Welcome to Understanding Dementia

My name is Lee-anne Godfrey and thank you for joining me early this morning.

It's hard to find a time where everybody can make it, so sometimes we do these early in the morning and I think the next one will do will be at lunchtime so hopefully it will work for a few more people but.

Thank you for showing up today.

It's a really important topic and I'm sure that in your roles, whatever position you have out there, you've taken a course or two or very many possibly.

Classes on dementia, cognitive decline for seniors, etc. So hopefully today we're going to get down to the basics of dementia and I chose this topic to do a CE4 because when I work out in the senior community, I notice that there is some confusion about what is dementia.

What is Alzheimer's disease?

Alzheimer's disease a type of dementia or is dementia type of Alzheimer's disease?

There seems to be a lot of confusion, so I thought that it would be good just to have a basic understanding of dementia.

So today we're going to go over some terminology so that we're all talking about the same terms when we talk about dementia, Alzheimer's disease, or Lewy body disease.

Whatever, we're talking about that we have that common language of understanding.

So we're getting down to the basics for sure today.

My name is Leanne Godfrey. As I mentioned, I'm a nurse care manager. I've been doing care management for almost 10 years now and I started the company in health management back in 24.

13 and some of you I do know I can see who's on.

This is a repeat class.

Actually we did it last month as well.

So it's good to see some people that I know and welcome to the people that I.

Haven't met yet.

But we're a.

Care management company.

We're a team of nurses that do care management trying to help people to live their best life for as long as possible.

The setting that they've chosen for themselves, so we've been doing that for a little while now, and certainly a lot of our clients have a dementia of some sort.

So that's why this is such an important topic.

So in terms of today just a couple of nuts and bolts before we get going.

If you registered before about 6:00 o'clock last night, you should have received a copy of the PowerPoint as well as three handouts.

You have the full PowerPoint plus you have a handout sheet that you can make your notes on.

So you should have both.

I'm going to be sending out your certificate within the next seven days. It probably will be sooner than that, but just to make sure in case I have every anything come up that takes me away from doing this, you're going to have your certificate of CE completion as long as you stay the entire time, then you'll be able to get your CE credit for 1.5 hours.

And along with that certificate I'm going.

To also send you.

Uh, link to this presentation so you can forward that link to people you can forward it to family members.

Or maybe you have a client and you think that the family members of that client would benefit from knowing some of the basics of dementia.

Feel free to forward that so you will get that within seven days as well.

I don't have a formal.

Survey or a way to give feedback formally, but I welcome an email.

To say this was.

Great or we could have used more of that.

Or next time could you?

So I really am open to feedback as feedback from today's presentation so.

Feel free to do that.

And if you have any questions, if you find that after a week you don't have your CE certificate, please make sure that you contact me. You've got my contact information, so please feel free.

To reach out for that.

I think we did OK last time. I don't think we missed anybody, but sometimes people don't make it. Maybe they come on for 45 minutes or whatever so we will send you an email if on our side we don't see that you've attended the whole time, so you will get.

That heads up.

If that's your situation.

So let's dive.

In we do have an hour and a half to cover a lot of information.

This is just putting our tippy toe into the water of dementia care.

Of course there is so much to be learned.

Everybody expresses their disease a little bit differently.

People respond to medications differently.

They respond to.

Non pharmacological interventions differently.

The diseases just express themselves in different ways, and sometimes we also have the complication of not just one form of dementia in a client.

They may have two or three different types of dementia going on at the same time and.

That's really hard to tweeze out.

Plus we have aging individuals who may also have other chronic diseases, so they may have.

Congestive heart failure.

They may have copd.

They may have osteoarthritis and all these different things complicate the picture of dementia.

So this is.

It's not all cut and dried, and I know that by working in the senior industry.

Sending a fiduciary or whatever role you're in.

We have more than fiduciaries here today.

Whatever role you're in, you realize that this is a complicated picture.

It's not easy to sort through.

So the reasons why we're talking about this topic is a few things, and I'm just going to quote a couple of different statistics here.

Not that I'm a statistic statistics pro, but we're just going to talk a little bit about prevalence.

Most of the information that I'm sharing with you today I have obtained through Alzheimer's, Orange County.

In the Alzheimer's Association.

So if you have some questions about this, I would really recommend those two organizations as wonderful resources.

If you haven't tapped into them already.

I've got their email.

I'm sorry their websites at the end of the presentation.

If you haven't been.

There already, but.

Certainly they are a wealth of information on dementia and all the different, all the different types of dementia.

It's a bit of a misnomer when you talk about Alzheimer's, Orange County, or Alzheimer's Association because they deal with all the different dimensions, not just Alzheimer's disease.

I've never understood why they don't change their names, but they didn't ask me, so some of the stats I'm going to give you right now are taken from the 2021 Alzheimer's disease. Facts and figures report, and this comes out on a yearly basis from the Alzheimer's Association.

