so I’m here today to talk about dementia
and the reason I’m here is because I’ve
found a better way to do it a way that
helps both the people who have it and
their families so why should we as
citizens of America as families be
concerned about dementia that’s
something we think of being taken care
of by our medical professionals well
there’s two really good reasons number
one this is a an epidemic
it’s still growing and we don’t have a
cure so last year 2016 5.5 million
Americans were diagnosed with
Alzheimer’s and Alzheimer’s represents
about 60 to 80 percent of the dimensions
that we experience so that would be
about seven point eight million people
diagnosed with dementia and yet only
about half of us go to a doctor and are
diagnosed so that means last year alone
2016 over 15 million families began
struggling to live with someone
experiencing progressive cognitive
impairment and that’s not the biggest
problem that we face because this year
10,000 Americans turned 60 every day and
by 2050 we will have twice as many
people living over the age of 65 and
that’s why we talk about our silver
tsunami but if you have an ageing
population then you have a shrinking
workforce right now we have a caregiver
shortage and in some places in the
country it’s critical but it’s going to
get a whole lot worse and so the reason
we as families as citizens should be
thinking about dementia and how we can
live with it and how we can work with it
is because a lot of us are going to be
forced to do that
in the coming decade and if you have
someone in your family now or somebody
that you know that it is experiencing
dementia you you already know this is a
very expensive disease but it’s an
emotionally devastating one for the
family and for the person experiencing
it so why is that you know some people
are aware that they are becoming
impaired so think about what it would
feel like if you woke up tomorrow
morning and you could not figure out
where your socks were and it wasn’t
because you were in a hotel room you
walk into the kitchen and you can’t make
coffee with your own coffee maker or you
walk out of work one night and you’re
looking at a parking lot full of cars
and you cannot think of what your car
looks like it’s scary and and then you
go to the doctor and your doctor says
yeah you know this looks like dementia
and now you know you’ve got 8 to 12
years of a life expectancy and if
something else doesn’t kill you first
you are looking at becoming bedridden
and in need of complete care so people
are terrified and rightfully so but then
other people are not aware they are not
able to comprehend that it’s their brain
that is changing and so these people
don’t feel as much afraid as they feel
frustrated and angry because of course
it seems to them that everybody around
them is being difficult hiding things
losing things accusing them of doing
things that they did not do and so these
people begin to feel a little persecuted
maybe a little paranoid and so they’re
more angry than afraid but how do we
behave when we’re angry or afraid we’re
not very reasonable we’re not very easy
to live with
and so even before you take into account
what happens
to communication and interactions when
your cognitive skills are fading away it
is really stressful to try to live with
somebody who has dementia but you know
it really doesn’t have to be as bad as
it has been and it’s it’s not expensive
to fix this and we don’t have to all go
to medical school and become doctors or
nurses or even CNAs and you don’t even
need a college education but what we
have to do is step back and look at
dementia from a different approach so
how do we currently look at dementia we
see it as a medical problem a disease
something that has symptoms these
symptoms are called dementia related
behaviors and we’ve got a whole list of
terms to talk about them with so if I
went to the doctor and my doctor said to
me you know Judy I really think you’ve
got cancer then immediately I would want
a referral to a specialist probably to a
surgeon
and I would want to know everything
there is to know about my cancer how far
along it is where it is whether it’s red
all possible treatments and I’d want all
of my doctors focused on that cancer
because there’s treatments and I’ve got
a really good chance I’m not gonna have
to live the rest of my life with it
so I want everyone focused on what’s
wrong with me
my disability because we’ve got
treatment and with dementia we do the
same thing we we go straight to the
doctor as well we should for diagnosis
but this is one of those instances where
you know we think we’ve been seeing
something clearly we think we’re doing
the best we can but there’s no way to
know that we could do it better until we
actually
look at it from a different angle and
and so with dementia yes let’s get
diagnosis but if we don’t have a
reliable treatment one that works for
everybody one that works every time if
we don’t have a cure why are we still
then turning to medical professionals
focused on on what’s wrong under
disabilities the person is displaying
what why don’t we focus on the person
because if you have to live with
something the rest of your life it
wouldn’t it make more sense wouldn’t it
be more helpful if we knew what you
could do rather than what you couldn’t
do and if we knew how it was affecting
you emotionally this condition that’s
what we need to know if we have to live
with something and actually you know
