September 19, 2024 • 34 mins
In this episode of the Advice From Your Advocates podcast, host Attorney Bob Mannor has a conversation with Morgan Donoghue, a speech pathologist specializing in neurodegenerative diseases like dementia and Alzheimer's. Together, they discuss the critical role of a speech pathologist in managing communication, and swallowing difficulties, the importance of caregiver education and support, and practical tips for communicating with individuals with dementia. Morgan also introduces her business, Memorable Minds, and shares valuable resources from her website and Instagram page to help caregivers navigate the challenges of dementia care.
Episode Takeaways:
- Caregivers often lack education on dementia.
- Maintaining communication is crucial for quality of life.
- Nonverbal communication plays a significant role.
- It's important to validate feelings rather than correct them.
- Activities should reflect the person's interests pre-diagnosis.
- Social media can provide support and community for caregivers.
- Caregivers should not feel guilty for what they don't know.
- Nutrition is vital; consider appealing food options.
- Body language can influence interactions significantly.
- Finding the right communication strategy is essential for each individual.
Morgan's website: https://www.memorablemindsconsulting.com
Learn more about Mannor Law Group: www.mannorlawgroup.com
Host: Elder Law Attorney Bob Mannor
Executive Producer: Savannah Meksto
Assistant Producer: Samantha Noah
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ABOUT US:
Mannor Law Group helps clients in all matters of estate planning and elder law including special needs planning, veterans’ benefits, Medicaid planning, estate administration, and more. We offer guidance through all stages of life.
We also help families dealing with dementia, Alzheimer’s disease, Parkinson’s disease, and other illnesses that cause memory loss. We take a comprehensive, holistic approach, called Life Care Planning. LEARN MORE...
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Morgan Donoghue (00:00):
You're listening to Advice from your
Advocates, a show where weprovide elder law advice to
professionals who work with theelderly and their families.
Attorney Bob Mannor (00:10):
Welcome back to Advice from your
Advocates.
I'm Bob Mannor.
I'm a certified elder lawattorney here in Michigan and
I'm really excited about theguest today, who is a speech
pathologist that works primarilywith those with
neurodegenerative diseases suchas dementia and Alzheimer's and
things like that.
(00:30):
So, morgan, welcome.
Morgan Donoghue (00:32):
Hi there.
Thank you so much for having metoday.
Attorney Bob Mannor (00:35):
So this is a really interesting topic.
Why don't you first, if we canstart off by if you can just
tell us a little bit aboutyourself and how you got into
this field?
Morgan Donoghue (00:43):
Sure, so my name name is Morgan and I am a
speech language pathologist.
I do still work full time.
So I'm currently working in thehome health setting, where I go
into people's homes and I alsogo into memory cares and
assisted livings to treat mypatients.
But on the side, I started abusiness called Memorable Minds
(01:05):
where I help caregivers navigatethe complexities of dementia.
One thing I found while I wastreating during my full-time job
is that caregivers had not alot of education on dementia, so
a lot of my sessions wereproviding caregiver education
and that is kind of howmemorable minds formed.
(01:26):
Where I wanted to reach alarger audience, I realized
there was a bigger need for this.
Attorney Bob Mannor (01:31):
That's great and you know it's
absolutely true and it'sunderstandable because when you
think about it you know if thisis your loved one, your spouse,
your parent, it comes with alifetime, right, it comes with a
lifetime of history, andsometimes those relationships
were, you know, really great andsometimes they were strained a
(01:51):
little bit, and so there's atendency it's almost a human
nature, to ascribe the behaviorsto just the relationship,
behaviors to just therelationship.
Oh, that's just my husband beingstubborn, or, you know, that's
just dad in the way he is, whenit really is significantly
different once there's thisneurodegenerative disease and so
(02:18):
one of the things.
So it's, I think it's reallygreat that you're working with
the families and I think thatthat's a real.
There's a vacuum there thatneeds to be filled, because I
think a lot of families we hadone guest recently that was
talking about how many familieskind of cocoon.
They get that diagnosis ofdementia.
Now they cocoon and they justsay, okay, we're just going to
make sure dad never leaves thehouse again, which is the worst.
(02:39):
You know, that's terrible.
And so the education for thefamily and really helping them
understand how how they cannavigate this, I think that's
just a fantastic goal andcalling yeah, and absolutely I
mean.
Morgan Donoghue (02:55):
the point that you just brought up is that
family might not have been toldabout local resources in their
area where there are theseprograms, memory cafes in their
area where there are theseprograms memory cafes different
outings for other people who areliving with dementia and
caregivers where they could goand communicate with them and
build a local support group forthemselves.
So it's a shame that peoplearen't receiving those education
(03:16):
and that those resources thatare local to them.
Attorney Bob Mannor (03:20):
Well, and I appreciate the efforts that
you're making in that regard.
So the first question I havefor you you're probably going to
laugh about a little bit, butyou know so.
I remember when I met my wifeand she's an occupational
therapist and I had no idea thiswas.
You know, I was in my 20s, Ihad no idea what an occupational
therapist was and so, you know,in my family, once I introduced
(03:40):
her, they could not get itthrough her head what an
occupational therapist was.
I think my brother said oh soyou just help people get jobs,
and so occupational therapist?
I think people have the samekind of confusion about a speech
pathologist, so can justeducate us.
What does a speech pathologist?
Morgan Donoghue (03:58):
do Well, of course.
So our thing that we alwayshear is but I know how to speak,
so people always say that to us.
But what a speech therapistdoes and what we specialize in
is we specialize in treating andassessing communication, speech
, language, cognition andswallowing, which, if you think
about dementia, it pretty muchtouches every aspect of what we
(04:21):
specialize in of what wespecialize in.
Attorney Bob Mannor (04:28):
Yeah, that's absolutely true.
And so one of the things that Ithink it's probably neglected
sometimes by the families andperhaps even people in the
healthcare industry because, ifyou know, one of the things when
we're talking about dementia islet's make these years as
positive as possible.
You know, it's not going to begreat, because this is a
terrible disease, but we canmake it better.
(04:50):
Not great, but better Meaningcommunication of all things is
one of those things thatprobably and swallowing things
like that but communication, inparticular for the family,
that's probably one of the mostimportant things to maintain
some quality of life.
And so your services are justso important and I think the
(05:11):
family's just it's not intuitive, it's not something that they
immediately go to to say, if wecan preserve communication for
longer, that's going to providenot only the person with memory
issues a better quality of life,but the family surrounding them
a better quality of life.
Morgan Donoghue (05:28):
Absolutely, and that is our goal too.
It's to provide them with abetter quality of life.
Are we able to communicate intwo-step directions with them?
Sometimes we're not able to,and we need to simplify it down
to one step at a time.
When I say that to you, youmight be like, oh yeah, I knew
that.
But when you're in the momentof talking to your loved one,
(05:49):
who you've talked to your wholelife, it is not familiar to
change the way that you've beenspeaking to them.
So a lot of times it's alearning curve and we have to
change our habits.
So that's sometimes a hard parttoo, of learning how to
communicate in a more effectiveway with our loved ones.
Attorney Bob Mannor (06:08):
Yeah so and I know that, just to make sure
we say this right off the batand we'll get back to it later
that you've gotmemorablemindsconsultingcom,
which is a great resource to goto go to.
But my question for you aboutMemorable Minds is how did you
get into that?
How'd that come about where youyou know you started this
(06:29):
website and started thisconsulting.
Tell us a little bit more aboutthat process.
Morgan Donoghue (06:34):
Yeah.
So, like I said, my drive fordementia started when more of
when I started my home healthjourney and job and I was
educating so much on dementiaand I knew that I just wanted to
reach a bigger audience and Ifound one to two other speech
therapists doing it and I waslike I can do this.