The topic is important because our prevalence of dementia in our population is increasing and of course you see this with your population as.

Well, we're all getting older. The baby boomers are going through the age group of 85 plus is the fastest growing demographic that we have in in our country. So certainly.

The longer we

Live the increased chance that we have of developing a form of dementia.

Age is a huge risk factor, probably the number one risk factor I should say for developing a dementia.

So just aging is our biggest risk factor.

So we have about.

Six million Americans, according to the 2021 report, 6 million Americans right now are living with Alzheimer's disease.

That is only Alzheimer's disease.

There are many other forms of dementia.

Many, many other forms of dementia, so.

Just with Alzheimer's disease alone, 6 million people are living with that right now.

That number isn't is projected to increase to about 13 million people just with Alzheimer's disease. Again by the year 2050.

So that's less than 30 years away, so it's closing in on us very quickly, actually. And for many of us, we may still be living when that 2050 hits, so.

It's projected to be a huge number again 13 million just with Alzheimer's disease.

Worldwide, they say that 50 million people are living with Alzheimer's disease and other dementias.

It is a huge money pit for people.

It's not just the personal tragedy, the family tragedy that happens when this disease comes.

It's also the financial hit to the health care system.

We know that people with Alzheimer's or Alzheimer's disease or another dementia they are twice as likely.

I'm sorry two times they have two times as many hospitalizations per year as other older people within their age group.

So two times as many hospitalizations per year.

They're more likely to have chronic conditions.

Such as heart.

Disease, diabetes, kidney disease, and you know this, they have more skilled nursing days.

They have more health home health visits.

They have more visits to places like adult day services, adult day health programs and nursing related.

Here at home and also I will throw in their home care our wonderful care.

Members through these homecare organizations that are caring for these folks day. Today they are more likely to use resources over time and we see that all the time and one in three seniors dies with Alzheimer's disease or another form of dementia. So at least 33 percentage.

The people seniors die with a diagnosis of Alzheimer's disease or other dementia.

The other thing to consider is that sometimes these folks do not get diagnosed properly, so these numbers I'm sure are a little bit higher actually than what they're quoting, because many times we don't really know what that person exactly has died from.

They haven't been diagnosed formally and we're going to talk a little bit about the need to have a formal diagnosis.

It's also a.

Really important topic because of the work that you do, I think everybody on this from what I can see is involved in senior care.

You're a fiduciary.

You are a nurse.

You are working with this population, so the more you know, especially with what we're doing.

Today with the basics, have that.

Basic understanding and a really good.

A place to come from in terms of learning other things very, very important so.

Your work is.

Definitely one reason why you're here today.

I'm sure also your personal life.

You may have someone in your life, whether it's a parent, whether it's a sibling, a cut.

And maybe you have a friend, husband that's been recently diagnosed with dementia.

So in your personal life, you probably have run up against this.

Both of my parents died from vascular dementia when they were in their early 90s, so I think it touches all of us in not just it's beyond work.

It's also personal.

Speaking personally, in terms of your own cognitive health, your own brain health, I think this is really important information to kind of tuck in the back of your brain.

To determine what kinds of things can you be doing on a day to day basis to maximize the health of your brain, we know now that lifestyle, lifestyle choices, how we live, our day to day life has great impact on.

Our brain health.

So we're going to talk a little.

Bit about that, but you've heard this before.

You know that exercising you know that.

Cognitively stimulating your brain.

You know that your nutrition stress management.

All of those things really impact your own brain health.

So I encourage you if you're not doing it already.

Or maybe you are.

Maybe you want to add a couple little items after our today's presentation.

On this, I really encourage you to do that.

You see day to day, the impact of dementia on your clients and their families and we sure want to avoid that.

If we can by making some different choices in our life, it's not all tide up with that.

We know that there's a little bit of genetics, a little bit of genetics, there's environmental impacts, and of course the aging process itself.

So it's not like changing your lifestyle is going to prevent absolutely prevent a dementia from occurring in your brain, but minimizing that risk is certainly worth the.

So now objectives.

We do have a CD being offered here today, so we need to get through our objectives.

We're going to talk about what is normal brain aging and what how.

Is that different?

From a brain that is actually not aging in a healthy way.

It has a dementia, possibly of some sort, So what can we expect as we age from our brain and what is not normal?

We're going to define dementia and believe it or not, I think this is where we need to start in this conversation here today, in a way, because, as I mentioned at the at the front end of this presentation, many people are confused or maybe are not clear on what exactly is dementia.

If you were to try and define that and how is it different from the types?

Of dementia that are out there.

So we'll get into that.

We're going to describe the process of Alzheimer's disease and how it progresses through the brain over time.

I have some cool pictures of the brain.

Which will walk.

