The Proper Way to Approach Someone with Dementia - Encore

Are you caring for a loved one with dementia? You don't have to figure this out all on your own. Welcome to Truth, Lies Alzheimer's, the show that helps you reimagine a new relationship with your loved one, a relationship a little more free of stress and anxiety. Join host Lisa Skinner and her 30+ years of experience as she guides you on a new path to a better relationship with those you care for. Here's Lisa.

Hello to all of you who have tuned in to listen to this episode of the Truth, Lies Alzheimer's Show. Once again, I'm Lisa Skinner, your host, and I'd like to shout out a very warm welcome to all of you who have joined us today. I really appreciate you being here. And I hope that you all had a wonderful Father's Day yesterday and that you were able to spend time with your dads. So, as I emphasized before, the purpose of this show is to talk about every aspect of Alzheimer's disease and dementia which includes the good, the bad, and the ugly. My goal is to get to the truth, dispel the lies and myths, and unveil what I call the secret faces of Alzheimer's disease. That way, hopefully, you'll be able to understand what it is truly like to live with brain disease. My hope is also to zoom outside the paradigm of it exclusively being a memory loss condition and to shift people's understanding of just how dramatically this disease impacts the lives of those who have it, as well as their caregivers and family members. Well, for that matter, anybody involved in the life of a person living with dementia. As Ken mentioned, I have authored several books on the subject, written a training program, and believe it or not, I have personally watched 8 of my own family members fall prey to one of the brain diseases that causes dementia. I'm also a certified dementia practitioner as well as a certified dementia care trainer. You know, there are so many aspects of living with dementia that are unexpected and can surface out of nowhere at any time. And as many of you know, they show up unannounced and are completely unpredictable. That is why it is so important to be prepared for anything that emerges on this journey. And that is the purpose of this show, is to help prepare you for whatever shows up on your journey. So tonight, or today, I'm going to be giving you some recommended communication So, these are really important to take note of because, as I've discussed before, people who suffer from Alzheimer's disease and related dementia, they have so dramatically lost their cognitive abilities. They just do not receive or interpret information the same way that they did when they had healthy brains or that we do. So, with that said, I'm going to provide you with a list of best practice approaches. So, here we go. Always make eye contact. Always approach them face to face in full view and slowly. Say their name, and it is vital that they are able to see you and that their attention is focused on you. Read their eyes. Always approach from the front, as approaching and speaking from the side or from behind can startle them. Be at their level. Position your head to be at the same level as their head. Bend your knees or sit down to reach their level. Do not stand or hover over them. It is very intimidating and scary to be in that position. They can't focus on you and what you're saying if they are focused on their fear. Explain what is going to happen to them before you do it. In short, clear statements such as, "I'm going to help you take your coat off," especially if you're going to touch them. They need to know what is coming first so they don't think that you are grabbing them. Always speak calmly. Always speak calmly.

Slowly.

