© Positive Approach to Care® to be reused only with ......Why Do We Laugh? Something Seems ‘Funny’ to Us: •What we see •What we hear •What we experience •What we see

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Humor and Dementia Care

and

Creative and Practical Tips

for Getting Through the Day


Laughing Versus Surviving:

Our goals for you:

•Understanding of what’s happening with

the person with dementia

•Support so you can survive

•Insight for the moments of joy


Why is Humor Important?

• Laughter is healthy

• Laughter connects you to others

• Laughter makes your brain work better

• Laughter makes you learn faster

• Laughter energizes you

• Laughter refocuses your thoughts

• Laughter relieves stress and worry

• Laughter heals

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Why Do We Laugh?

Four Theories:

•Superiority Theory

•Relief Theory

•Incongruity Theory

•Play Theory


Some Types of Humor:

Funny stories

Funny comments

Jokes

Professional humor:

topic-specific humor

Puns or word play

Cartoons (TV)

Riddles

Mimicry

Slapstick

Self-deprecation

Sarcastic

Dry or wry

Caricature

Photos or pictures

Video clips

Comics

Tongue twisters


Why Do We Laugh?

Something Seems ‘Funny’ to Us:

•What we see

•What we hear

•What we experience

•What we see compared to what we hear

•What we see compared to our experiences

•What we experience compared to what we

expected

•What other people say or do, or say versus do

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Finding the Right Humor for

You:

Your sense of humor may stay the same

Your sense of humor may change over time

Ability to understand humor will change

over time


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, etc.


Humor for a Person Living

with Dementia:

• ‘Silly’ or ‘stupid’ may become ‘funny’

• ‘Funny’ may become ‘not funny’!

• It may take longer for them to ‘get it’ – slow

down

• Familiar stories and jokes may become more

fun than those they don’t already know

• They may want more visual humor versus

written or spoken humor

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Laughter Breeds Laughter:

• Hang out with happy people

• Decide to look on the bright side - for right

now

• Think about what might be funny about this

• Expose yourself to funny things: try some

different resources and types

• Work your way up from a smile to belly

laugh


Put Humor In Your Day:

• Make time for having fun

• Make time to laugh

• Smile at someone

• Smile at yourself in the mirror

• When you are having a hard time:

•Stop

•Take a break

•Laugh

•Try again


When the Going Gets Tough

Take a Break and Change

Gears:• Back off

• Breathe, and then and change focus for

a few minutes:

•Change place and space

•Go to a different sensory experience

•Alter the social situation

•Find a different surface for some part of

you

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Here Are Some Ideas…


History According to Kids:

Ancient Egypt was old. It was inhabited by

gypsies and mummies who all wrote in

hydraulics. They lived in the Sarah Dessert.

The climate Of the Sarah is such that all the

inhabitants have to live elsewhere.

Solomon had three hundred wives and seven

hundred porcupines. He was an actual

hysterical figure as well as being in the bible.

It sounds like he was sort of busy too.


Socrates was a famous old Greek teacher who went around giving people advice. They killed him. He later died from an overdose of wedlock which is apparently poisonous. After his death, his career suffered a dramatic decline.

In the first Olympic games, Greeks ran races, jumped, hurled biscuits, and threw the java. The games were messier then than they show on TV now.

Madman Curie discovered radio. She was the first woman to do what she did. Other women have become scientists since her but they didn't get to find radios because they were already taken.

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Sir Francis Drake circumcised the world with a 100 foot clipper which was very dangerous to all his men.

Johann Bach wrote a great many musical compositions and had a large number ofchildren. In between he practiced on an old spinster which he kept up in his attic. Bach died from 1750 to the present. Bach was the most famous composer in the world and so was Handel. Handel was half German, half Italian, and half English. He was very large.



How many dogs does it

take to change a light

bulb?

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Golden Retriever: The sun is

shining, the day is young, we've

got our whole lives ahead of us,

and you're inside worrying about

a stupid burned out bulb?

Border Collie: Just one. And then

I'll replace any wiring that's not up

to code.

Dachshund: You know I can't

reach that stupid lamp!


Rottweiler: Make me

Boxer: Who cares? I can still play

with my squeaky toys in the dark.

Lab: Oh, me, me!!!!! Pleeeeeeeeeze

let me change the light bulb! Can I?

Can I? Huh? Huh? Huh? Can I?

Pleeeeeeeeeze, please, please,

please!


German Shepherd: I'll change it as

soon as I've led these people from the

dark, check to make sure I haven't

missed any, and make just one more

perimeter patrol to see that no one has

tried to take advantage of the situation.

Jack Russell Terrier: I'll just pop it

in while I'm bouncing off the walls

and furniture.

Old English Sheep Dog: Light

bulb? I'm sorry, but I don't see a

light bulb!

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Cocker Spaniel: Why change it? I can

still pee on the carpet in the dark.

Greyhound: It isn't moving. Who

cares?

Australian Shepherd: First, I'll put all the light bulbs in a little circle....


Poodle: I'll just blow in

the Border Collie's ear

and he'll do it. By the

time he finishes rewiring

the house, my nails will

be dry.


How many cats does it take

to change a light bulb?

The Cat's Answer:

“Cats do not change light bulbs. People change light bulbs. So, the real question is: how long will it be before I can expect some light, some dinner, and a massage?”

All of which proves, once again, that while dogs have masters, cats have staff!

