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

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

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www.teepasnow.com/presentations

Slides will be available for 2 weeks

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Copyright 2017, All Rights Reserved

Teepa Snow and Positive Approach® to Care

Any redistribution or duplication, in whole or in part, is strictly prohibited,

without the expressed written consent of Teepa Snow and

Positive Approach, LLC

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

Learning the Art of

Being an Advocate

and Partner in

Dementia Care

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

Realize:

It Takes Two to Tango…

or Tangle!

Learn How to Dance with Your

Partner!

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

Being ‘right’ doesn’t

necessarily translate

into a good outcome

for both of you

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

It’s the relationship

that is most critical

Not the outcome of

one encounter

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

So what is needed for a

successful journey?

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

Intervention and

Programming For:

- Physical activity

- Mental activity

- Social activity

- Spiritual involvement

- Well-being and self-worth

- Minimizing risky, challenging, or

dangerous behaviors

- Reducing anxiety or distress

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

Four Probabilities

On This Journey:

Road Blocks

Detours

Rest Stops

Scenic Overlooks and ‘Wow’ Moments

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

Road Blocks:

Something is not

working!

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

What Makes ‘Stuff’ Happen?

Six Pieces:

1.) The level of dementia now

2.) The person and who they have been:

personality, preferences, and history

3.) The environment: setting, sound, sights

4.) Other medical conditions and sensory

status

5.) The whole day: how things fit together

6.) How the helper helps: approach,

behaviors, words, actions, and reactions

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

What Can You Control? Or

Not!Control:

•The environment: setting, sound, sights

•The whole day and how things fit together

•How the helper helps:

Approach, behaviors, words, actions, and reactions

Not Control:

•The person and who they have been:

Personality, preferences and history

•The level of dementia now

•Other medical conditions and sensory status

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

So… What Should You Do?

- Plan for the probabilities

- Create environments that reduce risk

- Get skilled or find someone who is

- Get others on board

- Keep track of ‘what is’

- Watch for signs of changes

- Get help early: call or contact

- Be flexible

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Keep Travel Logs:

Behavior Log

Medication Log

Doctor Visit Log

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

Unexpected and Sometimes

Nasty Detours:

Be Ready for Possible Detours

They will Probably Happen at Some

Point!

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

Hospitalizations and

Dementia:

What Should Every Care Partner Know?

How Can You Be Ready?

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

Pain Management:

Comparing patients with dementia and

without dementia admitted for hip

fracture repair:

-Same number of procedures

-Same types of procedures

-¼ the pain medications

-3 times the antipsychotics

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

Some Statistics and

Information of Note:

- Feeding tubes are still being placed

- Feeding tube placement did not affect

outcome

- Having an infection coming in did worsen

risk for death

- Average survival with or without a feeding

tube was 6 months

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

Advance Planning Helps:

When advanced planning takes place in advance:

-There is greater satisfaction on the part of family

and care providers

-Quality of care is described as better

When decisions ‘forced’ by immediate circumstances:

-More dissatisfaction with decisions

-Longer hospital stays, more procedures done

-Survival outcomes at 3 months not changed

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

If admitted acutely ill with a

diagnosis of Dementia, the

primary diagnosis is typically:

- Pneumonia

- Aspiration pneumonia

- UTI

- Dehydration

- Fall related injury: fracture, head injury

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

Acute Problems With

Hospital Stays and Dementia:

- Falls and fall-related injuries

- Wandering or elopement attempts

- New onset incontinence

- Acute confusion: delirium

- Skin tears and skin breakdown

- Physical aggression toward care providers

- Pulling out tubes and monitoring equipment

- Inability to use call system

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

So:

- Hospitalizations happen

- Hospital stays are risky for those with

dementia

- Hospital stays are stressful for staff and

family members

- Standard communication and monitoring

systems are frequently ineffective

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

What Can We Do to Help?

Get Ready:

-Pack a hospital bag for them

-Build a team: share the load

-Consider your options: what is possible versus what makes sense

Evaluate How It Is Going:

-Now

-Probable outcome

-Re-consider

- Learn from the experience

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

A Great Resource:

Hospitalizations Happen

ADEAR - NIH

http://www.nia.nih.gov/Alzheimers/Publications/happens.htm

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

Rest Stops:

Take Advantage of ‘Rest Stops’

to Re-Energize

We all need a break, especially

care partners and advocates!

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

Why do we care about you?

- Being a dementia care partner is very hard work!

- Over 40% of the time we will lose a care partner before we lose the person with dementia

- Your emotional state affects the person you are caring for

- You are just as important as the person with dementia

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

Step #1:

Become Aware of Yourself:

-What is most important to you/top priorities?

-What is necessary for you to keep going?

-How much sleep?

-Physical health issues?

-Breaks?

-$$$?

-Time to meet other demands?

-Someone to listen?

-What is necessary for you to thrive?

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

Step #2:

Think and Remember:

- When have you been really miserable?

-What were you doing?

-Where were you?

-Was anyone with you?

-What made it awful?

-How did you get over it?

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

Step #3:

Think and Remember:

-When was the last time you felt really good?

-What were you doing?

-Where were you?

-Were you with someone? Who?

-What made it great?

-How did you feel?

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

Step #4:

Where are you now?

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

How You Feel is Real and

Important!

- However you feel is okay, it’s how you feel!

- It’s not about judgment, it’s about support!

- Acknowledge the feelings, then decide

what to do about it

- Is it how you want to feel?

- If yes, go with it

- If no, work to change it!

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

If You are Having a Hard Time:

Think about:

-What helps you

-What you need

-What is missing

-What you are struggling with

-Who else might help

-What will happen if you don’t do something

-What might happen if you do

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

Don’t Forget to Check Out:

The Beautiful Scenery

and

Moments of Joy

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

A Few More Ideas:

- Set aside a few minutes to do something

you enjoy: use a timer!

- Breathe

- Smile, laugh, look for some funnies

- Remember a good time

- Think about what do you get out of the

relationship

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

What is There to Laugh

About?

- What the person says

- What the person does

- What the person says versus what is done

- Your mistakes and ‘oops’ moments

- Your moments of joy

- Your moments of insight

- Their moments of insight, awareness, or humor

- Other people and their behaviors or words

- Things you see, hear, read

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

Breathe!

Take a deep breath in

Blow it all the way out

Take another breath in and blow it out

Take one final breath in and sing it out

Feel what happened to you

Look at what happened to the people around you

Think about how and when you might do this

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

Final Suggestions:

- Back off, change something and try again

- Adopt a ‘So What’ mentality

- Try a support group

- Accept yourself, and the person with dementia

- Look for the joy!

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

The content contained in this presentation is strictly for informational purposes. Therefore, if you wish to apply concepts o r ideas contained from this presentation you are

taking full responsibility for your actions. Neither the creators, nor the copyright holder shall in any event be held liable to any party for any direct, indirect, implied,

punitive, special, incidental or other consequential damages arising directly or indirectly from any use of this material, which is provided as is, and without warranties.

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

DISCLAIMER

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