Breathe in between each sentence. They are not able to process words as fast as you can speak them. Give them a chance to catch up to your words. And also, speak in short sentences. Speak in short, direct sentences with only one idea to a sentence. That way, they only have to focus on one idea at a time. Only ask one question at a time and let them answer it before you ask another question. You can ask who, what, where, and when, but it's best not to ask why. And I'll tell you why. Why is much too complicated for them. They will try to answer, fail, and become frustrated. Try not to say remember. Many times they will not be able to do so, and you are just pointing out to them their difficulties and their shortcomings. This can actually cause anger and embarrassment. Turn negatives into positives. For example, say, "Let's go here," instead of, "Don't go there." Be inclusive and don't talk down to them like they are a child. Respect the fact that they are an adult and treat them as such. Don't argue with them. Why is that? It gets gets you nowhere. Check to see if the aggressive behavior is about getting what they want. If so, trying to anticipate their needs may help. Validate their feelings by saying something like, "I see that you are angry or sad or upset, etc." It lets them know that they are not alone and then redirect them into another Now, this list that I'm going to share with you is a list of communication tips that were expressed directly from individuals who are living with memory loss. So, if they could tell you how to properly communicate with them to make it the easiest for both of you and the most effective, This is what they would tell you. Speak with a smile so I know you care. If you are tense, remember, I feel your tension too. A smile takes away tension and helps put me at ease. Use language I understand. Please keep it simple. No jargon or slang. Slow down your speech. Keep it short and to the point, one idea at a time. Let me take the time to think through what you just said to me. Let me set the pace for the conversation. Let me be the leader in the conversation. Give me charge of the conversation. Make sure you have my attention. Pause once you say your thoughts. Pause so I can say my thoughts. Give me time to find the words and to say my thoughts. That's difficult for me. Take turns during the conversation. Please let me finish what I'm trying to say as it takes a lot longer. Please repeat information if I ask you to. I didn't understand you the first time. Make sure I hear you and ask if I understand what you have said. Your tone of voice is very important to me. Adjust it up or down. Louder is not always better. Face me when you talk. Eye contact helps to get my complete attention. And please don't interrupt me. Lastly, please be patient. Don't give up on me. I really do want to be part of our conversation. Now, these are tips for you to help family members and caregivers handle the challenging behaviors that are associated with dementia. So number 1, don't be afraid to ask help from others. Getting input from others can help caregivers see a new solution. Take a course or understand the underlying cause of challenging behaviors. That is critical. Number 2, attempt to accommodate the behavior if possible instead of controlling it. Number 3, be aware that the underlying cause of some symptoms can be a physical problem. Always report behavioral symptoms to a healthcare provider. Number 4, be prepared to be flexible because what works today may not work tomorrow. That's why you wanna have lots of tools in your toolbox so you can try something different. Change your perspective. The best way to do something different is to first attempt to see it differently. Changing how you see a situation will oftentimes enable the person with dementia to exhibit a different behavior. Number 6, develop Coping strategies in advance for dealing with bad days. Number 7, disrupt patterns which can help to change negative behavior. For example, try a different approach to how you ask a person with dementia to do something. Number 8, employ compassion, flexibility, and patience. Tall order, I know, but extremely beneficial. Number 9, keep in mind that although you cannot change your loved one's behavior, you can change your own. Number 10, realize that when you try to control the person's behavior, it will most often be met with resistance. Number 11, remember that behaviors are motivated by something. Although it may not seem like it, a person with dementia is usually making a statement even when performing repetitive actions such as taking all the dishes out of the cupboard. He or she may be acting out of a sense of needing to do something meaningful or productive. Again, they're trying to tell you something and cannot articulate it, so it comes out in the form of behaviors. And then lastly, try to anticipate the person with dementia's underlying needs. This will allow caregivers to redirect many negative behaviors. For example, A person who is bored can be redirected to help with simple household chores with supervision, of course. So, what's news? In today's What's New segment, I would like to give you an update on studies on cognitive decline. Scientists have known for years that diets high in fat and sugar can impair the brain. This was posted in a publication called The Conversation on April 15th, 2023, so it's fairly recent. And I know that we've done— I've done a segment on this in previous episodes, but this is the most updated information on this topic. This article was written by Sarah M. Burke, who is an associate professor of neurobiology and cognitive aging at the University of Florida. So, again, scientists have known for years that unhealthy diets, particularly those that are high in fat and sugar, may cause detrimental changes to the brain and lead to cognitive impairment. Many factors that contribute to cognitive decline are out of a person's control, such as genetics and socioeconomic factors. But ongoing research increasingly indicates that a poor diet is a risk factor for memory impairment during normal aging and increases the risk of developing Alzheimer's disease. So, two recent large-scale studies suggest that eating ultra-processed foods may exacerbate age-related cognitive decline and increase the risk of developing dementia. But in contrast, another recent study reported that ultra-processed food consumption was not associated with worse cognition in people over 60. So, let's take a deeper dive into what this research revealed. They say, although more research is needed, as a neuroscientist who researches how diet can influence cognition in later life, Sarah found that these early studies studies add a new layer for considering how fundamental nutrition is to brain health. These are her findings. Ultra-processed foods tend to be lower in nutrients and fiber and higher in sugar, fat, and salt compared to unprocessed or minimally processed foods. Some examples of ultra-processed ultra-processed foods include soda, packaged cookies, chips, frozen meals, and even flavored nuts, flavored yogurt, distilled alcoholic beverages, and fast food. Even packaged breads, including those high in nutritious whole grains, qualify as ultra-processed— in many cases because of the additives and preservatives that they contain. This is another way to look at it. You are not likely to find any of the ingredients that make up most of these foods in your home kitchen. Do not, though, confuse ultra-processed foods with processed foods. Which still retain much of their natural characteristics, although they've undergone some form of processing like canned vegetables, dried pasta, or frozen fruit. Now, in a December 2022 study, so that was what, 7 months ago, researchers compared the rate of cognitive decline over approximately approximately 8 years between groups of people that consumed different amounts of ultra-processed foods. At the beginning of the study, over 10,000 participants living in Brazil reported their dietary habits from the previous 12 months. Then, for the ensuing years, the researchers evaluated the cognitive performance of the participants with standard tests of memory and executive function. Those who ate a diet containing more ultra-processed foods at the start of the study showed slightly more cognitive decline compared with those that ate little to no ultra-processed foods. This was a relatively modest difference in the rate of cognitive decline between the experimental groups. So, it is not yet clear if the small difference in cognitive decline associated with higher consumption of ultra-processed foods will have a meaningful effect at the level of an individual person. The second study with about 72,000 participants in the UK measured the association between eating ultra-processed foods and dementia. For the group eating the highest amounts of ultra-processed foods, approximately 1 out of 120 people were diagnosed with dementia over a 10-year period. For the group that consumed little to no ultra-processed food, the number was 1 out of 160. 70. The research examining the relationship between health and ultra-processed foods uses the— what's called the NOVA, N-O-V-A classification, which is a categorization system based on the type and extent of industrial food processing. Some nutritionists have criticized the NOVA classification for not having definitions of food processing, which could lead to misclassification. They also argue that the potential health risk from consuming ultra-processed foods could be explained by low levels of fiber and nutrients and high levels of fat, sugar, and salt in the diet rather than the amount of processing. Many ultra-processed— are higher in additives, preservatives, and/or coloring agents while also having other features of an unhealthy diet such as being low in fiber and nutrients. Thus, it is unclear if eating food that has undergone more processing has an additional negative impact on health beyond the low diet quality. So, for example, you could eat a burger and fries from a fast food chain, which would be high in fat, sugar, and salt, as well as being ultra-processed. Now you can make that same meal at home, which could also be high in fat, sugar, and salt, but would not be ultra-processed. But However, more research is needed to determine whether one is worse than the other. And even when the processes that lead to dementia are not occurring, the aging brain undergoes biochemical and structural changes that are associated with worsening cognition. So, for adults over the age of 55, a healthier diet, could increase the likelihood of maintaining brain function. In particular, the Mediterranean diet and the ketogenic diet are associated with better cognition in advanced age. And I know from other information I researched and shared with you in previous episodes, we have— studies have shown a direct correlation there. The Mediterranean diet emphasizes the consumption of plant-based food and healthy fats, like olive oil, seeds, and nuts. And then the ketogenic diet is high in fat, but low in carbohydrates, with the primary fiber source being from vegetables. Both diets minimize or eliminate the consumption of sugar. Our research and the work of others show that both diets can reverse some of these changes and improve cognitive function, possibly by reducing harmful inflammation. And although inflammation is a normal immune response to injury or infection, chronic inflammation can be detrimental to the brain. Studies have shown that excess sugar and fat can contribute to chronic inflammation, and ultra-processed foods might also exacerbate harmful inflammation. There's a lot of studies showing correlation between inflammation and dementia. This is a newer finding. Before, it was believed that it was pretty exclusive to the plaques and the tangles, but now studies are showing that there is a direct correlation between inflammation and developing Alzheimer's disease and/or related dementia. Another way that diet and ultra-processed foods may influence brain health is through the gut-brain axis, which is the communication that occurs between the brain and the gut microbiome, or the community of microorganisms that live in the digestive tract. This is another newer theory. Not only does the gut microbiome help with digestion, but it also influences the immune system while producing hormones and neurotransmitters that are critical for brain function. Studies have shown that the ketogenic and Mediterranean diets do change the composition of microorganisms in the gut in ways that benefit a person. Ultra-processed food consumption Sugar consumption is also associated with alterations in the type and abundance of gut microorganisms that have more harmful effects. Now, disentangling the specific effects of individual foods on the human body is very difficult, in part because maintaining strict control over people's diets— to study them over long periods of time is problematic. Moreover, randomized controlled trials, which is the most reliable type of study for establishing causality, are unfortunately very expensive to carry out. So far, most nutritional studies, including these two, have only shown correlations between ultra-processed foods consumption and health, but they cannot rule out other lifestyle factors such as exercise, education, socioeconomic status, social connections, stress, and many more variables that may influence cognitive function. This is where lab-based studies using animals are incredibly useful. Rats show cognitive decline in old age that parallels humans. It's easy to control rodents' diets and activity levels in a laboratory. And rats go from middle to old age within months, which shortens study times. So lab-based studies in animals will and can make it possible to determine if ultra-processed foods are playing a key role in the development of cognitive impairments and dementia in people. As the world's population ages and the number of older adults with dementia increases, this knowledge certainly cannot come soon enough. So, this is the most updated information that I was able to surface regarding diet and food consumption. And these are probably the most recent and up-to-date findings. So that concludes our episode for today. Thanks again for being here, and I am going to turn the microphone back over to Ken to give us a few announcements, and I'll be back.

