EMS Alzheimer’s TrainingEMS Alzheimer’s Training

Alzheimer’s Association of NENYAlzheimer’s Association of NENY

Hollie GrayHollie Gray

What is Alzheimer’s?What is Alzheimer’s?

Progressive brain disorderProgressive brain disorder Gradually destroys a person’s memory, Gradually destroys a person’s memory,

ability to learn, reason, make judgments, ability to learn, reason, make judgments, communicate, and carry out daily activities.communicate, and carry out daily activities.

How is Alzheimer’s changing the How is Alzheimer’s changing the brain?brain?

Alzheimer’s Disease Alzheimer’s Disease leads to nerve cell leads to nerve cell death.death.

AD causes tissue loss AD causes tissue loss throughout the brainthroughout the brain

Overtime the brain Overtime the brain shrinks dramatically.shrinks dramatically.

More changes in the brain…More changes in the brain…

The cortex of the brain The cortex of the brain shrivels up.shrivels up.

Hippocampus shrinks Hippocampus shrinks severally.severally.

Ventricles in the brain Ventricles in the brain grow larger.grow larger.

What is causing these changes?What is causing these changes?

Scientists are not Scientists are not 100% sure what is 100% sure what is causing cell death and causing cell death and brain shrinkage, but brain shrinkage, but they have suspects.they have suspects.

Prime suspects are Prime suspects are plaques and tangles plaques and tangles that occur in the brain that occur in the brain of person with AD.of person with AD.

Lets talk about plaque…Lets talk about plaque…

Formed by beta-amyloid protein buildup. Formed by beta-amyloid protein buildup. This protein comes from a larger protein that is This protein comes from a larger protein that is

involved in mylenation of cells.involved in mylenation of cells. The abnormal clumps of protein that form we call The abnormal clumps of protein that form we call

plaque may be blocking cell to cell signaling.plaque may be blocking cell to cell signaling. Scientists believe it may also trigger an immune Scientists believe it may also trigger an immune

response that causes the disabled cells to be response that causes the disabled cells to be destroyed.destroyed.

Lets talk about tangles…Lets talk about tangles…

Tangles destroy a cell Tangles destroy a cell transport system made transport system made of proteins.of proteins.

The tau protein keeps The tau protein keeps the tracks straight. the tracks straight.

When tau fails to do When tau fails to do it’s job transport can it’s job transport can not take place and cell not take place and cell death results.death results.

Progression through the BrainProgression through the Brain

Plaques and tangles tend to Plaques and tangles tend to spread through the brain in a spread through the brain in a predictable pattern.predictable pattern.

First -Learning and Memory First -Learning and Memory Second-Speaking, Second-Speaking,

Understanding, and Understanding, and understanding relation of ones understanding relation of ones self to things around them.self to things around them.

Third- Communication, Third- Communication, recognizing family and friends, recognizing family and friends, and care for ones self is lost.and care for ones self is lost.

*** NOTE THIS IS A GENERAL *** NOTE THIS IS A GENERAL PATTERNPATTERN

Brain of Normal Elderly Brain of Normal Elderly PersonPerson

Brain of Alzheimer’s Brain of Alzheimer’s PatientPatient

Normal Elderly Brain vs. Brain of AD Normal Elderly Brain vs. Brain of AD PatientPatient

Large Brain Size

Cell Functioning Normal Brain activity

Brain Shrinkage

Cell Death Plaque Build Up Abnormal Brain activity

Symptoms of ADSymptoms of AD

Memory lossMemory loss DisorientationDisorientation Problems doing complicated tasksProblems doing complicated tasks Language problemsLanguage problems Lack of concentrationLack of concentration Loss of visuo-spatial skillsLoss of visuo-spatial skills

How many people are affected by How many people are affected by AD Nationally?AD Nationally?

4.5+ have AD4.5+ have AD 2+ million have another Dementia2+ million have another Dementia Year 2030 40-70% increase expected.Year 2030 40-70% increase expected.

How many people are affected How many people are affected locally? locally?

Within the 17 county region of NENY 1.5 Within the 17 county region of NENY 1.5 million people are living.million people are living.