I was like this is somethingthat I am extremely passionate
(06:55):
about.
And then I almost didn't do itbecause I was like there's one
to two other people doing that,but you don't hear other people
in other professions lawyers,therapists not doing those
things because, oh, there'salready one doing it.
So finally decided to go for itand I went all in and it is the
best thing I've ever done.
I used to go to my day jobspeech therapy and I would come
(07:18):
home and just live my life.
And now I come home and I amconstantly researching dementia,
constantly trying to finddifferent strategies, resources
that I don't know about, justreally pushing myself further to
be more knowledgeable in thearea, and I have built an
amazing community online.
Who never would have met theseother caregivers, health care
(07:41):
providers had I not started this.
And it's been an amazing journeyso far.
Attorney Bob Mannor (07:46):
Yeah, that's one of the things I like
about doing this podcast.
I've met some really incrediblepeople throughout the country
and throughout the world thathave the same, you know, passion
to help people, especially helppeople with you know, memory
diseases and dementia, and justsome really fascinating stories
and interesting stories, andit's something I probably
(08:07):
wouldn't have.
That opportunity I've had lotsof opportunities to teach other
lawyers and work within my localcommunity, but just hearing the
different folks that I get towork with and talk to and really
expanding our resources and Iimagine that's a lot of what
you're doing too, you really bygrowing your network you're
doing too.
You really by growing yournetwork, you're really growing
your resources that you canshare with your families.
Morgan Donoghue (08:37):
Yeah, yes, and I've learned about so many that
I didn't know before, so now I'mable to better help my clients
that I see on a full-time basisfor speech therapy too.
So it's a win-win on both sides.
Attorney Bob Mannor (08:45):
So tell us a little bit.
I know two of the main thingsthat are sort of the more
popular things that you do areyour website,
memorablemindsconsultingcom, andthen you have a big Instagram
following.
Tell us about your Instagrampage.
Morgan Donoghue (09:00):
Yeah.
So I try to post on Instagramalmost every single day.
Some of it is education, Someof it is tips and tricks, Some
of it is humor or justrelatability for the caregivers.
I want my Instagram to be aspot where they can say they
feel comfortable in it, they caninteract with me, and I want
them to know that my messagesare always open.
(09:22):
I have caregivers frequentlymessaging me like oh, I related
to that post today.
Do you have any advice for X, Y, Z?
And I try to.
If there's a trend going on, Itry to see if there's a way that
I can fit it into dementia andthen add a little bit of
education into it as well,Because most people you know,
(09:43):
with social media we're gettinginto the way of let me watch a
quick video on it and that'skind of where we're heading
towards sometimes with learning.
So I try to lean into that alittle bit.
Attorney Bob Mannor (09:54):
And that's great and I really do think, you
know, I think that it's an easyway to get new ideas or new
thought processes in shortsegments, and I really, you know
, it seems like that's the wayof things are trending, but it's
also probably always been thatway a little bit, to the extent
(10:17):
that, you know, most peoplearen't going to read a 90 page
research letter, but the if theycan get a concept that's going
to help them interact or evenjust make them feel a little bit
better about their situation,to say they're not alone and
that they you know other peopleshave experienced this with
their loved one I think that canmake a big difference in
(10:38):
people's lives.
Morgan Donoghue (10:39):
Absolutely, and I want my Instagram to be a
space where maybe they connectwith other caregivers in the
comments my mom is doing thattoo and then let them connect to
be a space where maybe theyconnect with other caregivers in
the comments my mom is doingthat too and then let them
connect to each other too.
Yeah, being a caregiver, I wantyou to know that you are not
alone.
There's other caregivers outthere, and so I encourage
caregivers to reach out toothers to see what have a
(11:02):
shoulder to lean on, becauseyou're not alone.
Attorney Bob Mannor (11:06):
Yeah, excellent.
So talk us through how peopleshould interact or would likely
interact with your website.
So anybody that's.
We're not near done with ourconversation, but I want to get
to your website to the extent ofyou know if somebody is already
their interest is piqued,they'd like to learn more.
They'd like to learn some ofyour tips and advice on.
You know if somebody is alreadytheir interest is piqued,
(11:27):
they'd like to learn more.
They'd like to learn some ofyour tips and advice on.
You know helping with theirfamily member.
What is interacting with yourwebsite look like and what would
you have any you know, help forsomebody that's going to your
website for the first time.
Morgan Donoghue (11:38):
Yeah, so my website is
memorablemindsconsultingcom andon there I just recently started
a blog, so I'm trying to postmore longer form content on
there for if people want to bereading more information instead
of on Instagram, where it's theshort form content, and then
(11:58):
the other thing that they can dois either book a free 15-minute
discovery call with me to seeif we're a good match and to see
how I can help them in theirsituation, and then that can
lead into booking our one-on-oneconsultations, which are one
hour long and it's all virtual,so I see people across the US.
Attorney Bob Mannor (12:18):
Yeah, I was going to ask you that, so I
want to get into some of themore substantive tips and things
like that in a second.
But since we're talking aboutthis, I did want to highlight
that that it doesn't matterwhere.
They don't have to.
You're currently calling infrom Cincinnati, Ohio, I believe
.
Is that right?
Morgan Donoghue (12:33):
Yeah.
Attorney Bob Mannor (12:35):
It doesn't matter, they don't have to be in
Ohio or in the Cincinnati area,they can be anywhere in the
United States and you'd be ableto interact with them and assist
with this process, and you'd beable to interact with them and
assist with this process.
So let's talk a little, let'sget into some of the substance
of what you do and how you helpfolks, and so, you know, one of
the ways, I think, is just tokind of talk about some of the
tips or give some examples orsome case studies.
(12:58):
You know, tell us a little bitmore things that might be, you
know, provide value to some ofour listeners of how just things
that can help the caregivers,help the person with dementia.
Morgan Donoghue (13:10):
Yeah, sure.
So I think, in broad terms, oneof the main things that I will
always ask my caregivers or makesure that we know is things
that they enjoyed or habits thatthey had before the diagnosis.
That's going to be reallyimportant post-diagnosis.
Just because they have thediagnosis doesn't mean they've
(13:32):
changed as a person.
So I love to follow theirsimilar routines, their similar
interests.
So, for example, if you go tothe doctor, they might just tell
you to give them some morepuzzles.
Well, that's not really the bestpiece of advice for somebody
who's hated puzzles their entirelife.
(13:52):
So for somebody who's enjoyedbaking, they might not be able
to bake a whole cake bythemselves anymore, but they can
definitely help with differentpieces of baking a cake.
But they can definitely helpwith us like different pieces of
baking a cake.
So I love to get my caregiversinvolved in thinking about what
did they do before theirdiagnosis and let's continue
(14:14):
that post-diagnosis.
Let's keep their interests inmind and their hobbies, routines
, foods they liked let's try tokeep all of those and keep it
how it was.
Just because they received adiagnosis doesn't mean
everything has to change.
Attorney Bob Mannor (14:30):
One of the favorite couples that we've
worked with.
The husband was blind and thewife had memory issues and so,
but you know, we often see thisand we we lovingly say this is
not intended to be condescendingat all but we lovingly say two
halves make a whole.
Both of them had deficits buttogether they were getting by
(14:51):
and of course, from a legalstandpoint that's great.
We need to plan for when thatyou know, when we turn the page
on that.
So when we have that two halvesmake a whole and they're doing
fine, that's the time to planfor the next step.
But in this particular case, tofollow through on what you were
saying, they used to love tobake together and they make
cookies and uh, so he was blind,he couldn't, uh, he couldn't uh
(15:17):
see how much he was pouring inor measuring things.
So she would help them measureit.
He would, you know, he would bethe one sort of directing the,
the baking of the cookies.
But she would help, you know,she would measure everything.
