around issues

• PLWD take time one way or another, better to spend time on the front end and keep the relationship than to force a task ending in a distressed resident.

• They remember feelings.

• Better to spend the time on the front end rather than the back end of the interaction.

• What hiding your agenda looks like.

The Lyrics to ‘The Gambler’

Is to be applied here.

You got to know when to hold up, know when to fold up, know when to walk away and when to run.

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

When Words Don’t Work Well

Hand-under-Hand™

• Uses established nerve pathways

• Allows the person to feel in control

• Connects you to the person

• Allows you to DO with not to

• Gives you advance notice of ‘possible

problems’

• Connects eye-hand skills

• Use the dominant side of the person

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

Sensory Strip

Motor Strip

White Matter

Connections

BIG CHANGES

Formal Speech &

Language

Center

HUGE CHANGES

Automatic Speech

Rhythm – Music

Expletives

PRESERVED

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

When Doing

• Do ‘With’

• Give SIMPLE and Short Pieces of Information

• Offer concrete CHOICES

• Ask for HELP

• Ask the person to TRY

• Break the TASK DOWN to single steps at a time

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

The Basics for Success

• Be a Detective NOT a Judge

• Look, Listen, Offer, Think…

• Use Your Approach as a Screening Tool

• Always use this sequence for CUESVisual - Show

Verbal - Tell

Physical – Touch

• Match your help to remaining abilities

- * “I don’t know what went wrong!” Role play trying to figure out what is wrong

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

Use Hand-Under-Hand™

• Connecting – comforting and directing gaze

• Guiding and helping with movement

• Getting eye contact and attention

• Providing help with fine motor

• Offering a sense of control, even when you are doing almost everything

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

Dementia Can Be Treated

• With knowledge

• With skill building

• With commitment

• With flexibility

• With practice

• With support

• With compassion

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

Keep it SIMPLE

• USE VISUAL combined VERBAL (gesture/point)“It’s about time for… ““Let’s go this way…”“Here are your socks…”

• DON’T ask questions you DON’T want to hear the answer to…

• Acknowledge the response/reaction to your information…

• LIMIT your words – SIMPLE is better always

• Wait, Pause, Slow Down- *Role play

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

Care Partners Need To…

• Take care of yourself

• Understand the symptoms and progression

• Build skill in support and caregiving

• Build skill in communication and interactions

• Understand ‘the condition’ of brain change

• Identify and utilize local resources

• Set limits for yourself

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

Five Ways to Say

“I Am Sorry!”

• I’m sorry, I was trying to help.

• I’m sorry I made you feel (name the emotion…. angry, irritated, frustrated, sad, isolated).

• I’m sorry I made you feel (name the experience you created….diminished, relationally unequal- like a child, stupid, or incompetent).

• I’m sorry that happened (their perspective).

• I’m sorry, this is HARD (for both of you)!

- *Role Play Validate and I’m Sorry

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

For ALL Communication

If what you are trying is NOT working…

• STOP

• Back off

• THINK IT THROUGH…

• Then, re-approach

• And try something slightly different

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.

ADL Practice

- Dressing

- Brief Changing

- Shower – Wash up, Modified bed bath, Hair wash, Beauty

shop

- Transfers – Sit, Stand, W/C, Getting in cars

- Waking person while in bed

- Eating

- * Lewy Body – a little different - modify

© Teepa Snow, Positive Approach, LLC – to be reused only with permission.