this is an approach that’s already in
use we call it being person-centered or
person directive and when we focus on a
person’s condition and the person
themselves and we’re paying attention to
their strengths rather than what’s wrong
with them we call that strength based
care and and that we use it with other
populations right now it’s very
effective with adults who are
developmentally disabled but you know
many of us here today also have been
using strength based care some of us for
quite a few decades because strength
based care is how we raise children so
think about it you know when you have a
child you look at your child and you
evaluate the child’s cognitive
development and then you shape the
environment so the child will be safe
and comfortable and then you pay
attention to the child’s emotional needs
and you try to meet those needs so if
you have a toddler you Institute nap
time but if you have a teenager
it’s curfews and so if you have a
four-year-old we we don’t think the
four-year-old will live and be
comfortable and safe in the same
environment of that the
fourteen-year-old would so so we’ve been
doing this for centuries with our
children if that’s the case how come
we’re failing so badly with their loved
ones when they develop dementia if you
know it’s because it’s exactly the
opposite it’s counterintuitive to
everything we’ve been doing all their
lives children are learning and growing
and improving every day gaining skills
cognitively but when one of our loved
ones develops demented they are not able
to learn they’re not gaining and skills
they’re losing skills and Trust in
America it’s really hard to not seek
solution or improvement or hope but
there’s a different kind of hope and and
that’s why I’m here today because we can
do it we can look after people who have
dementia if we know what their strengths
are so here’s their strengths and this
is a picture of dementia this is what
dementia looked to me looked like to me
after I’d worked for about eight years
with many people who lived alone in
their own homes even though they had
dementia so it doesn’t look medical I
haven’t listed the types of dementia
people can get I don’t have a list there
of dementia related behaviors what this
is is the set of six skills that every
one of us can use at will with our
healthy brains and right now while I’m
talking I’m primarily using my rational
thinking skills my memory and
mindfulness the skills on the left-hand
side and each of you are primarily doing
the same your
using the skills on the left-hand side
and those are the three skills that the
person who’s experiencing dementia will
lose but that’s not really bad news if
they have a companion family somebody
who cares who can take care of those
things for them because the really fun
stuff is all on the right-hand side
right intuitive thought intuitive
thought is how we access beauty enjoy
nature enjoy music it’s creativity it’s
also how we feel our own feelings and
it’s how we interpret and receive the
feelings of the people around us and
it’s our experiential selves that part
of us that exists right now in the
moment receiving all kinds of sensory
stimulation information from our five
senses that’s what keeps us connected
and and mindlessness isn’t it lovely
that we don’t have to think ourselves
consciously through every task we do
every day I can make coffee in my sleep
I do it regularly so the person with
dementia can do the same thing they can
use mindlessness skills automatic
thinking scripts muscle memory but only
for as long as we don’t move them out of
their familiar location so example
examples always work best Bob and Anne
high school sweethearts married for six
decades
Anne was diagnosed five years ago with
dementia and Bob is becoming exhausted
from her dementia related behaviors and
the other morning they had to go down to
downtown to a dentist appointment so Bob
sits and down on the couch he kisses her
on the forehead and he says darlin why
don’t you put your shoes and socks on
and I’ll go take care of the dog
and he leaves the room in a minute later
he comes back and there’s an and sitting
on the couch she has one foot bare one
shoe on and she’s trying to put a sock
over the toe of the shoe now Bob feels a
little flash of frustration a little bit
of irritation and a little bit of panic
because they really need to hurry and so
as he comes into the room he says no
honey no you know how to put on shoes
and socks you’ve been doing it your
whole life
socks first socks first and he hurries
down the hall to brush his teeth he
comes back in a few minutes later now
Anna’s sitting there holding a sock and
now he is frustrated and now he is
worried because they’ve got to get ready
before the daughter comes and so he
reaches for the sock and he says fine
I’ll do it and she reaches for him and
she hits him and when the daughter
arrives a few minutes later both parents
are in tears and Bob is trying to
restrain and and Anna’s trying to hit
him and this is what we call combative
behavior right it’s symptom of dementia
and so what happened what did Bob do
wrong why did it happen that way
Bob didn’t realize that but he asked and
to do several things that she did not
have the ability to do
she doesn’t have rational thought so she
can’t follow the steps in a process and
he asked her to do two things at once
shoes and socks and then he gave her
directions socks first and he asked her
