Creating a Geriatric Life Enhancement Environment · you walk your journey as life circumstances change. would know how to best communicated with you if you had hearing, vision, speech,

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Creating a Life Enhancement Environment

for the Older Adults with Dementia

Kathryn Kilpatrick M.A. CCC/SLP

Speech-Language Pathologist

Geriatric Life Enhancement Consultant

Memory Fitness Specialist

COMMUNICATION CONNECTION

www.connectionsincommunication.com

[email protected]

Copyright 2017 Communication Connection 1

Communicate and Connect

“It is one of the most beautiful compensations of life that no man can sincerely try to help another without

helping himself.” Ralph Waldo Emerson

It is a privilege to walk their journey with them.

Offers us opportunities to enhance the quality of each of their days.

2 Copyright 2017 Communication Connection

Bill of Rights

To be treated as an adult, not like a child

To have expresses feelings taken seriously

To be free from psychotropic medications if possible

To be cared for people who are well trained

To live in a safe, structured, and predictable environment

To enjoy meaningful activities

David Troxel and Virginia Bell


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Often……

When there is a decline in - cognitive functioning

- communication skills

- mobility

- and safety

ACTIVITY PARTICIPATION BEGINS TO DECLINE

If a person cannot initiate or modify an activity, there is likely to be

- less overall interest

- less involvement

- increased confusion

- increased withdrawal

- less visitors

- more sleeping

- more sundowning


Need to Assess Care Partners

Equally important are members of support system

including family, friends and professionals providing care

o Availability

o Personality and attitude

o Relationship

o Cognitive status, hearing, vision


Life Enhancement Focus Can lead to

Increased awareness of care partners through education

Decreased difficult behaviors

Increased interactions

Potentially more positive health outcomes

Increased family and care partner participation


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CONSIDER

Things that Make a Person Unique www.advancecareplan.com

__ History

__ Habits

__ Preferences

__ Routines

__ Lifestyle

__ Values

* Eat/ wear/ spare time

* People/settings enjoyed

* Makes you smile

* Annoys you

* How practice your religion/spirituality

* How want let go of life


Copyright 2017 Communication Connection

What if your care partner….. had information and “clues” to deal with issues that

made you unhappy.

could save time, money, energy and effort trying to obtain information (if you were unable to provide it)

could share what is important to you with others as you walk your journey as life circumstances change.

would know how to best communicated with you if you had hearing, vision, speech, memory and/or cognitive deficits.

knew your story for conversational purposes

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Know their Story Education

Occupation(s)

Interests

Values

Fears

Family background

Personality and attitudes

Health history

Overall financial options

Family dynamics

Long term planning – (estate, legal, living will etc.)

Appropriate and reasonable options


http://www.advancecareplan.com/

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Copyright 2017 Communication Connection

Sample from Lynn’s Story (Home Care) 7:30 AM without the Lifestyle Care Plan Taken to kitchen for breakfast. Given a cup of tea with sweet and low, served with egg

beaters and dry toast due to MD order low cholesterol diet. Difficulty feeding herself so caregiver tries to feed her and she resists.

7:30 AM with the LCP Served several cups of Irish tea with 5 tsp. sugar in each one. Lynn and the caregiver

read the newspaper together.

Noon without the LCP

The caregiver gets Lynn out of bed and takes her to the kitchen for lunch. She puts Lynn in front of TV so they can watch soap opera. Lynn falls asleep.

Noon with the LCP

Lynn and the caregiver go out for lunch then stop by the United Way office. Lynn was a volunteer there for 3 decades and is missed by all. With the help of her caregiver she is able to help out with some small projects.

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Dependence It is not necessarily a need for assistance

It is a loss of choice on how you are assisted

It is about showing them a new way

Creating a lifestyle care plan proactively can help to provide a life enhancement experience www.lifestylecareplan.com


GERIATRIC LIFE ENHANCEMENT

Meets the physical, emotional, intellectual and spiritual needs

Builds on their strengths and interests

Transforms days from mere existence into more enjoyment

Promotes meaningful and memorable exchanges

May engage older adults who may otherwise be removed from activities

Provides the opportunity for each person to participate, elevating the level of

interactions

Involves interaction of family, friends and care partners

Elevates the value we place on the older adult


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GLOBAL DETERIORATION SCALE

Stage 1 - No problems

Stage 2 - Normal Aging Word finding, slower to learn and process information

Stage 3 - Mild Cognitive Impairment Not dementia – may progress

Stage 4 - Mild to Moderate Impairment – Dementia

Able to learn

Stage 5 - Moderate/Marked Dementia Supervision needed

Stage 6/7 - Severe stages


NEED EDUCATION - KEY ISSUES

Major impact on quality of life

Swallowing

Avoid certain foods

Aspiration Pneumonia

Often were many signs prior to diagnosis

Nutrition

Why? Education and resources

Hydration

Forget or poor choices


RESEARCH - HEARING LOSS * Number of people with hearing loss in USA doubled past 30 years

3% to 5% adults have hearing loss

40% those over 65 have problem with hearing

25% those over 85 deaf at least in 1 ear

Only 25-29% those over 70 years of age use a hearing aid

Dr. Lin regarding hearing loss and memory

May increase cognitive deficits and may contribute to dementia

24% more likely than those with normal hearing to see a faster decline in memory and thinking skills

Reasons not totally determined however

More isolation, straining to decode, cognitive overload


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HEARING AND THE 21ST CENTURY Hearing Assessment

Medical follow-up – wax in ears

Payment concerns and options

Good candidate

Hearing aids Why not wear? Likely misplace?

