Working with People with Dementia

1. Working with People with Dementia And Other Conditions that Affect the Brain

2. What we will be talking about today.. • Brief overview of what the brain does • What happens if the brain is damaged • Dementia – some background information • Understanding the behaviour of people with dementia

3. The Brain • The average human brain weighs 3lbs (1.5kg) • Men’s brains are slightly heavier…. • But bigger does not mean better - cavemen’s brains were even heavier!! • The brain contains roughly 15 - 33 billion neurons

4. To get us started……… • What has your brain been doing this morning???!! • Spend five minutes talking to the people next to you about what your brain has had to do since you got up this morning….

5. The Brain (continued) • The brain is responsible for our thoughts and emotions • The brain controls our movements • The brain is responsible for controlling all of our senses – the role of our eyes, ears, taste buds etc is to get information to our brains • The brain controls the other organ systems (eg breathing) • Different parts of the brain do different things

6. What Different Parts of the Brain Do…. • The temporal lobe is important for language and memory; it is also involved in our hearing and ability to recognise faces • The frontal lobe is our emotional and behavioural control centre - it also controls motivation and problem solving • The bottom part of the brain controls essential physical functions (eg heart rate & swallowing) • Other areas control our movements, senses, balance and vision. • Generally, the left side of the brain controls the right side of our body (and vice versa)

7. What happens if the brain is damaged.. • If only a small part of the brain is damaged (eg by a stroke or in an accident), people may have very specific problems • For example: • Frontal lobe damage caused by an accident with explosives (Phineas Gage – personality change) • Temporal lobe damage caused by surgery to prevent epilepsy (‘HM’ – loss of short term memory and memories for events for the 2 years before surgery)

8. Continued… • Dementia is caused by damage to the brain • We will be talking today about the cognitive and emotional problems experienced by people with dementia • Cognitive = memory / thinking • People who have suffered strokes may have similar kinds of problems • But remember, much about how the brain works remains a mystery…..

9. Working With People With Dementia - Task 1 • Symptoms/Signs of Dementia??? • Hint: Think about what the different parts of the brain do… • What percentage of people over 80 years of age suffer from dementia??? • How many types of dementia are there???

10. Working With Older People With Cognitive Problems • Dementia is a word that describes a progressive brain disease – it is not ‘normal’ aging • Different types of dementia effect different parts of the brain and therefore cause different problems • Alzheimer’s dementia is the most common type – early problems often include remembering new things and keeping track of the day/date. • As more and more people live longer, the number of people with dementia is increasing

11. Understanding Behaviour • Behaviour means something – it is a form of communication. • Behaviour is caused by our thoughts or feelings (emotions) • We work out from the way people are behaving what they are thinking and feeling • For example… • If somebody is shaking their fist, we would probably think that they are feeling angry.

12. But sometimes behaviour can be difficult to understand • And sometimes it is not as obvious as it seems… • For example…. • Imagine that you find your neighbour in floods of tears. He’d lost his job the week before and has a young family to support. What would you think? • (Actually, he’s won £2million on the lottery – they are tears of relief and joy!!)

13. Even though it may not seem to ‘make sense’ or to be ‘pointless’, the behaviour of people with dementia is no different from other people’s behaviour – it means something and is caused by thoughts and feelings • Because we do not know what it is like to have dementia, it can be more difficult for us to understand the thoughts, feelings and behaviour of people with dementia

14. TASK 2: How would You Feel If……………… • Give handout supplement 3 to the group and allow 5-10 minutes to complete it.

15. Discussion about Task 3 • Could the problems have been avoided?? • Communication?? • What could be done to cope with the thoughts and feelings in the three examples?? - Provide distraction: the more you know about the person, the better this will work - Feeling safe is vital….

16. Supporting People with Dementia We have to try to understand what the person with dementia may be thinking or feeling to be able to understand their behaviour Interaction with other people is crucial to the well being of people with dementia Understanding behaviour can help us to cope with it

17. A lot of people don’t like being told what to do – that does not change when someone gets dementia!! • Whenever possible, avoid confrontation and arguments • Try giving people time to calm down – go and do something else and when you return, don’t talk about what happened before…

18. Remember that we can all jump to the wrong conclusion. Be prepared to question yourself - is there another way of understanding the behaviour? • For example, pain is a very common cause of ‘challenging’ behaviour • It is very common to think that people with dementia are doing things to annoy us on purpose, but actually this is very unlikely

19. Some final thoughts… • Different ways of coping work for different people. It can take a few different approaches before you find one that works • Try to see the positive side of things – it is better if your way of coping works half the time than not at all • The better we feel in ourselves, the better we cope with stressful situations – look after yourself, too……