Snow Decodes the Meaning of Dementia Behaviors

Abstract

LOUISVILLE, KY – Teepa Snow, MS, OT, raised her voice, cursed, and generally made her audience uncomfortable – at times, even defensive. But at the end of her session “Decoding the Meaning of Dementia Behaviors,” at the AMDA Annual Conference, participants understood how to move from reacting to responding and communicating with their residents who have dementia. Through role playing – portraying residents, family members, and staff – Ms. Snow and her team demonstrated how to identify, interpret, and respond to verbal and nonverbal cues in ways that de-escalate behavior-related situations safely without pharmacologic interventions.Ms. Snow, an advocate for those living with dementia and other forms of brain change, acknowledged that behaviors “aren't an easy thing to fix,” adding that dementia changes over time. So, an approach or intervention that works with someone today make not work next week or next month. With dementia, she said, “The brain is literally shrinking. You'll lose two-thirds of brain tissue before this disease kills you.”An unmet need is the cause of most behaviors in people with dementia, she said. “They need or want something and are waiting for someone to help them. We want so badly to fix them. But, instead, we have to create the right setting and the right care so they can shine with the abilities they have left.”Instead of using negative labels – such as severely demented – for people with Alzheimer's and related brain diseases, Ms. Snow offered a “Living Gems” system to assess people and clarify their level of illness. Once the team determines what type of “gem” an individual is, they can focus on the best way to approach and work with them. The gem types — sapphire, diamond, emerald, amber, ruby, and pearl — represent different levels of dementia and loss of brain function.For example, she said, “With diamonds, it's their way or the highway. They are always right, so you can't argue with them. They are all about money, rules, and control. They respect authority, but you need to be respectful of them and ask their permission before you do anything.”Ms. Snow challenged the group to commit to change on their return home after the conference. “It's so easy to do what we've always done, but we can learn how to set down new neuropathways, starting by building these in ourselves.” LOUISVILLE, KY – Teepa Snow, MS, OT, raised her voice, cursed, and generally made her audience uncomfortable – at times, even defensive. But at the end of her session “Decoding the Meaning of Dementia Behaviors,” at the AMDA Annual Conference, participants understood how to move from reacting to responding and communicating with their residents who have dementia. Through role playing – portraying residents, family members, and staff – Ms. Snow and her team demonstrated how to identify, interpret, and respond to verbal and nonverbal cues in ways that de-escalate behavior-related situations safely without pharmacologic interventions. Ms. Snow, an advocate for those living with dementia and other forms of brain change, acknowledged that behaviors “aren't an easy thing to fix,” adding that dementia changes over time. So, an approach or intervention that works with someone today make not work next week or next month. With dementia, she said, “The brain is literally shrinking. You'll lose two-thirds of brain tissue before this disease kills you.” An unmet need is the cause of most behaviors in people with dementia, she said. “They need or want something and are waiting for someone to help them. We want so badly to fix them. But, instead, we have to create the right setting and the right care so they can shine with the abilities they have left.” Instead of using negative labels – such as severely demented – for people with Alzheimer's and related brain diseases, Ms. Snow offered a “Living Gems” system to assess people and clarify their level of illness. Once the team determines what type of “gem” an individual is, they can focus on the best way to approach and work with them. The gem types — sapphire, diamond, emerald, amber, ruby, and pearl — represent different levels of dementia and loss of brain function. For example, she said, “With diamonds, it's their way or the highway. They are always right, so you can't argue with them. They are all about money, rules, and control. They respect authority, but you need to be respectful of them and ask their permission before you do anything.” Ms. Snow challenged the group to commit to change on their return home after the conference. “It's so easy to do what we've always done, but we can learn how to set down new neuropathways, starting by building these in ourselves.”