She would be his eyes and she,he would be, you know, the
person that was able to kind ofput all of it together and it
was very sweet and they, youknow, and it worked really well,
(15:41):
you know, for the time thatthey were able to do that, and I
think those are the types ofthings Another example of that
that we see often.
So we have a number of clientsthat in their working they were
either a supervisor or in themedical field, and so then when
we get into a setting withothers whether it be a senior
(16:01):
center or a daycare or a respiteor any, or even a live-in, you
know, caregiving situation theyseem to want to take that role
and they're getting up to go towork every day and they're
helping out everybody else andthey're helping with getting
people around, because they feellike they're going to their job
, because that's what they knewand that's what they loved was
(16:22):
helping other people.
And so we see that time andtime again, somebody who was a
manager or supervisor they'rethere kind of directing people.
Somebody who was in the medicalfield they're there helping
people get around and justhelping the others, and the
family's always calm.
I think she thinks she's backat work because she's out there
really helping everybody everyday.
(16:42):
And we go and we say, mom, youcan just sit with us.
Oh no, no, I've got to helpDaisy.
She's over there and she needsto get down to the lunchroom,
and I just love that because,like you say, it's not always
puzzles for everybody, it's notthe same thing for everybody.
It's what they still have apassion for, that they can still
have some interaction with,even if it's not at the same
(17:04):
level that it used to be.
Morgan Donoghue (17:06):
Yeah, exactly, we want to improve and maintain
quality of life, so findingthose activities that give them
purpose into their day andmeaning into their day can go
really go a long way forsomebody, and it's a win-win
relationship when the personliving with dementia is doing
well.
That also helps the caregiversand decreases their risk of
(17:29):
burnout, because that's not whatwe want either.
So hopefully, with education,finding all these resources,
getting to know their loved one,and activities, routines and
everything that they wereinvolved in, that's the goal.
The goal is to not have ourcaregivers have burnout.
Attorney Bob Mannor (17:47):
How about some tips related to
communication?
So I know this is one of thethings that we worry about and
that you know there could andlikely could, you know very well
come to a point wherecommunication is very difficult,
but to try to if we.
I think what you're telling usis that there are ways that we
(18:09):
can communicate, to allow forcommunication longer and really
have that better quality of lifeboth for the caregiver and for
the person needing care.
So what about some tips oncommunicating with somebody with
dementia and then not justtoday, but sort of kind of
setting it up to extend that sothat we're able to communicate
(18:31):
with them longer?
Morgan Donoghue (18:33):
Yeah.
So one of the first things,even before communication, is
our nonverbal communication, sohaving a positive approach.
When you come up to greet them,I just said, hey, how are you
today?
Versus Hi, how are you today?
My pitch went up my tone.
I had a smile on my face.
(18:53):
I had good body language.
Pitch went up my tone, I had asmile on my face, I had good
body language.
Somebody living with dementia ismore likely to respond and have
a good reaction to them insteadif I was not using that.
So I think it's reallyimportant for caregivers to make
sure that we are using ournonverbal communication, which
it's our family sometimes.
(19:14):
So we kind of push all of thosethings to the side because, oh,
they've known us their wholelife.
But it's actually something wehave to think about.
The other thing that is reallyimportant is to keep our
communication simple.
We need to be using one stepdirections.
Sometimes when we use two stepdirections, it's just
information overload for them.
(19:34):
Another great communication tipis to avoid phrases like oh,
you know who that is, that'syour granddaughter, or remember,
when those are stressful forsomebody living with dementia.
So we need to kind of avoidthose.
So we need to not rely on theirshort-term memory.
(19:58):
We can base our conversationsaround their senses or their
long-term memory, things likethat.
Attorney Bob Mannor (20:03):
I know this is done in love and well
intentions, but I know a lot offamilies struggle with, and I
don't know if they think that byreminding people or trying to
get them to remember, thatthat's going to somehow help
them.
You know, we see these movies.
I dislike a lot of thedepictions of dementia in movies
(20:24):
because you know, and sometimescommercials and things like
that, that somehow, if we justyou know, oh, remember, this is
your sister, this is yourdaughter, remember this and
really try to put them underthat stressful thing that that's
going to somehow snap them outof it.
And I'm sure that there is, ofcourse, things like that that
are going to be where they cankind of get.
You know there's going to beebbs and flows in their ability
(20:47):
to understand their surroundings, but it is, I think,
misinterpreted sometimes that wehave to go oh no, you know,
your husband died, daddy died.
Why would you say that tosomebody that doesn't remember
that their husband died and makethem grieve through that again?
And I know that they're doing itin loving and well-intentioned
and probably trying to.
You know they think, oh well,this is important that we, you
(21:09):
know, we help the personunderstand.
And you know they think, ohwell, this is important that we,
you know, we help the personunderstand.
Well, they're, you know, evennow they might understand it and
now have to grieve it foranother.
You know, couple hours, whereasin a couple hours they may ask
the same question, and so it'sone of those things that I think
, you know, this communicationis very important, but I think
(21:35):
you'll agree with me never argue, you know, never try to correct
and argue, because that's juststressful and actually could
cause a lot of grief for theperson Absolutely and that is
something that I educate a loton is something that we call
reality orientation versusvalidation.
Morgan Donoghue (21:48):
So somebody in the earlier stages of dementia
might be okay with realityorientation, where we are
orienting them to where they areright now.
If they do well with saying, ohno, you are at this memory
facility and they're like, ohyeah, okay, I knew that, and
they respond well, then that'san okay strategy for that person
(22:11):
.
But if you try it the firsttime and maybe they don't
respond well and it's I want togo home, then that's where we
can turn to the validationtherapy, where we are validating
everything that they arefeeling.
I bet you do miss your home.
Why don't you tell me about it?
It sounds like you have a lot ofgreat memories there, and then
we try to shift the conversationto get them off of that topic
(22:35):
and then try to get theminvolved in something else.
So that way we are validatingtheir feelings but we're not
upsetting them like no, you'renot home, you're at this memory
care facility, don't youremember?
So we're just validating theirfeelings.
Somebody in the earlier stagescould benefit from reality
orientation.
As dementia progresses we mightsee that validation might be
(22:57):
the better strategy to use forsomebody.
Attorney Bob Mannor (23:01):
Yeah, my sisters came up with a great
answer for whenever my mom wouldask about her mom or ask about
her sister, and so theirresponse was always the same.
So if she was asking about hermom, they'd say when both of
them are deceased for many years.
So if she was asking about hermom, they'd say when both of
them are deceased for many years.
So if she was asking about hermom where's, where's, where's my
mom, where's, where's my mom?
(23:21):
And they'd say, oh, she's okay,she's with Dan, helen.
And if they'd say, well,where's, where's Helen, where's
my sister?
Oh, she's okay, she's with yourmom.
And so, you know, cause they'reboth deceased, it was a great
answer and it did help sort ofdistract, to go to the next step
and not make her, you know,relive that or grieve it or
anything like that, and it wasreally just a settling thing for
(23:43):
her.
So you know, it was interestingbecause the people that she
would ask about most were theones that were deceased.
So some level she probably knewthat they were gone, but
because she wasn't asking abouther living siblings, which was
interesting, and so but you know, it made her feel a little bit
better to say, oh, you know,your sister's with your mom,
your mom's with your sister, youknow things like that, and
(24:06):
that's sort of a distraction,but it's also.
You know, it was a good way for, at least for my family, to
address that kind of questions.
Morgan Donoghue (24:15):
Exactly, and for each person living with
dementia you're going to finddifferent strategies that work
for everybody.
I could list out 50 differentstrategies and maybe only one
would have worked for your mom.
Everybody has.
We have to find the techniquethat works best for them.