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Other Practical Tips:

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


To Help, Use the Positive Physical

Approach™

-Pause at edge of public space (6 feet away)

-Greet with your open hand next to your face, smile

-Call the person by name, if possible

-Move your hand into handshake position

-Approach slowly and within visual range

-Move from a handshake to Hand-under-Hand® position

-Shift into a Supportive Stance on their side

-Get low by standing or kneeling, but don’t lean in

-Make a connection and wait for their response


Hand-under-Hand®

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Use of Hand-Under-Hand®:

-Connecting: comforting and directing gaze

-Guiding and helping with movement

-Uses established nerve pathways

-Getting eye contact and attention

-Providing help with fine motor

-Offering a sense of control, even when you

are doing almost everything

-Gives advanced notice of possible problems

-Allows you to do with, not to


What to Say:•Keep your voice calm, low, and slow

•Use very few words

•Make positive statements:

•“Let’s try…”

•“Do this…”

•“Could you please help me…”

•Give simple choices – ‘this or that’

•Use objects to show them, not just words

•Break task or movement down to one step at a

time

•Use empathetic statements

•“Sounds like you are… (give emotion)”

•“Looks like you might be… (give condition)”

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Be a Detective, Not a Judge!

Try to figure out what is being communicated:

•Words

•Thoughts

•Actions

•Needs

•Beliefs

Don’t assume or presume

Don’t discount me because of how the

message is delivered

To Communicate:


Progression of Dementia:

The GEMS®

Sapphires

Diamonds

Emeralds

Ambers

Rubies

Pearls


Sapphires

- Us on a good day

- Clear and true to ourselves

- May feel ‘blue’ over changes

- Can typically choose our behavior

-May have other health issues that affect

behaviors

-Recognize life experiences, achievements

and values

-Can follow written info and hold onto it

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Diamonds

-Sharp, hard, rigid, inflexible, can cut

-Many facets, still often clear, can really shine

-Are usually either Joiners or Loners

-Can complete personal care in familiar place

-Usually can follow simple prompted schedules

-Misplaces things and can’t find them

-Resents takeover or bossiness

-Notices other people’s misbehavior and mistakes

-Vary in lack of self-awareness

-Use old routines and habits

-Control important roles and territories, use refusals


Emeralds

-Changing color

-Not as clear or sharp, more vague

-On the go, need to ‘do’

-Flaws may be hidden

-Time traveling is common

-Are usually Doers or Supervisors

-Do what is seen, but miss what is not seen

-Must be in control, but not able to do it correctly

-Do tasks over and over, or not at all


Ambers-Amber Alert- Caution!

-Caught in a moment

-All about sensation and sensory tolerance,

easily over or under stimulated

-May be private and quiet or public and noisy

-No safety awareness

-Ego-centric

-Lots of touching, handling, tasting, mouthing,

manipulating

-Explorers, get into things, invade space

-Do what they like and avoid what they do not

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Rubies:-Hidden depths

-Major loss of fine motor finger and mouth skills, but can do gross motor skills like walking, rolling, rocking

-Comprehension and speech halted

-Wake-sleep patterns very disturbed

-Balance, coordination, and movement losses

-Eating and drinking patterns may change

-Tends toward movement unless asleep

-Follows gross demonstration and big gestures for actions

-Limited visual awareness

-Major sensory changes


Pearls:-Hidden in a shell: still, quiet, easily lost

-Beautiful and layered

-Spends much time asleep or unaware

-Unable to move, bed or chair bound, frequently fall

forward or to side

-May cry out or mumble often, increases

vocalizations with distress

-Can be difficult to calm, hard to connect

-Knows familiar from unfamiliar

-Primitive reflexes

-The end of the journey is near, multiple systems are

failing

-Connections between the physical and sensory

world are less strong but we may be the

bridge


Finding Joy for Diamonds:

-What they feel competent at

-What they enjoy

-Who they like

-What makes them feel valued

-Where they feel comfortable but stimulated

-What is familiar but intriguing

-What is logical and consistent with historic

values and beliefs

-Whoever is in charge

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Finding Joy for Emeralds:

-Doing familiar tasks

-Doing visible tasks

-Historic tasks and people and places

-Engaging with or helping others

-Finding important people or things

-Having a ‘job’ or ‘purpose’

-Being an ‘adult’

-Getting finished and doing something else


Finding Joy for Ambers:

-Things to mess with (may be people!)

-Places to explore

-Stuff to take, eat, handle, move

-Visually interesting things

-People who look or sound interesting, or

places that are quiet and private

-Textures, shapes, movement, colors,

numbers, stacking, folding, sorting


Finding Joy for Rubies:

-Walking a routine path

-Going forward

-Watching others

-Being close or having space

-Things to pick up, hold, carry, push, wipe,

rub, grip, squeeze, pinch, slap

-Things to chew on, suck on, grind

-Rhythmic movements and actions

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Finding Joy for Pearls:

-Pleasant and familiar sounds and voices

-Warmth and comfort

-Soft textures

-Pleasant smells

- ‘Good’ tastes

-Smooth and slow movement

- ‘Just right’ touch and feel


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!


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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Some Ideas for Changing:

Pick one thing

Plan on baby steps

Get support for you

Build a routine

Check in on your feelings

Add something before giving something up

Believe it: not everyone is meant to do

hands-on care

Give it a try… not permanent… just try


Identify:

What you’re good at…and what you’re not

Who can help…and how they can help

What really matters

Where do you find joy? Get there regularly!


Let Go:

How it ‘used to be’

How it ‘should be’

How you ‘should be’

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Final Suggestions:Back off, change something and try again

Adopt a “So What” mentality

Try being supportive, not confrontational

Accept yourself, and the person with dementia

Get support for you!

Find something you like about the person you are trying to help

Get help for them so you can take a break!


The content contained in this presentation is strictly for informational purposes. Therefore, if you wish to apply

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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

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Documents

© Positive Approach to Care® to be reused only with ......Why Do We Laugh? Something Seems ‘Funny’ to Us: •What we see •What we hear •What we experience •What we see