to use her remembering self or memory to
recall something she’d done her whole
life and in doing that he put her on the
spot and he embarrassed her and that
never goes really well in a marital
relationship and the mindlessness tools
that she probably still had at her
disposal if she don’t even give in one
step in the task went right out the
window when that turned into a really
negative event in her life
how could Bob have done it differently
if Bob knew what her disabilities were
but he knew what her strengths were if
Bob knew that Ann had fully operational
intuitive thought and was picking up
every one of his emotions like radar
then he could have been very careful not
to display or feel his frustration what
if he dealt with the whole thing
differently let’s say bob says he ran
sit down on the couch kisses her on the
forehead and says here honey here’s your
favorite blue socks I love the way they
bring out the color in your beautiful
blue eyes why don’t you put your socks
on and I’ll go put Muffy out and a
minute later he comes back in and maybe
she got the socks on maybe she didn’t
and he kneels down and he helps her put
the socks on then he says wonderful
darling thanks so much
how about you put your shoes on well I
go brush my teeth
well this time nobody got put in the
spot nobody’s been asked to do something
they cannot do and and this time Ann
feels like she has a partner she feels
like she and her husband are working
together like they always did and so
this time maybe she did succeed in
putting on shoes as a single task but
one thing that happened for sure is her
experience Hill self continued to
experience the present in a very
comfortable way she felt loved she felt
safe and you know it doesn’t matter
whether we are children or adults
whether we have a disease or we don’t
have a disease and it doesn’t matter
whether we have dementia or not we all
have the same human emotional needs and
when somebody’s experiencing progressive
cognitive impairment yeah those skills
they have at their disposal are changing
they’re going to be using the three on
the right hand side of my table but they
still need to feel secure and they still
need to feel successful in social
situations and have a sense of
well-being
in control able to make decisions it
doesn’t go away when we get dementia so
that’s why I’m here today we can do this
we we raise children we’ve been doing
that for decades centuries entire
civilizations and we can be kind to
people as they get dementia because we
can we can learn this simple little
pattern of the skills they retain so
thank you and I look forward to having
many families joining in this new way of
approaching dementia care
[Applause]
and the reason I’m here is because I’ve
found a better way to do it a way that
helps both the people who have it and
their families so why should we as
citizens of America as families be
concerned about dementia that’s
something we think of being taken care
of by our medical professionals well
there’s two really good reasons number
one this is a an epidemic
it’s still growing and we don’t have a
cure so last year 2016 5.5 million
Americans were diagnosed with
Alzheimer’s and Alzheimer’s represents
about 60 to 80 percent of the dimensions
that we experience so that would be
about seven point eight million people
diagnosed with dementia and yet only
about half of us go to a doctor and are
diagnosed so that means last year alone
2016 over 15 million families began
struggling to live with someone
experiencing progressive cognitive
impairment and that’s not the biggest
problem that we face because this year
10,000 Americans turned 60 every day and
by 2050 we will have twice as many
people living over the age of 65 and
that’s why we talk about our silver
tsunami but if you have an ageing
population then you have a shrinking
workforce right now we have a caregiver
shortage and in some places in the
country it’s critical but it’s going to
get a whole lot worse and so the reason
we as families as citizens should be
thinking about dementia and how we can
live with it and how we can work with it
is because a lot of us are going to be
forced to do that
in the coming decade and if you have
someone in your family now or somebody
that you know that it is experiencing
dementia you you already know this is a
very expensive disease but it’s an
emotionally devastating one for the
family and for the person experiencing
it so why is that you know some people
are aware that they are becoming
impaired so think about what it would
feel like if you woke up tomorrow
morning and you could not figure out
where your socks were and it wasn’t
because you were in a hotel room you
walk into the kitchen and you can’t make
coffee with your own coffee maker or you
walk out of work one night and you’re
looking at a parking lot full of cars
and you cannot think of what your car
looks like it’s scary and and then you
go to the doctor and your doctor says
yeah you know this looks like dementia
and now you know you’ve got 8 to 12
years of a life expectancy and if
something else doesn’t kill you first
you are looking at becoming bedridden
and in need of complete care so people
are terrified and rightfully so but then
other people are not aware they are not
able to comprehend that it’s their brain
that is changing and so these people
don’t feel as much afraid as they feel
frustrated and angry because of course