Every technique and strategy isnot going to work for everybody
(24:35):
, so we just have to kind ofkeep being creative and find
those techniques that work foreverybody.
So it sounds like your familyfound a great response to use
when she would ask thosequestions.
Attorney Bob Mannor (24:51):
So I don't know, you know what kind of
advice that you'd give in thissituation.
But there are occasionallywhere some folks with dementia
and you know sometimes they callit sundowners, but sometimes
it's just, you know, the braintrying to figure out everything
and there might be some lashingout or some irritation or some
(25:14):
anger and a lot of times that isa communication issue, I
believe Sometimes it's a bodylanguage thing and I'll give you
a couple examples in a minute.
But what's your advice on if wehave somebody in the healthcare
, in the long-term care industry?
They also often say behaviors,they have behaviors, and so how
(25:37):
do we any advice on when we havea loved one that's showing some
negative behaviors and how tomaybe distract or redirect on
that?
Morgan Donoghue (25:48):
Sure.
So a lot of times, when you areseeing these behaviors what
people will call it A lot oftimes it might be a
communication breakdown or itmight be that their needs are
not being met.
So they might be in pain, theymight be hungry, they might be
thirsty, needing to go to thebathroom.
Maybe they've gone to thebathroom on themselves and they
(26:09):
need to be changed.
So my first piece of advice isto approach them with a positive
attitude, because a lot oftimes, if they're showing that
anger, agitation, frustrationthey're not going to want
somebody coming up to them in athreatening, in a threatening
way.
They're not going to respondwell to that.
So if you come up to them,positive all those non-verbal
(26:32):
cues that we just talked aboutsmiling, high pitch tone, all of
that we need talked aboutsmiling high pitch tone, all of
that we need to approach themthat way.
And then this is another pointwhere we need to validate
everything that they are feeling.
I'm not going to correct them,I'm not going to argue with them
.
I'm going to be the one in thewrong.
I am so sorry you feel that way.
Let me help you figure this out,and then I'm going to do
(26:52):
everything I can to try tofigure it out In the best way.
I'm going to try to redirectthem into something that I know
that my loved one enjoys doing.
Maybe that's going for a walk,Maybe that is letting them fold
laundry, maybe they do need togo to the bathroom.
So I'll try to guide them intothe bathroom to see if that's
where they need to go.
It is kind of that trial anderror.
(27:14):
What do they need?
What need is not being metright now.
So once we figure out that need, we need to try to take
advantage of that and solve it.
Attorney Bob Mannor (27:25):
That's great advice and great
information.
I want to give the listeners anexample of something that we
had in our office.
So we had a husband and wifecome in and they had called us
on their way over, but they hadbeen at their gerontologist and
the gerontologist said go overand go to Manor Law, see what
(27:47):
they can do to help you with.
You know, because they werestill at home and he was a large
man and he had Lewy bodydementia, which sometimes with
Lewy body, we see, you know, wehave hallucinations and there
can be.
You know, it can be a dangerousthing.
And he was a very large man andshe was a small woman and she
was fearful.
And so he said before you gohome, go over to the law office.
(28:10):
And so, fortunately, we wereable to meet with him in such a
short notice.
And so I was, you know, sort ofhuddling with the wife to
gather information, and I hadone of my social workers sitting
with the husband and this is anexample of what you're talking
about with regard to the bodylanguage.
And it took us.
(28:31):
We didn't realize what washappening at the time, but now,
looking back on it, we knowexactly what was happening.
So I was talking to the wife,Our social worker was trying to
keep the husband sort ofdistracted so that I could talk
to the wife, and so she wastalking in low voice, low tones,
(28:51):
and so then he would respond inlow tones because body language
, you know, responsiveness.
And when he would speak quietly,she would lean in because
that's, you know, that's kind ofnormal behavior, but that's not
how his brain interpreted it.
His brain interpreted it as oh,I guess it's time to go.
She's leaning in to get out ofher seat.
So he would get up and towerover her and she was afraid.
(29:13):
He was a large man, very talland strong, and we thought he
was being aggressive.
And we realized afterwards hewas as gentle as could be.
He was not being aggressive.
He was responding to her bodylanguage.
Her body language was hergetting out of her seat a little
bit, and so that was a cue tohim oh, it's time to get up.
(29:35):
So he got up and he was such abig man he was towering over.
It seemed like he was beingaggressive, when all he was
doing was responding to the bodylanguage that she had given.
That's one of those things that, you know, at the time we were
all a little nervous about thesituation and we looked back on
it afterwards and like, oh, hewasn't being aggressive, he was.
That's where body languagecomes into this whole picture of
(29:57):
communication.
You know, especially withdementia, probably body language
might be one of the mostimportant forms of communication
.
Morgan Donoghue (30:05):
Our body language is everything.
So, to kind of piggyback off ofan example, think about when we
are trying to assist with ashower for somebody with
dementia and let's say they'resitting in a shower chair and I
have one of those handheldthings and I am standing over
you just soaking you with water.
(30:27):
That is very intimidating andfrightening.
So our body language in theshower absolutely matters.
Maybe we, while they're sitting, we need to be at eye level
with them so we are not hoveringover them and seeming like a
threat While we are showering.
Maybe we start at their feetand we are starting down there,
(30:49):
making sure they're comfortable.
They know exactly what we'redoing.
They can see me at all times.
I'm not in a threatening stanceand then we gradually go up the
body to make them feelcomfortable and not like we are
a threat.
So body language absolutelymatters.
Attorney Bob Mannor (31:07):
So the next question I have for you is you
know, occasionally or frequently, with some forms of dementia,
eating can be an issue as towhether or not the you know, and
so there could be a variety ofeating issues.
And do you have any tips forsomebody where their loved one
(31:28):
with dementia they're struggling, family members struggling with
making sure that the person'swell-nourished or is receiving
enough fluids, and things likethat?
Morgan Donoghue (31:38):
Sure.
My first tip is that if you areseeing your loved one is having
troubles chewing, swallowing,coughing when they are eating or
drinking, I would ask theirprimary care physician to see a
speech language pathologist sothat they can fully evaluate
their swallow function to seewhat's going on.
But outside of that, I wouldget a dietician involved if they
(32:03):
are malnourished.
That's something that a lot ofpeople don't think to get on
their care team and it canactually be really important for
them if they are not gettingenough calories, which sometimes
that happens.
One of the biggest tips ortricks that I give to some of my
patients and my families andpeople living with dementia love
sweets.
It's been one of the last tastebuds to go, so let's use that to
(32:25):
our advantage.
So let's say, in the morninglet's have a smoothie.
We can call it a milkshake ifwe want.
That sounds way more appetizingthan a smoothie.
But we can pack that all bunchof nutrition in there without
them even knowing that it's inthere.
Pack it with vegetables, youcan pack it with the Greek
(32:46):
yogurt, with protein, you canpack it with all these different
nutrients.
So for the malnourished side,we want to make sure that they
are getting the calories whenthey are eating.
Attorney Bob Mannor (33:01):
We need to make sure we are packing it with
the calories that they need.
Yeah, that's great advice.
I really like the advice.
Well, it's been very greattalking to you, morgan Donahue,
and you can find her atmemorablemindsconsultingcom and
on Instagram at memorableminds.
Any other last minute tips orthings that you want to leave
(33:21):
our audience with?
Morgan Donoghue (33:29):
is.
I just want caregivers to knowthat they are doing an amazing
job.
You can't, I don't want them tobeat themselves up of something
they didn't know, Like if Isaid a tip today like, oh my
gosh, I've not.
I've been doing that.
I feel horrible.
I don't want that to be thereaction.
I want it to be that, oh, Ilearned something new and now
I'm going to start doing that.
Because you can't beat yourselfup on something that you were
never taught, and they shouldhave been taught at diagnosis.
Unfortunately, they might nothave been.
