Life is a Highway & Every Mile a Memory

Sharing life with individuals with dementia as a journey and not a destination

Life is a highway and Every Mile a Memory

Taking a look at the journey of individuals with Dementia and those

who travel the road with them.

What is Dementia?• Dementia is a loss of intellectual functions of

sufficient severity to interfere with a person’s daily functioning. It is not a disease in itself, but rather a group of symptoms which may accompany certain diseases or physical conditions

What is Alzheimer’s Disease• A degenerative brain disease of unknown cause

that is the most common form of dementia.• Usually starts in late middle age or in old age.• It results in progressive memory loss, impaired

thinking, disorientation, and changes in personality and mood.(Dementia)

• It leads in to a profound decline in cognitive and physical functioning.

• It is marked by the degeneration of brain neurons and by the presence of neurofibrillary tangles and plaques containing beta-amyloid

Normal Brain Function

Perception

• The brain is receiving information from our environment and all of our senses, what we see, what we smell, what we taste, what we feel, what we touch.

Memor

y

• The brain then calls upon our memory to interpret those things. • The brain cannot go to the next step if the memory piece is missing.

Action

Though

t

• After interpreting the information, the brain then can have an appropriate thought and/or take action

• If the brain did not interpret the information at all or it interpreted incorrectly, the behavior may not be appropriate.

So… all actions/behaviors begin with a perception.Normal Traffic Patterns in the brain becomes disrupted

when individuals have Alzheimer’s Disease.

Normal Traffic Patterns

Traffic Patterns in Individuals with Dementia

The “roads” or pathways are damaged and eventually are closed to traffic.

Roads/Pathways are closed due to the formation of plaque and tangles

Perception – Memory - ActionNeurons inside the brain of someone with Advanced Alzheimer’s Disease

• Information cannot be received properly

• A memory cannot be formed or interpreted

• Consequently the behavior may not be appropriate

A Digital Map of the Aging Brain could aid the diagnosis of Alzheimer's disease

A Digital Map of the Aging Brain could aid the diagnosis of Alzheimer's disease

• Brain scans of normal older adults were compared to brain scans of individuals with Cognitive Impairment.

• The atlas was able to pinpoint changes in patients brain structure that can be an underlying sign of Alzheimer's Disease

Our brain – The Super Highway

• Our brain is like a super highway, full speed ahead, merging traffic, passing lanes, traffic jams and the occasional rest stops..

• For those individuals with Alzheimer's disease, the brain changes, the superhighway shuts down and avenues that were familiar may now become a dead end.

• They may have to explore alternate routes

Alternate RoutesTaking the alternate route may feel strange and awkward at first

An alternate route may take longer at first. The more the route is taken the easier it will become

The alternate route will become familiar as long as the directions stay the same

Using Procedural Memory as the Alternate Route

• Also known as Implicit or the "know how memory”

• Knowing how without being able to explain how.

• Procedural memory remains robust in the face of early memory loss and even into dementia.

• This means that a task or activity that has been repeated or practiced over and over can be remembered.

Life is a Highway..I want to ride it all night long.

Entering the world of Dementia

This is going to be a difficult journey. I will need help and understanding from those who are taking this ride with me.

Alzheimer’s

Dementia

The DriverThe Resident

• The driver may not be able to go

as fast as he/she would like to go.

• The driver may be fearful of getting lost on this road less traveled.

• The driver may know that regardless of their driving skills, they may have to stop now and then and ask for directions.

• The driver may become frustrated and angry and this may lead to “road rage”

The Road MapThe life story

• Every individual has their own road map• This road map is their personal history.

• The map shows where they have been, what they have seen, the places and the things they have enjoyed and the people they have met along the way.

Every Mile a Memory!!

The GPSThe Care or Support Plan

The GPS will keep the driver and the co-pilot on track even when they miss a turn, or take the wrong exit.

A plan that is up to date

A plan that is adjusted as new roads open

A plan that shows not only highways but rest stops and construction zones.

A plan that shows speed limits and other conditions that could change the course.

The Co-pilot (Family and Staff)

• The driver should have an understanding co-pilot. • The co-pilot can take over when the driver starts

to feel tired . • When the driver is exhausted they know they can

let someone else drive for a while. • The Co-pilot should be following the same GPS as

the driver.• The Co-pilot recognizes when the vehicle is

“overheating” , knows when to stop and allow the vehicle to “cool off”

• The Co-pilot always needs to be willing and able to learn new ways and not be afraid to try a new road, when the road on which they are traveling becomes bumpy.

Knowledge – Knowing the wayGetting an understanding of what lies ahead on this journey

• Before you can be a co-pilot and get behind the wheel you will need some driving education. Knowledge is Power.

• Knowledge is the fuel needed to keep moving forward. Without knowledge you may simply run out of gas.– You should top off your tank daily by reading an

article, watching a short video, taking a class, or talking to an individual with dementia or their family.

– As your knowledge grows, your confidence builds and you will be better prepared to handle the curves ahead.

10 Early Warning Signs of Dementia

1. Memory loss that disrupts daily life2. Challenges in planning and problem solving3. Difficulty completing familiar tasks4. Confusion about dates and time5. Trouble with spacial images6. Word finding difficulties7. Misplacing things and loss of ability to retrace steps8. Poor judgment – more vulnerable9. Withdrawal from social events10. Changes in mood and personality

Early Stages of Alzheimer’s Dementia

One Way – Their Way!!! Mild Cognitive Impairment Use old habits and routines to get by Cover up their mistakes Get angry at others Fears getting “found out” Likes being valued Likes to tell old stories Likes to let you know who they are and where they have been Likes to give to others Does not adapt well to change

Teepa Snow; gems of caregiving

Early to Middle Stages of Alzheimer’s Dementia

They believe they have the “Right of Way” and don’t want “back seat drivers” telling them what to do !!• Depression is common• Cognitive loss may only be noticed by family and close friends• Repeats or skips steps• Fears being disrespected• Gets lost in time and space• Mis-remembers, so makes things up to fill in the holes• Wants to be in the action• Wants to help or supervise• Makes mistakes in social settings• Wants to talk about the past• Repetitive questions and stories

Teepa Snow; gems of caregiving

Middle Stages of Alzheimer’s Dementia

CAUTION: Not always aware of danger or risk SAFETY BECOMES AN ISSUE ! • In the moment• Into touch, fiddling and “getting into stuff”• Not aware of the “big picture”• Not aware of how their actions affect others• Like what they like and avoids what they don’t• Always in motion• All about exploration• All about sensations• Change in reasoning skills• Dis-inhibition• Withdrawal from social events Teepa Snow; gems of

caregiving

Middle to Late Stages of Alzheimer’s Dementia

FULL SPEED AHEAD OR STOPPEDSeldom stays still unless totally exhausted

• Big movement – loss of fine motor skills• Repetitive words • Repetitive actions and movement• Word soup• Loss of depth perception• Startles easily• May not remember names of family

members or friends Teepa Snow; gems of caregiving

Late Stages of Alzheimer’s Dementia• Moments of Clarity !!• Limited Movement• Reactions can be extreme• Needs stimulation• Limited awareness of the world

around them• Responds to tactile stimulation• Changes in sleeping patterns• Slow to respond

Teepa Snow; gems of caregiving