it seems to them that everybody around
them is being difficult hiding things
losing things accusing them of doing
things that they did not do and so these
people begin to feel a little persecuted
maybe a little paranoid and so they’re
more angry than afraid but how do we
behave when we’re angry or afraid we’re
not very reasonable we’re not very easy
to live with
and so even before you take into account
what happens
to communication and interactions when
your cognitive skills are fading away it
is really stressful to try to live with
somebody who has dementia but you know
it really doesn’t have to be as bad as
it has been and it’s it’s not expensive
to fix this and we don’t have to all go
to medical school and become doctors or
nurses or even CNAs and you don’t even
need a college education but what we
have to do is step back and look at
dementia from a different approach so
how do we currently look at dementia we
see it as a medical problem a disease
something that has symptoms these
symptoms are called dementia related
behaviors and we’ve got a whole list of
terms to talk about them with so if I
went to the doctor and my doctor said to
me you know Judy I really think you’ve
got cancer then immediately I would want
a referral to a specialist probably to a
surgeon
and I would want to know everything
there is to know about my cancer how far
along it is where it is whether it’s red
all possible treatments and I’d want all
of my doctors focused on that cancer
because there’s treatments and I’ve got
a really good chance I’m not gonna have
to live the rest of my life with it
so I want everyone focused on what’s
wrong with me
my disability because we’ve got
treatment and with dementia we do the
same thing we we go straight to the
doctor as well we should for diagnosis
but this is one of those instances where
you know we think we’ve been seeing
something clearly we think we’re doing
the best we can but there’s no way to
know that we could do it better until we
actually
look at it from a different angle and
and so with dementia yes let’s get
diagnosis but if we don’t have a
reliable treatment one that works for
everybody one that works every time if
we don’t have a cure why are we still
then turning to medical professionals
focused on on what’s wrong under
disabilities the person is displaying
what why don’t we focus on the person
because if you have to live with
something the rest of your life it
wouldn’t it make more sense wouldn’t it
be more helpful if we knew what you
could do rather than what you couldn’t
do and if we knew how it was affecting
you emotionally this condition that’s
what we need to know if we have to live
with something and actually you know
this is an approach that’s already in
use we call it being person-centered or
person directive and when we focus on a
person’s condition and the person
themselves and we’re paying attention to
their strengths rather than what’s wrong
with them we call that strength based
care and and that we use it with other
populations right now it’s very
effective with adults who are
developmentally disabled but you know
many of us here today also have been
using strength based care some of us for
quite a few decades because strength
based care is how we raise children so
think about it you know when you have a
child you look at your child and you
evaluate the child’s cognitive
development and then you shape the
environment so the child will be safe
and comfortable and then you pay
attention to the child’s emotional needs
and you try to meet those needs so if
you have a toddler you Institute nap
time but if you have a teenager
it’s curfews and so if you have a
four-year-old we we don’t think the
four-year-old will live and be
comfortable and safe in the same
environment of that the
fourteen-year-old would so so we’ve been
doing this for centuries with our
children if that’s the case how come
we’re failing so badly with their loved
ones when they develop dementia if you
know it’s because it’s exactly the
opposite it’s counterintuitive to
everything we’ve been doing all their
lives children are learning and growing
and improving every day gaining skills
cognitively but when one of our loved
ones develops demented they are not able
to learn they’re not gaining and skills
they’re losing skills and Trust in
America it’s really hard to not seek
solution or improvement or hope but
there’s a different kind of hope and and
that’s why I’m here today because we can
do it we can look after people who have
dementia if we know what their strengths
are so here’s their strengths and this
is a picture of dementia this is what
dementia looked to me looked like to me
after I’d worked for about eight years
with many people who lived alone in
their own homes even though they had
dementia so it doesn’t look medical I
haven’t listed the types of dementia
people can get I don’t have a list there
of dementia related behaviors what this
is is the set of six skills that every
one of us can use at will with our
healthy brains and right now while I’m
talking I’m primarily using my rational
thinking skills my memory and
mindfulness the skills on the left-hand
side and each of you are primarily doing
the same your
using the skills on the left-hand side
and those are the three skills that the
person who’s experiencing dementia will
lose but that’s not really bad news if
they have a companion family somebody
who cares who can take care of those