Attorney Bob Mannor (33:51):
Yeah, that's an excellent tip.
That's a pretty important onetoo, that the fact that the
caregiver is giving up theirblood, sweat and tears to take
care of somebody.
We certainly don't want them tofeel bad about anything, and
it's all a learning process foreverybody, right?
And so yeah, it's going to be.
You know what was it?
(34:12):
I think it was Angelou saidsomething like you know, when
you know better, do better.
So Exactly.
Morgan Donoghue (34:19):
And you can't do better before you knew about
it Exactly.
Attorney Bob Mannor (34:24):
Thank you so much, morgan.
This is great information.
I appreciate you coming on.
If you enjoyed this podcast ofAdvice from your Advocates, you
can find it anywhere you listento your podcast or you can go to
ManorLawGroupcom and you canfind it there.
Thanks for listening and we'llsee you next time.
You're listening to Advice from your
Advocates, a show where weprovide elder law advice to
professionals who work with theelderly and their families.
Attorney Bob Mannor (00:10):
Welcome back to Advice from your
Advocates.
I'm Bob Mannor.
I'm a certified elder lawattorney here in Michigan and
I'm really excited about theguest today, who is a speech
pathologist that works primarilywith those with
neurodegenerative diseases suchas dementia and Alzheimer's and
things like that.
(00:30):
So, morgan, welcome.
Morgan Donoghue (00:32):
Hi there.
Thank you so much for having metoday.
Attorney Bob Mannor (00:35):
So this is a really interesting topic.
Why don't you first, if we canstart off by if you can just
tell us a little bit aboutyourself and how you got into
this field?
Morgan Donoghue (00:43):
Sure, so my name name is Morgan and I am a
speech language pathologist.
I do still work full time.
So I'm currently working in thehome health setting, where I go
into people's homes and I alsogo into memory cares and
assisted livings to treat mypatients.
But on the side, I started abusiness called Memorable Minds
(01:05):
where I help caregivers navigatethe complexities of dementia.
One thing I found while I wastreating during my full-time job
is that caregivers had not alot of education on dementia, so
a lot of my sessions wereproviding caregiver education
and that is kind of howmemorable minds formed.
(01:26):
Where I wanted to reach alarger audience, I realized
there was a bigger need for this.
Attorney Bob Mannor (01:31):
That's great and you know it's
absolutely true and it'sunderstandable because when you
think about it you know if thisis your loved one, your spouse,
your parent, it comes with alifetime, right, it comes with a
lifetime of history, andsometimes those relationships
were, you know, really great andsometimes they were strained a
(01:51):
little bit, and so there's atendency it's almost a human
nature, to ascribe the behaviorsto just the relationship,
behaviors to just therelationship.
Oh, that's just my husband beingstubborn, or, you know, that's
just dad in the way he is, whenit really is significantly
different once there's thisneurodegenerative disease and so
(02:18):
one of the things.
So it's, I think it's reallygreat that you're working with
the families and I think thatthat's a real.
There's a vacuum there thatneeds to be filled, because I
think a lot of families we hadone guest recently that was
talking about how many familieskind of cocoon.
They get that diagnosis ofdementia.
Now they cocoon and they justsay, okay, we're just going to
make sure dad never leaves thehouse again, which is the worst.
(02:39):
You know, that's terrible.
And so the education for thefamily and really helping them
understand how how they cannavigate this, I think that's
just a fantastic goal andcalling yeah, and absolutely I
mean.
Morgan Donoghue (02:55):
the point that you just brought up is that
family might not have been toldabout local resources in their
area where there are theseprograms, memory cafes in their
area where there are theseprograms memory cafes different
outings for other people who areliving with dementia and
caregivers where they could goand communicate with them and
build a local support group forthemselves.
So it's a shame that peoplearen't receiving those education
(03:16):
and that those resources thatare local to them.
Attorney Bob Mannor (03:20):
Well, and I appreciate the efforts that
you're making in that regard.
So the first question I havefor you you're probably going to
laugh about a little bit, butyou know so.
I remember when I met my wifeand she's an occupational
therapist and I had no idea thiswas.
You know, I was in my 20s, Ihad no idea what an occupational
therapist was and so, you know,in my family, once I introduced
(03:40):
her, they could not get itthrough her head what an
occupational therapist was.
I think my brother said oh soyou just help people get jobs,
and so occupational therapist?
I think people have the samekind of confusion about a speech
pathologist, so can justeducate us.
What does a speech pathologist?
Morgan Donoghue (03:58):
do Well, of course.
So our thing that we alwayshear is but I know how to speak,
so people always say that to us.
But what a speech therapistdoes and what we specialize in
is we specialize in treating andassessing communication, speech
, language, cognition andswallowing, which, if you think
about dementia, it pretty muchtouches every aspect of what we
(04:21):
specialize in of what wespecialize in.
Attorney Bob Mannor (04:28):
Yeah, that's absolutely true.
And so one of the things that Ithink it's probably neglected
sometimes by the families andperhaps even people in the
healthcare industry because, ifyou know, one of the things when
we're talking about dementia islet's make these years as
positive as possible.
You know, it's not going to begreat, because this is a
terrible disease, but we canmake it better.
(04:50):
Not great, but better Meaningcommunication of all things is
one of those things thatprobably and swallowing things
like that but communication, inparticular for the family,
that's probably one of the mostimportant things to maintain
some quality of life.
And so your services are justso important and I think the
(05:11):
family's just it's not intuitive, it's not something that they
immediately go to to say, if wecan preserve communication for
longer, that's going to providenot only the person with memory
issues a better quality of life,but the family surrounding them
a better quality of life.
Morgan Donoghue (05:28):
Absolutely, and that is our goal too.
It's to provide them with abetter quality of life.
Are we able to communicate intwo-step directions with them?
Sometimes we're not able to,and we need to simplify it down
to one step at a time.
When I say that to you, youmight be like, oh yeah, I knew
that.
But when you're in the momentof talking to your loved one,
(05:49):
who you've talked to your wholelife, it is not familiar to
change the way that you've beenspeaking to them.
So a lot of times it's alearning curve and we have to
change our habits.
So that's sometimes a hard parttoo, of learning how to
communicate in a more effectiveway with our loved ones.
Attorney Bob Mannor (06:08):
Yeah so and I know that, just to make sure
we say this right off the batand we'll get back to it later
that you've gotmemorablemindsconsultingcom,
which is a great resource to goto go to.
But my question for you aboutMemorable Minds is how did you
get into that?
How'd that come about where youyou know you started this
(06:29):
website and started thisconsulting.
Tell us a little bit more aboutthat process.
Morgan Donoghue (06:34):
Yeah.
So, like I said, my drive fordementia started when more of
when I started my home healthjourney and job and I was
educating so much on dementiaand I knew that I just wanted to
reach a bigger audience and Ifound one to two other speech
therapists doing it and I waslike I can do this.
I was like this is somethingthat I am extremely passionate
(06:55):
about.
And then I almost didn't do itbecause I was like there's one
to two other people doing that,but you don't hear other people
in other professions lawyers,therapists not doing those
things because, oh, there'salready one doing it.
So finally decided to go for itand I went all in and it is the
best thing I've ever done.
I used to go to my day jobspeech therapy and I would come
(07:18):
home and just live my life.
And now I come home and I amconstantly researching dementia,
constantly trying to finddifferent strategies, resources
that I don't know about, justreally pushing myself further to
be more knowledgeable in thearea, and I have built an
amazing community online.
Who never would have met theseother caregivers, health care
(07:41):
providers had I not started this.
And it's been an amazing journeyso far.
Attorney Bob Mannor (07:46):
Yeah, that's one of the things I like
about doing this podcast.