Through and you can sort of see what happens over time.

When someone has Alzheimer's disease, we're going to focus on Alzheimer's because it is the most prevalent.

The most common form of dementia that we tend to see out there, and you've probably.

Seen that in your practice.

And we're also going to talk about the impact of dementia on the client.

And how can we?

We as people who have oversight over some of these clients.

How can we best address their needs as an individual?

This really is a disease that expresses itself very individually, even though there's common things between different clients with a dementia diagnosis, everybody progresses in their own way through this disease process.

So how can we?

Best address that for our clients.

So let's talk about what is.

Normal aging and what?

Is a disease process.

I know that for myself there are many days, many moments that I think that perhaps my brain is heading in this direction and I think that all of us kind of joke about it.

But some days I'm not joking, so I really wonder about my brain.

Sometimes when I forget things etc.

So there when we are, it wasn't.

Very long ago even I think when I was in.

Nursing school they talked.

About when you're born.

You were born with all the brain cells you're ever going to have, and that was sort of just the way we thought about the brain.

And we now know that that is not true.

We know that our brains.

Can constantly learn.

They can constantly add brain cells and brain connections.

You've probably heard the term neuroplasticity.

We have cognitive reserve where we can build as much muscle in our brain as possible by learning as much as challenging our brains as often as we can.

That goes back to.

Stimulating our brain, learning new things.

A new hobby.

Going home from work a different way, actually.

I'm in my Home Office so I don't get that opportunity.

Much these days.

But even when.

You go to the grocery store.

If you go into the grocery store and go a different direction than you normally do, or you park in a different place, I think we all get into these habits, right?

So even little things like changing those things up can have an impact.

On your brain.

So we have opportunities.

Almost every moment of our day to shake up our brains.

A little bit to.

Challenge our brains in a different way.

So what is normal aging?

What can we expect and what is maybe not such a good thing?

Well, we do know that dementia is not a normal part of aging, just as having kidney disease or developing diabetes over time.

It is not a.

Normal part of aging.

It is a disease Prof.

Success if we don't have a dementia, we will have a brain that can consistently learn right up until the very last day.

Of our lives.

We can.

We can continually challenge ourselves.

That being said, we also need to remember that people with dementia can also challenge their brains.

They may need assistance to do that, but it's never too late to challenge someone.

Frame and to try and encourage a growth of brain cells and brain connections.

When we do trainings we talk about.

So focusing not on the weaknesses, not on what the client can't do anymore, but what can the client do and adding to that overtime and stimulating their brain in that area if they're not able to feed themselves anymore.

Or I'm sorry if they're not able to maybe make something in the kitchen anymore.

Is there a?

Part of that that they can do.

They're not independent.

They can't cook at the stove etc anymore, but can they sit and can they, you know, put the salad together.

Maybe someone cuts up the salad pieces and they put that salad together so it's focusing on.

The strengths and not just saying you know what they can't cook anymore.

I'm just going to have them wait in the living room or at the kitchen table while I do everything in here.

So constantly looking for opportunities to stimulate the brain of someone who even does have a dementia diagnosis.

Thankfully for many of us, a certain degree of forgetfulness is common as we age, so I'm hopeful with that statement right there.

We compensate for our forgetfulness in a big way, and we have a lot going on these days.

We're constantly being torn between different demands.

We have our devices around us all day long.

We have a lot of distraction.

So what we tend to do is we have sticky notes and if I was to turn this camera around you would see a lot of different sticky notes.

On my monitor, and maybe that's the same for you.

Too, or maybe you have lists beside.

You, or maybe you have on your phone.

You have a lot of.

Your lists on there, but we compensate for our brains, right?

We know that we're going to forget this and that, so I'm going to write that down so I don't forget I'm going to.

Slap it on my monitor so I make sure I do that today.

So a certain degree of forgetfulness is OK.

We adapt to forgetfulness through all these different means.

We usually remember things later, so if I'm trying to think of a movie that I watched last weekend and I want to tell you about it and I can't quite grab that that movie name, I'll maybe remember it later.

It might be at three in the morning when I'm.

Laying there trying.

To sleep, or we compensate.

So maybe I'm trying to tell you a story and there's a certain word.

That I'm trying to grab.

I can't grab that word, but I'll substitute a different word that is almost just as good so we can compensate for those kinds of things.

That is normal aging in terms of carbs.

And as I've mentioned, the normal aging human brain without dementia does not stop functioning with age, so that is very good news.

If we can keep our brains cognitively intact for all the time that we age, some typical age related changes involved making a bad decision now and again.

I think all of us.

Or a little bit guilty of maybe.

Making a bad decision, that's OK.

Maybe we make.

An error in paying something, maybe we don't have all of our bills.

Probably you, as fiduciaries have all of your bills on autopay, you're very organized, probably in that department.