Of the 1.5 million it is estimated that 40,000 Of the 1.5 million it is estimated that 40,000 are suffering from the challenges associated are suffering from the challenges associated with AD.with AD.

Mortality RatesMortality Rates

7th leading cause of death.7th leading cause of death.

65,82965,829 Number does NOT reflect any of the “other” Number does NOT reflect any of the “other”

dementia’s.dementia’s. 45,000 45,000 44thth leading cause of death in women. leading cause of death in women.

Risk FactorsRisk Factors

AGEAGE HeredityHeredity SexSex LifestyleLifestyle EnvironmentEnvironment Head InjuryHead Injury

Prevention?Prevention?

NO way to prevent adNO way to prevent ad NO VaccineNO Vaccine ARE ways to reduce risk factors.ARE ways to reduce risk factors.

Reducing Risk FactorsReducing Risk Factors

Adopt a Brain Healthy DietAdopt a Brain Healthy Diet Numbers Count Numbers Count Remain Socially ActiveRemain Socially Active Remain Mentally ActiveRemain Mentally Active ExerciseExercise

Complications Sometimes Complications Sometimes Associated with Alzheimer’s DiseaseAssociated with Alzheimer’s Disease PneumoniaPneumonia InfectionsInfections FallsFalls Pulmonary EmbolismPulmonary Embolism Violent BehaviorViolent Behavior Wandering (Person may get lost)Wandering (Person may get lost)

Things to consider when Assessing Things to consider when Assessing A Person with AD…A Person with AD…

Several medications. Several medications. UUnreliable informant.nreliable informant. Easily overwhelmed or frustrated. Easily overwhelmed or frustrated. Ask simple yes or no questionsAsk simple yes or no questions

Things to consider when Assessing Things to consider when Assessing A Person with AD continued…A Person with AD continued…

Tell the person who you are and why you are there even if Tell the person who you are and why you are there even if it seems obvious.it seems obvious.

Give Positive Instructions.Give Positive Instructions. Approach using a non-aggressive stance.Approach using a non-aggressive stance. Use your NON Verbal communication. Use your NON Verbal communication. Avoid over stimulation.Avoid over stimulation. Check for a Safe Return bracelet that will indicate the Check for a Safe Return bracelet that will indicate the

person has a memory impairment.person has a memory impairment. Smile and Keep eye contact.Smile and Keep eye contact. Be patient a person with AD may take longer to assess.Be patient a person with AD may take longer to assess.

How we communicateHow we communicate

Body Language 55%

Verbal 7%Pitch and Tone 38%

Guidelines for CommunicationGuidelines for Communication

1.1. Call the person by the name she prefersCall the person by the name she prefers2.2. Talk to him or her as an adultTalk to him or her as an adult3.3. Give simple directions, one step at a timeGive simple directions, one step at a time4.4. Use the same wordsUse the same words5.5. Avoid pronouns . Avoid pronouns . 6.6. Speak slowly and clearlySpeak slowly and clearly7. Don’t argue7. Don’t argue8. Ask for what you want8. Ask for what you want9. Say exactly what you mean9. Say exactly what you mean10. Offer multiple cues10. Offer multiple cues

Making a Positive Physical ApproachMaking a Positive Physical Approach

Come from the frontCome from the front Go slowGo slow Get to the sideGet to the side Get lowGet low Offer your hand (palm up)Offer your hand (palm up) Use the person’s preferred nameUse the person’s preferred name Wait for a responseWait for a response

Community Based Services To Community Based Services To Help Individuals and Families Help Individuals and Families

dealing with AD…dealing with AD… Adult Day ProgramsAdult Day Programs Home Health Agencies Home Health Agencies HospiceHospice Meals on Wheels Meals on Wheels Respite (Companion) Care Respite (Companion) Care Safe Return Safe Return Support Groups Support Groups Transportation ServicesTransportation Services

QUESTIONS???QUESTIONS???

1-800-272-39001-800-272-390024 Hours a Day, 7 days a week24 Hours a Day, 7 days a week

24hour helpline24hour helpline Information and referralInformation and referral Care consultationCare consultation Safe ReturnSafe Return Support GroupsSupport Groups