I've met some really incrediblepeople throughout the country
and throughout the world thathave the same, you know, passion
to help people, especially helppeople with you know, memory
diseases and dementia, and justsome really fascinating stories
and interesting stories, andit's something I probably
(08:07):
wouldn't have.
That opportunity I've had lotsof opportunities to teach other
lawyers and work within my localcommunity, but just hearing the
different folks that I get towork with and talk to and really
expanding our resources and Iimagine that's a lot of what
you're doing too, you really bygrowing your network you're
doing too.
You really by growing yournetwork, you're really growing
your resources that you canshare with your families.
Morgan Donoghue (08:37):
Yeah, yes, and I've learned about so many that
I didn't know before, so now I'mable to better help my clients
that I see on a full-time basisfor speech therapy too.
So it's a win-win on both sides.
Attorney Bob Mannor (08:45):
So tell us a little bit.
I know two of the main thingsthat are sort of the more
popular things that you do areyour website,
memorablemindsconsultingcom, andthen you have a big Instagram
following.
Tell us about your Instagrampage.
Morgan Donoghue (09:00):
Yeah.
So I try to post on Instagramalmost every single day.
Some of it is education, Someof it is tips and tricks, Some
of it is humor or justrelatability for the caregivers.
I want my Instagram to be aspot where they can say they
feel comfortable in it, they caninteract with me, and I want
them to know that my messagesare always open.
(09:22):
I have caregivers frequentlymessaging me like oh, I related
to that post today.
Do you have any advice for X, Y, Z?
And I try to.
If there's a trend going on, Itry to see if there's a way that
I can fit it into dementia andthen add a little bit of
education into it as well,Because most people you know,
(09:43):
with social media we're gettinginto the way of let me watch a
quick video on it and that'skind of where we're heading
towards sometimes with learning.
So I try to lean into that alittle bit.
Attorney Bob Mannor (09:54):
And that's great and I really do think, you
know, I think that it's an easyway to get new ideas or new
thought processes in shortsegments, and I really, you know
, it seems like that's the wayof things are trending, but it's
also probably always been thatway a little bit, to the extent
(10:17):
that, you know, most peoplearen't going to read a 90 page
research letter, but the if theycan get a concept that's going
to help them interact or evenjust make them feel a little bit
better about their situation,to say they're not alone and
that they you know other peopleshave experienced this with
their loved one I think that canmake a big difference in
(10:38):
people's lives.
Morgan Donoghue (10:39):
Absolutely, and I want my Instagram to be a
space where maybe they connectwith other caregivers in the
comments my mom is doing thattoo and then let them connect to
be a space where maybe theyconnect with other caregivers in
the comments my mom is doingthat too and then let them
connect to each other too.
Yeah, being a caregiver, I wantyou to know that you are not
alone.
There's other caregivers outthere, and so I encourage
caregivers to reach out toothers to see what have a
(11:02):
shoulder to lean on, becauseyou're not alone.
Attorney Bob Mannor (11:06):
Yeah, excellent.
So talk us through how peopleshould interact or would likely
interact with your website.
So anybody that's.
We're not near done with ourconversation, but I want to get
to your website to the extent ofyou know if somebody is already
their interest is piqued,they'd like to learn more.
They'd like to learn some ofyour tips and advice on.
You know if somebody is alreadytheir interest is piqued,
(11:27):
they'd like to learn more.
They'd like to learn some ofyour tips and advice on.
You know helping with theirfamily member.
What is interacting with yourwebsite look like and what would
you have any you know, help forsomebody that's going to your
website for the first time.
Morgan Donoghue (11:38):
Yeah, so my website is
memorablemindsconsultingcom andon there I just recently started
a blog, so I'm trying to postmore longer form content on
there for if people want to bereading more information instead
of on Instagram, where it's theshort form content, and then
(11:58):
the other thing that they can dois either book a free 15-minute
discovery call with me to seeif we're a good match and to see
how I can help them in theirsituation, and then that can
lead into booking our one-on-oneconsultations, which are one
hour long and it's all virtual,so I see people across the US.
Attorney Bob Mannor (12:18):
Yeah, I was going to ask you that, so I
want to get into some of themore substantive tips and things
like that in a second.
But since we're talking aboutthis, I did want to highlight
that that it doesn't matterwhere.
They don't have to.
You're currently calling infrom Cincinnati, Ohio, I believe
.
Is that right?
Morgan Donoghue (12:33):
Yeah.
Attorney Bob Mannor (12:35):
It doesn't matter, they don't have to be in
Ohio or in the Cincinnati area,they can be anywhere in the
United States and you'd be ableto interact with them and assist
with this process, and you'd beable to interact with them and
assist with this process.
So let's talk a little, let'sget into some of the substance
of what you do and how you helpfolks, and so, you know, one of
the ways, I think, is just tokind of talk about some of the
tips or give some examples orsome case studies.
(12:58):
You know, tell us a little bitmore things that might be, you
know, provide value to some ofour listeners of how just things
that can help the caregivers,help the person with dementia.
Morgan Donoghue (13:10):
Yeah, sure.
So I think, in broad terms, oneof the main things that I will
always ask my caregivers or makesure that we know is things
that they enjoyed or habits thatthey had before the diagnosis.
That's going to be reallyimportant post-diagnosis.
Just because they have thediagnosis doesn't mean they've
(13:32):
changed as a person.
So I love to follow theirsimilar routines, their similar
interests.
So, for example, if you go tothe doctor, they might just tell
you to give them some morepuzzles.
Well, that's not really the bestpiece of advice for somebody
who's hated puzzles their entirelife.
(13:52):
So for somebody who's enjoyedbaking, they might not be able
to bake a whole cake bythemselves anymore, but they can
definitely help with differentpieces of baking a cake.
But they can definitely helpwith us like different pieces of
baking a cake.
So I love to get my caregiversinvolved in thinking about what
did they do before theirdiagnosis and let's continue
(14:14):
that post-diagnosis.
Let's keep their interests inmind and their hobbies, routines
, foods they liked let's try tokeep all of those and keep it
how it was.
Just because they received adiagnosis doesn't mean
everything has to change.
Attorney Bob Mannor (14:30):
One of the favorite couples that we've
worked with.
The husband was blind and thewife had memory issues and so,
but you know, we often see thisand we we lovingly say this is
not intended to be condescendingat all but we lovingly say two
halves make a whole.
Both of them had deficits buttogether they were getting by
(14:51):
and of course, from a legalstandpoint that's great.
We need to plan for when thatyou know, when we turn the page
on that.
So when we have that two halvesmake a whole and they're doing
fine, that's the time to planfor the next step.
But in this particular case, tofollow through on what you were
saying, they used to love tobake together and they make
cookies and uh, so he was blind,he couldn't, uh, he couldn't uh
(15:17):
see how much he was pouring inor measuring things.
So she would help them measureit.
He would, you know, he would bethe one sort of directing the,
the baking of the cookies.
But she would help, you know,she would measure everything.
She would be his eyes and she,he would be, you know, the
person that was able to kind ofput all of it together and it
was very sweet and they, youknow, and it worked really well,
(15:41):
you know, for the time thatthey were able to do that, and I
think those are the types ofthings Another example of that
that we see often.
So we have a number of clientsthat in their working they were
either a supervisor or in themedical field, and so then when
we get into a setting withothers whether it be a senior
(16:01):
center or a daycare or a respiteor any, or even a live-in, you
know, caregiving situation theyseem to want to take that role
and they're getting up to go towork every day and they're
helping out everybody else andthey're helping with getting
people around, because they feellike they're going to their job
, because that's what they knewand that's what they loved was
(16:22):
helping other people.
And so we see that time andtime again, somebody who was a
manager or supervisor they'rethere kind of directing people.
Somebody who was in the medicalfield they're there helping
people get around and justhelping the others, and the
family's always calm.
