Promoting Function & Maintaining Independence in the Face of Dementia – Jane Yakel

Outline

DEMENTIA AND DISEASES

• Differential diagnosis of degenerative neurological diseases
  • Detect how dementia symptoms vary among the diseases

ASSESSING OR STAGING? WHAT DO THEY TELL US AND WHICH DO WE DO?

• Standardized assessments
• Patient-centered assessments
• “Staging Tools”
• What patient skills to expect at each stage
• Chronological ages that go with the stages

DOCUMENTING DEMENTIA SKILLED INTERVENTIONS

• Write patient-centered goals
• Measure progress and justify medical necessity
• Making daily documentation “skilled”
• Key words that reflect functional outcomes in dementia therapy

APPROACHES TO THE MEMORY SYSTEM

• Memory system to use for new learning/conscious memory
• Memory system for procedural learning unconscious memory
• Documenting memory systems per medical diagnosis

EVIDENCE-BASED THERAPEUTIC INTERVENTIONS

• Errorless Learning
  • Error vs. Errorless learning
  • Directions for successful use of errorless learning
  • Interactive lab/case discussion
• Spaced Retrieval
  • Specific timing and directions of spaced retrieval for the dementia population
  • Designing a “prompt question”
  • Discipline-specific demonstrations using Spaced
  • Retrieval
  • Written goals and skilled documentation
• Montessori-based Dementia Programming
  • Translate Montessori teaching into successful therapy intervention
  • Retrogenesis: Understanding First In – Last Out Theory
  • Create structured stimulating activities appropriate to individual cognitive levels
  • Written goals & skilled documentation specific for
  • Montessori techniques
• Ability-Based Approach
  • Design successful therapeutic interventions according to patient abilities
  • Determine the patients best ability to function
  • Written goals & skilled documentation specific for ability-based techniques
  • Examples and case studies provided
• Reminiscence Therapy
  • Powerful use of the “senses” designed to awaken the soul
  • Know the patient is “alive inside”
  • Design individual and/or group Reminiscing Therapy sessions
  • Select activities and create reminiscing themes and kits
  • Written goals and skilled documentation
• Memory Books/Aids
  • Proven methods in presenting functional & factual information in written & picture format
  • Idea suggestions for individual stages of life/ “stages” of dementia

COMMUNCATION SKILLS: THE KEYS TO BEHAVIOR

• Reflective Listening
  • Listening from a position of empathy & emotional intelligence
  • Practice multiple verbal formulas proven for success
  • Client-centered communication – Reflection of Feeling
  • Avoiding pitfalls all listeners fall into
  • Interactive lab/case examples and discussion
• Validation Therapy: A Powerful Communication Tool
  • Principles and pointers for dismantling power struggles and resolving arguments
  • Accepting values, beliefs, and reality regardless of accuracy
  • Handling hallucination, delusions, hoarding, blamers, and accusers
  • Interactive lab/case examples and discussion
• Re-direction
  • Learn the key to “agree” with what the patients wants/needs through conversation
  • Case study for safety, ambulation, hallucinations, and delusions
  • Interactive lab/case examples and discussion