things for them because the really fun
stuff is all on the right-hand side
right intuitive thought intuitive
thought is how we access beauty enjoy
nature enjoy music it’s creativity it’s
also how we feel our own feelings and
it’s how we interpret and receive the
feelings of the people around us and
it’s our experiential selves that part
of us that exists right now in the
moment receiving all kinds of sensory
stimulation information from our five
senses that’s what keeps us connected
and and mindlessness isn’t it lovely
that we don’t have to think ourselves
consciously through every task we do
every day I can make coffee in my sleep
I do it regularly so the person with
dementia can do the same thing they can
use mindlessness skills automatic
thinking scripts muscle memory but only
for as long as we don’t move them out of
their familiar location so example
examples always work best Bob and Anne
high school sweethearts married for six
decades
Anne was diagnosed five years ago with
dementia and Bob is becoming exhausted
from her dementia related behaviors and
the other morning they had to go down to
downtown to a dentist appointment so Bob
sits and down on the couch he kisses her
on the forehead and he says darlin why
don’t you put your shoes and socks on
and I’ll go take care of the dog
and he leaves the room in a minute later
he comes back and there’s an and sitting
on the couch she has one foot bare one
shoe on and she’s trying to put a sock
over the toe of the shoe now Bob feels a
little flash of frustration a little bit
of irritation and a little bit of panic
because they really need to hurry and so
as he comes into the room he says no
honey no you know how to put on shoes
and socks you’ve been doing it your
whole life
socks first socks first and he hurries
down the hall to brush his teeth he
comes back in a few minutes later now
Anna’s sitting there holding a sock and
now he is frustrated and now he is
worried because they’ve got to get ready
before the daughter comes and so he
reaches for the sock and he says fine
I’ll do it and she reaches for him and
she hits him and when the daughter
arrives a few minutes later both parents
are in tears and Bob is trying to
restrain and and Anna’s trying to hit
him and this is what we call combative
behavior right it’s symptom of dementia
and so what happened what did Bob do
wrong why did it happen that way
Bob didn’t realize that but he asked and
to do several things that she did not
have the ability to do
she doesn’t have rational thought so she
can’t follow the steps in a process and
he asked her to do two things at once
shoes and socks and then he gave her
directions socks first and he asked her
to use her remembering self or memory to
recall something she’d done her whole
life and in doing that he put her on the
spot and he embarrassed her and that
never goes really well in a marital
relationship and the mindlessness tools
that she probably still had at her
disposal if she don’t even give in one
step in the task went right out the
window when that turned into a really
negative event in her life
how could Bob have done it differently
if Bob knew what her disabilities were
but he knew what her strengths were if
Bob knew that Ann had fully operational
intuitive thought and was picking up
every one of his emotions like radar
then he could have been very careful not
to display or feel his frustration what
if he dealt with the whole thing
differently let’s say bob says he ran
sit down on the couch kisses her on the
forehead and says here honey here’s your
favorite blue socks I love the way they
bring out the color in your beautiful
blue eyes why don’t you put your socks
on and I’ll go put Muffy out and a
minute later he comes back in and maybe
she got the socks on maybe she didn’t
and he kneels down and he helps her put
the socks on then he says wonderful
darling thanks so much
how about you put your shoes on well I
go brush my teeth
well this time nobody got put in the
spot nobody’s been asked to do something
they cannot do and and this time Ann
feels like she has a partner she feels
like she and her husband are working
together like they always did and so
this time maybe she did succeed in
putting on shoes as a single task but
one thing that happened for sure is her
experience Hill self continued to
experience the present in a very
comfortable way she felt loved she felt
safe and you know it doesn’t matter
whether we are children or adults
whether we have a disease or we don’t
have a disease and it doesn’t matter
whether we have dementia or not we all
have the same human emotional needs and
when somebody’s experiencing progressive
cognitive impairment yeah those skills
they have at their disposal are changing
they’re going to be using the three on
the right hand side of my table but they
still need to feel secure and they still
need to feel successful in social
situations and have a sense of
well-being
in control able to make decisions it
doesn’t go away when we get dementia so
that’s why I’m here today we can do this
we we raise children we’ve been doing
that for decades centuries entire
civilizations and we can be kind to
people as they get dementia because we
can we can learn this simple little
pattern of the skills they retain so
thank you and I look forward to having
many families joining in this new way of
approaching dementia care
[Applause]
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