Thank you, Lisa. Just really incredibly important topics that you covered today. I'm quite sure that our audience appreciates them. To our audience, thank you very much for listening to the Truth, Lies Alzheimer's Show with your host, Lisa Skinner. This program can be found on our website at passionateworldtalkradio.com under the shows tab, and you can also search for us on YouTube. If you're on Facebook, you can find Lisa by searching for Lisa Skinner author, and if you're interested in Lisa's books or training programs, go to truthliesalzheimer's.com. Lisa's books are also available on on all major bookselling platforms, including Amazon and Apple Books. And with that, I'll turn it back over to Lisa to take us home.

I just wanted to thank you all again for listening today. We have so much to cover in our upcoming episodes, and I really want to provide you with useful and valuable information that you will be able to have, so you will be able to have a more positive experience with your loved one or the person that you're caring for with Alzheimer's disease or related dementia. Remember, dementia awareness is every day. Kindness is the ability to speak with love, listen with compassion, and act with patience. And these are all very necessary attributes to have in order to outlast Alzheimer's disease. So, we'll be back next week, and I certainly hope you join us. Thanks.

Thank you for listening to Truth, Lies Alzheimer's. We hope you found something in today's episode that helps. We understand that caring for a loved one with dementia can be the challenge of a lifetime, but you don't have to do it alone. If you're ready for exclusive access to even more great content and resources, head on over to Facebook and join Lisa Skinner's Minding Dementia support group. We're a community of like-minded caregivers, and we're here to help.