Listening devices – keep one in your office to try

Technology issues Answering machines

Cell phones vs smart phones


HEARING TIPS Pronounce words carefully and eliminate background noises can be

helpful.

Many have difficulty with higher - pitched voices. S Z CH SH TH F V harder to be understood

Slow rate and face the person

Present shorter, less complex messages

Shorter pieces of information

GET THEIR ATTENTION FIRST

Written words or spelling a few letters aloud MORE DETAILS

Visit Kathryn’s Eldercare blogs on website


Radio Shack

Stereo Amplified Listener

RADIO SHACK Catalog number 33010973 Band Equalizer


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GERIATRIC LIFE ENHANCEMENT

Honors the older adult’s life story

and meets them where they are in their journey

EDUCATION AND SHARING can help to

elevate the quality of ALL those walking

the journey with an older adult


MOST COMMON AGE-RELATED

VISION LOSS Macular Degeneration – central vision loss

Dry most common

Letters may appear to be missing

Glaucoma

May not be aware - gradual changes

Impacts driving or missing a step

Cataracts

Hazy vision, trouble distinguish colors

Increased sensitivity to light

Print fades in later stages and hard to read

Diabetic Retinopathy

Hemorrhages in retina

Blurred vision, difficulty reading


VISION TIPS

Assess the busyness of information you create Enlarge information Shorter stories Guide card Right/left neglect strategies

Line on the neglected side when reading Often need more light Avoid information on blue or green background Reduce the glare Simplify activities

Help with organization so not visually complex


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Marcel Proust

The real voyage of discovery

lies not in seeking

new landscapes

but in having new eyes.


COMMUNICATION TIPS Get their attention before you start speaking

Make sure you face the person. Many people ask

questions with their back to the person.

If they are seated or in bed, try to get get down to their

eye level.

Slow down the rate of your presentation and make sure

you continue to do so while talking. Speakers have a

tendency to pick up the rate as conversation progresses.


COMMUNICATION TIPS Simplify the complexity of the information whenever

possible, but keep it on an adult level.

Repeat any details that are more complicated and try to present them in shorter segments.

Look for any non-verbal cues from the listener that they are missing some of the information. Do not assume that they processed what you are saying.

Point to something that will help you clarify the information or use meaningful gestures.


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MAKING A PLAN** Needs that you identify

Current plan

Resources

Family programs/education

How to share the information

Who can you partner with?

Activities and modification


Creating Time Well Spent* What appeals to them?

What disinterests them?

Which technique helps?

What frustrates or agitates?

What has changed?

What do family and caregivers show interest in?

How does the “family” stay connected?

What can you share with others?


Why Modify

Hearing Loss

Reduced vision

Forgetfulness

Memory Loss

Poor attention

Confusion

Agitation

Withdrawal


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Components of Life Enhancement Meets them where they are

o Creating a culture of compassion

o Valuing the person

o Learning their story

o Honoring their journey

o Promoting communication/connection

o Enhancing the quality of their days


WHY Focus on Life Enhancement? Can lead to

Decreased difficult behaviors

Improved attitude

More participation

Positive health outcome

Increased family participation

Boost in care partner/staff engagement


Keys to Activity Participation Maximize their highest

quality of life

Need to match skills, abilities, needs, lifestyle and preferences

Adapt to facilitate participation

Incorporate skills from former work, religious activities and recreational interests

Relevant activities that amount to something

o Have variety

o Not childish

o Require thinking

Focus on

o Dignity

o Positive self image

o Independence


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Tips for Planning Success

Utilize their strengths

Accommodate their weakness

Often need help initiating and repeated cues

Activities are everywhere

Identify the triggers – pacing, distractions?

Share what works with others

Reminiscence

Humor, positive attitude


Enhancing Conversation

Photos and memorabilia

Short stories

Religious materials

Hobbies

Food

Humor

Celebrations

Pets

Nature

Drives

Word games

Jigsaw puzzles

Crafts

Weather

Mail

Drives

Children

Music

Sports

Technology


Walking Their Journey

Information available and can be confusing to families

Need develop programs that reach out to provide helpful information specific to quality of life

Caregiver education and conversation groups to provide recommendations and resources Safety concerns

Home modification

Communication strategies

Handling difficult behaviors

Risk factors

Activity modification


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SOME OF THE BASICS Be present

Assess your energy level

Notice your attitude

What are the little things you can do?

What has special meaning to you? To your loved one?

How can you bring others more reluctant into the circle?

“It is not how much we do, but how much love we put in the doing.

It is not how much we give, but how much love we put in the giving.”

Mother Teresa


Additional Resources Blogs on Elder Care Concerns

http://www.connectionsincommunication.com/index.php/kathryns-

blogs/eldercare-link

Lifestyle Care Plan

www.lifestylecareplan.com

Products – view sample pages

http://www.connectionsincommunication.com/index.php/products

Webinars, interviews, podcasts, newsletters

http://www.connectionsincommunication.com/index.php/resources

Blogs - Memory Fitness Matters

http://www.connectionsincommunication.com/index.php/kathryns-

blogs/memory-fitness


http://www.connectionsincommunication.com/index.php/kathryns-blogs/eldercare-link





http://www.lifestylecareplan.com/





http://www.connectionsincommunication.com/index.php/kathryns-blogs/memory-fitness






Documents

Creating a Geriatric Life Enhancement Environment · you walk your journey as life circumstances change. would know how to best communicated with you if you had hearing, vision, speech,