I think she thinks she's backat work because she's out there
really helping everybody everyday.
(16:42):
And we go and we say, mom, youcan just sit with us.
Oh no, no, I've got to helpDaisy.
She's over there and she needsto get down to the lunchroom,
and I just love that because,like you say, it's not always
puzzles for everybody, it's notthe same thing for everybody.
It's what they still have apassion for, that they can still
have some interaction with,even if it's not at the same
(17:04):
level that it used to be.
Morgan Donoghue (17:06):
Yeah, exactly, we want to improve and maintain
quality of life, so findingthose activities that give them
purpose into their day andmeaning into their day can go
really go a long way forsomebody, and it's a win-win
relationship when the personliving with dementia is doing
well.
That also helps the caregiversand decreases their risk of
(17:29):
burnout, because that's not whatwe want either.
So hopefully, with education,finding all these resources,
getting to know their loved one,and activities, routines and
everything that they wereinvolved in, that's the goal.
The goal is to not have ourcaregivers have burnout.
Attorney Bob Mannor (17:47):
How about some tips related to
communication?
So I know this is one of thethings that we worry about and
that you know there could andlikely could, you know very well
come to a point wherecommunication is very difficult,
but to try to if we.
I think what you're telling usis that there are ways that we
(18:09):
can communicate, to allow forcommunication longer and really
have that better quality of lifeboth for the caregiver and for
the person needing care.
So what about some tips oncommunicating with somebody with
dementia and then not justtoday, but sort of kind of
setting it up to extend that sothat we're able to communicate
(18:31):
with them longer?
Morgan Donoghue (18:33):
Yeah.
So one of the first things,even before communication, is
our nonverbal communication, sohaving a positive approach.
When you come up to greet them,I just said, hey, how are you
today?
Versus Hi, how are you today?
My pitch went up my tone.
I had a smile on my face.
(18:53):
I had good body language.
Pitch went up my tone, I had asmile on my face, I had good
body language.
Somebody living with dementia ismore likely to respond and have
a good reaction to them insteadif I was not using that.
So I think it's reallyimportant for caregivers to make
sure that we are using ournonverbal communication, which
it's our family sometimes.
(19:14):
So we kind of push all of thosethings to the side because, oh,
they've known us their wholelife.
But it's actually something wehave to think about.
The other thing that is reallyimportant is to keep our
communication simple.
We need to be using one stepdirections.
Sometimes when we use two stepdirections, it's just
information overload for them.
(19:34):
Another great communication tipis to avoid phrases like oh,
you know who that is, that'syour granddaughter, or remember,
when those are stressful forsomebody living with dementia.
So we need to kind of avoidthose.
So we need to not rely on theirshort-term memory.
(19:58):
We can base our conversationsaround their senses or their
long-term memory, things likethat.
Attorney Bob Mannor (20:03):
I know this is done in love and well
intentions, but I know a lot offamilies struggle with, and I
don't know if they think that byreminding people or trying to
get them to remember, thatthat's going to somehow help
them.
You know, we see these movies.
I dislike a lot of thedepictions of dementia in movies
(20:24):
because you know, and sometimescommercials and things like
that, that somehow, if we justyou know, oh, remember, this is
your sister, this is yourdaughter, remember this and
really try to put them underthat stressful thing that that's
going to somehow snap them outof it.
And I'm sure that there is, ofcourse, things like that that
are going to be where they cankind of get.
You know there's going to beebbs and flows in their ability
(20:47):
to understand their surroundings, but it is, I think,
misinterpreted sometimes that wehave to go oh no, you know,
your husband died, daddy died.
Why would you say that tosomebody that doesn't remember
that their husband died and makethem grieve through that again?
And I know that they're doing itin loving and well-intentioned
and probably trying to.
You know they think, oh well,this is important that we, you
(21:09):
know, we help the personunderstand.
And you know they think, ohwell, this is important that we,
you know, we help the personunderstand.
Well, they're, you know, evennow they might understand it and
now have to grieve it foranother.
You know, couple hours, whereasin a couple hours they may ask
the same question, and so it'sone of those things that I think
, you know, this communicationis very important, but I think
(21:35):
you'll agree with me never argue, you know, never try to correct
and argue, because that's juststressful and actually could
cause a lot of grief for theperson Absolutely and that is
something that I educate a loton is something that we call
reality orientation versusvalidation.
Morgan Donoghue (21:48):
So somebody in the earlier stages of dementia
might be okay with realityorientation, where we are
orienting them to where they areright now.
If they do well with saying, ohno, you are at this memory
facility and they're like, ohyeah, okay, I knew that, and
they respond well, then that'san okay strategy for that person
(22:11):
.
But if you try it the firsttime and maybe they don't
respond well and it's I want togo home, then that's where we
can turn to the validationtherapy, where we are validating
everything that they arefeeling.
I bet you do miss your home.
Why don't you tell me about it?
It sounds like you have a lot ofgreat memories there, and then
we try to shift the conversationto get them off of that topic
(22:35):
and then try to get theminvolved in something else.
So that way we are validatingtheir feelings but we're not
upsetting them like no, you'renot home, you're at this memory
care facility, don't youremember?
So we're just validating theirfeelings.
Somebody in the earlier stagescould benefit from reality
orientation.
As dementia progresses we mightsee that validation might be
(22:57):
the better strategy to use forsomebody.
Attorney Bob Mannor (23:01):
Yeah, my sisters came up with a great
answer for whenever my mom wouldask about her mom or ask about
her sister, and so theirresponse was always the same.
So if she was asking about hermom, they'd say when both of
them are deceased for many years.
So if she was asking about hermom, they'd say when both of
them are deceased for many years.
So if she was asking about hermom where's, where's, where's my
mom, where's, where's my mom?
(23:21):
And they'd say, oh, she's okay,she's with Dan, helen.
And if they'd say, well,where's, where's Helen, where's
my sister?
Oh, she's okay, she's with yourmom.
And so, you know, cause they'reboth deceased, it was a great
answer and it did help sort ofdistract, to go to the next step
and not make her, you know,relive that or grieve it or
anything like that, and it wasreally just a settling thing for
(23:43):
her.
So you know, it was interestingbecause the people that she
would ask about most were theones that were deceased.
So some level she probably knewthat they were gone, but
because she wasn't asking abouther living siblings, which was
interesting, and so but you know, it made her feel a little bit
better to say, oh, you know,your sister's with your mom,
your mom's with your sister, youknow things like that, and
(24:06):
that's sort of a distraction,but it's also.
You know, it was a good way for, at least for my family, to
address that kind of questions.
Morgan Donoghue (24:15):
Exactly, and for each person living with
dementia you're going to finddifferent strategies that work
for everybody.
I could list out 50 differentstrategies and maybe only one
would have worked for your mom.
Everybody has.
We have to find the techniquethat works best for them.
Every technique and strategy isnot going to work for everybody
(24:35):
, so we just have to kind ofkeep being creative and find
those techniques that work foreverybody.
So it sounds like your familyfound a great response to use
when she would ask thosequestions.
Attorney Bob Mannor (24:51):
So I don't know, you know what kind of
advice that you'd give in thissituation.
But there are occasionallywhere some folks with dementia
and you know sometimes they callit sundowners, but sometimes
it's just, you know, the braintrying to figure out everything
and there might be some lashingout or some irritation or some
(25:14):
anger and a lot of times that isa communication issue, I
believe Sometimes it's a bodylanguage thing and I'll give you
a couple examples in a minute.
But what's your advice on if wehave somebody in the healthcare
, in the long-term care industry?
They also often say behaviors,they have behaviors, and so how
(25:37):
do we any advice on when we havea loved one that's showing some
negative behaviors and how tomaybe distract or redirect on
that?