But some of us will miss a monthly payment.

That's OK, that happens.

That's normal.

We forget things sometimes I've, you know, people think what day is it.

What's the date?

And we are not quite sure we have to think about it right?

Doesn't come to top of mind, that's OK.

Sometimes forgetting which word to use as I just mentioned in the last slide, we can substitute maybe another word that works just as well.

Now we lose things from time to time, but we tend to remember or we backtrack.

On our steps, right?

Where did I leave my phone?

We backtrack where was I?

Oh, I was over in the kitchen I went I was washing my hands.

There it is.

So we compensate and we find things.

So let's take.

A look we probably won't go through.

All of these different examples.

But this is a chart here that talks about normal aging on the left hand column and then compare to the disease process within the brain on the right hand column and comparing what is normal aging versus what it is a disease process of the brain.

So let's just take the top one, temporarily forgetting a colleague's name, so maybe this is someone that you'd know pretty.

Well, but for.

Whatever reason it's gone and you may have had this happen to you, I know that I have.

That's normal aging to maybe temporarily forget and then you're like, Oh yeah, Kathy, and it comes to you on the other side of that.

The disease process is not being able to remember that name later, so the colleague that you've been working with for a while you still can't remember their name after some time goes by.

Let's do.

Forgetting carrots on the stove until the meal is over.

How many times have you gone into the oven the next morning and found there's the buns or there's something else that you forgot in the oven or on the stove and it just you know you got carried away and you had other food and there were people over and you were visiting with them, et cetera.

You just forgot that you had something else.

An example of a.

Disease process were would be that forgetting that the meal was ever prepared. You may hear stories of a client who says what's for breakfast and you know that they just had breakfast 35 minutes ago. But they've forgotten that. So that's an example of the disease process.

Let's do maybe the 4th one down, forgetting for a moment where you are going and I'm.

I'm thinking this happens to all of us that we're driving along and all of a sudden we know maybe we're listening to the news, or we're doing a phone call while we're in the car and we forget that momentary lapse of where am I going here and.

Have to get reoriented.

For a second, getting lost on one's own street is certainly an example.

Of a disease process.

Yes, we do get into trouble where people wander.

You hurt you hear that term where people wander when they have a dementia of some sort and this is one of those things and I used to work with the Alzheimer's Association and we would get calls of people being lost and some never did make it home.

But these were folks.

Who would walk every day?

I remember 1 gentleman in Laguna Beach had two dogs and he would go up and hike the same area every single day.

It was part of his routine in the morning.

One day he didn't come back from that.

And they found him a couple of days later.

The dogs came home without him and they did find him just off the trail.

So sometimes there's just a disorientation and it's hard to know whether something else happened to him as well, but this is not an unusual story and we hear people who drive.

And they keep driving until they have no more gas in the car and they're not quite sure how they got there or.

Why they are?

Where they are so it can have some really serious implications.

I have one more slide that gives a few.

I thought I had one more slide on that.

Hang on, I did.

Let's see, let's do.

A couple more here, so having trouble balancing a checkbook can be a normal.

I don't know how many people balance a.

Checkbook these days, but.

Getting into the numbers and trying to balance things and getting a little.

Bit befuddled with all.

Of that normal aging, you figure it out eventually, or you call your accountant whatever.

But another example of a disease process related to this is not knowing what those numbers mean, and if someone lives with the dementia for long enough.

Those kinds of things will happen where letters don't make sense where numbers don't make sense anymore.

One more, a gradual change in personality.

You know people over time do change a little bit with their personality.

An example of a disease process would be drastic personality changes.

Some of the dementias have more of a personality related aspect to them.

Frontal temporal lobe dementia can involve.

With some personality disorder, you may have heard.

Of picks disease.

Is sort of an older term for that, but.

Some pretty drastic personality changes.

The person is just not the same person that they used to be in terms of that, and that can be kind of a shocking transition for family members for loved ones.

All right, so let's move on to what I call.

The good news.

Dementia if there is such a.

Thing you have.

A handout on this that should have come with your packet last evening.

It's from the Alzheimer's, Orange County group treatable causes of memory loss.

There are certainly more than 13.

That's how many they have on that that document, but certainly there's more than that.

We'll just pick through a few as we go through here today, but certainly if.

We can address.

These causes of a temporary form of cognitive change.

Usually it's related.

To memory, is this, uh, the thing that we tend to observe in people that their memory has been changing, especially short term, but it can be due to dietary changes to nutritional deficiencies vitamins.

Or that are not being taken in in the proper amounts and we know going back to that old term, I haven't heard it for a long time, but the tea and toast syndrome of our seniors where they're barely getting enough calories and the calories that they do get, are pretty devoid of nutrition.

So this is a really important aspect for our seniors or anybody with dementia.

I'm going to go off on a tangent here because I don't think I address it anywhere else.