Morgan Donoghue (25:48):
Sure.
So a lot of times, when you areseeing these behaviors what
people will call it A lot oftimes it might be a
communication breakdown or itmight be that their needs are
not being met.
So they might be in pain, theymight be hungry, they might be
thirsty, needing to go to thebathroom.
Maybe they've gone to thebathroom on themselves and they
(26:09):
need to be changed.
So my first piece of advice isto approach them with a positive
attitude, because a lot oftimes, if they're showing that
anger, agitation, frustrationthey're not going to want
somebody coming up to them in athreatening, in a threatening
way.
They're not going to respondwell to that.
So if you come up to them,positive all those non-verbal
(26:32):
cues that we just talked aboutsmiling, high pitch tone, all of
that we need talked aboutsmiling high pitch tone, all of
that we need to approach themthat way.
And then this is another pointwhere we need to validate
everything that they are feeling.
I'm not going to correct them,I'm not going to argue with them
.
I'm going to be the one in thewrong.
I am so sorry you feel that way.
Let me help you figure this out,and then I'm going to do
(26:52):
everything I can to try tofigure it out In the best way.
I'm going to try to redirectthem into something that I know
that my loved one enjoys doing.
Maybe that's going for a walk,Maybe that is letting them fold
laundry, maybe they do need togo to the bathroom.
So I'll try to guide them intothe bathroom to see if that's
where they need to go.
It is kind of that trial anderror.
(27:14):
What do they need?
What need is not being metright now.
So once we figure out that need, we need to try to take
advantage of that and solve it.
Attorney Bob Mannor (27:25):
That's great advice and great
information.
I want to give the listeners anexample of something that we
had in our office.
So we had a husband and wifecome in and they had called us
on their way over, but they hadbeen at their gerontologist and
the gerontologist said go overand go to Manor Law, see what
(27:47):
they can do to help you with.
You know, because they werestill at home and he was a large
man and he had Lewy bodydementia, which sometimes with
Lewy body, we see, you know, wehave hallucinations and there
can be.
You know, it can be a dangerousthing.
And he was a very large man andshe was a small woman and she
was fearful.
And so he said before you gohome, go over to the law office.
(28:10):
And so, fortunately, we wereable to meet with him in such a
short notice.
And so I was, you know, sort ofhuddling with the wife to
gather information, and I hadone of my social workers sitting
with the husband and this is anexample of what you're talking
about with regard to the bodylanguage.
And it took us.
(28:31):
We didn't realize what washappening at the time, but now,
looking back on it, we knowexactly what was happening.
So I was talking to the wife,Our social worker was trying to
keep the husband sort ofdistracted so that I could talk
to the wife, and so she wastalking in low voice, low tones,
(28:51):
and so then he would respond inlow tones because body language
, you know, responsiveness.
And when he would speak quietly,she would lean in because
that's, you know, that's kind ofnormal behavior, but that's not
how his brain interpreted it.
His brain interpreted it as oh,I guess it's time to go.
She's leaning in to get out ofher seat.
So he would get up and towerover her and she was afraid.
(29:13):
He was a large man, very talland strong, and we thought he
was being aggressive.
And we realized afterwards hewas as gentle as could be.
He was not being aggressive.
He was responding to her bodylanguage.
Her body language was hergetting out of her seat a little
bit, and so that was a cue tohim oh, it's time to get up.
(29:35):
So he got up and he was such abig man he was towering over.
It seemed like he was beingaggressive, when all he was
doing was responding to the bodylanguage that she had given.
That's one of those things that, you know, at the time we were
all a little nervous about thesituation and we looked back on
it afterwards and like, oh, hewasn't being aggressive, he was.
That's where body languagecomes into this whole picture of
(29:57):
communication.
You know, especially withdementia, probably body language
might be one of the mostimportant forms of communication
.
Morgan Donoghue (30:05):
Our body language is everything.
So, to kind of piggyback off ofan example, think about when we
are trying to assist with ashower for somebody with
dementia and let's say they'resitting in a shower chair and I
have one of those handheldthings and I am standing over
you just soaking you with water.
(30:27):
That is very intimidating andfrightening.
So our body language in theshower absolutely matters.
Maybe we, while they're sitting, we need to be at eye level
with them so we are not hoveringover them and seeming like a
threat While we are showering.
Maybe we start at their feetand we are starting down there,
(30:49):
making sure they're comfortable.
They know exactly what we'redoing.
They can see me at all times.
I'm not in a threatening stanceand then we gradually go up the
body to make them feelcomfortable and not like we are
a threat.
So body language absolutelymatters.
Attorney Bob Mannor (31:07):
So the next question I have for you is you
know, occasionally or frequently, with some forms of dementia,
eating can be an issue as towhether or not the you know, and
so there could be a variety ofeating issues.
And do you have any tips forsomebody where their loved one
(31:28):
with dementia they're struggling, family members struggling with
making sure that the person'swell-nourished or is receiving
enough fluids, and things likethat?
Morgan Donoghue (31:38):
Sure.
My first tip is that if you areseeing your loved one is having
troubles chewing, swallowing,coughing when they are eating or
drinking, I would ask theirprimary care physician to see a
speech language pathologist sothat they can fully evaluate
their swallow function to seewhat's going on.
But outside of that, I wouldget a dietician involved if they
(32:03):
are malnourished.
That's something that a lot ofpeople don't think to get on
their care team and it canactually be really important for
them if they are not gettingenough calories, which sometimes
that happens.
One of the biggest tips ortricks that I give to some of my
patients and my families andpeople living with dementia love
sweets.
It's been one of the last tastebuds to go, so let's use that to
(32:25):
our advantage.
So let's say, in the morninglet's have a smoothie.
We can call it a milkshake ifwe want.
That sounds way more appetizingthan a smoothie.
But we can pack that all bunchof nutrition in there without
them even knowing that it's inthere.
Pack it with vegetables, youcan pack it with the Greek
(32:46):
yogurt, with protein, you canpack it with all these different
nutrients.
So for the malnourished side,we want to make sure that they
are getting the calories whenthey are eating.
Attorney Bob Mannor (33:01):
We need to make sure we are packing it with
the calories that they need.
Yeah, that's great advice.
I really like the advice.
Well, it's been very greattalking to you, morgan Donahue,
and you can find her atmemorablemindsconsultingcom and
on Instagram at memorableminds.
Any other last minute tips orthings that you want to leave
(33:21):
our audience with?
Morgan Donoghue (33:29):
is.
I just want caregivers to knowthat they are doing an amazing
job.
You can't, I don't want them tobeat themselves up of something
they didn't know, Like if Isaid a tip today like, oh my
gosh, I've not.
I've been doing that.
I feel horrible.
I don't want that to be thereaction.
I want it to be that, oh, Ilearned something new and now
I'm going to start doing that.
Because you can't beat yourselfup on something that you were
never taught, and they shouldhave been taught at diagnosis.
Unfortunately, they might nothave been.
Attorney Bob Mannor (33:51):
Yeah, that's an excellent tip.
That's a pretty important onetoo, that the fact that the
caregiver is giving up theirblood, sweat and tears to take
care of somebody.
We certainly don't want them tofeel bad about anything, and
it's all a learning process foreverybody, right?
And so yeah, it's going to be.
You know what was it?
(34:12):
I think it was Angelou saidsomething like you know, when
you know better, do better.
So Exactly.
Morgan Donoghue (34:19):
And you can't do better before you knew about
it Exactly.
Attorney Bob Mannor (34:24):
Thank you so much, morgan.
This is great information.
I appreciate you coming on.
If you enjoyed this podcast ofAdvice from your Advocates, you
can find it anywhere you listento your podcast or you can go to
ManorLawGroupcom and you canfind it there.
Thanks for listening and we'llsee you next time.
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