November 13, 2024 • 49 mins
Join us for an enlightening conversation with Teepa Snow!
A pioneering force in dementia care and the creator of the Positive Approach.
With her deep roots in occupational therapy, Teepa has reshaped how we perceive and engage with individuals living with dementia, focusing on empathy and personalized interaction.
This episode offers invaluable insights for caregivers and professionals, underscoring the critical importance of relationship-building and adapting techniques to meet individuals where they are.
We discuss the challenges of addressing agitation and distress in senior living spaces, advocating for curiosity over judgment.
The conversation highlights the need for proactive communication and engagement to manage expectations and prevent crises, while also recognizing the burdens faced by caregivers.
Exploring the intersection of technology, creativity, and dementia care, we emphasize that technology should complement rather than replace human interaction. Teepa shares her thoughts on the importance of adaptability and understanding individual needs when integrating technological tools, such as music and TV, into care practices. We also delve into preparing for a career in dementia care, stressing the importance of flexibility, creativity, and systemic changes in caregiver training.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:03):
Welcome to Senior Care Academy.
We are honored to welcome TipaSnow today, a true luminary in
dementia care and the visionaryfounder of Positive Approach.
With over 40 years ofexperience in occupational
therapy and dementia care, tipahas revolutionized how we
understand and approachcognitive challenges.
Her positive approach to caremethodology is a cornerstone in
the field, providing care withpractical, empathetic strategies
(00:26):
to improve the lives of thosewith dementia.
Tipa's work has been recognizedglobally and her educational
resources have reached millionsthrough her books, videos and
viral social media content.
From her widely acclaimedtraining programs to her
groundbreaking GEM model, tipa'scontributions have profoundly
shaped dementia care, offeringhope, dignity and a better care
(00:50):
for countless individuals andfamilies.
Speaker 2 (00:52):
TIPA welcome and it's an honor to have you on.
Oh, caleb, I'm so glad to beback with you.
I mean we met up, I guess, inUtah, but it's good to be back
with you virtually, even if notin person.
Speaker 1 (00:59):
Yeah, I'm really excited for this episode.
I think a lot of our listenersthey work directly or all of our
listeners work directly withseniors and dementia care.
I think, even though much morestudied in recent years, there's
still so much unknown andthere's still a lot of just
misconceptions about how to helpthose with dementia Not only
(01:26):
how to help but how to help themthrive even with it.
So my first question is whatinspired you originally to focus
on dementia care as your lifework, coming from occupational
therapy?
Speaker 2 (01:36):
Yeah, I was working in long-term care and there were
so many therapists.
This was back in the day whenwe could pick people up, treat
people, care for people and thenhave them be in the day when we
could pick people up, treatpeople, care for people and then
have them be in the facilityand we could do a follow-up
program and then turn them backover to staff.
And what I found is the peoplewho were in the therapy
department whether it was PT, otspeech they dreaded picking
(01:58):
people up living with dementia.
Number one because they weren'tsure they'd be covered under
the guidelines of Medicare.
But the other reason is theysaid, well, they're just going
to plateau and they don'tremember anyway, why would you
do that?
And it's like, whoa, well, theydon't actually plateau so much
as you guys get boring andthey're not interested in doing
it or you keep asking them to dothings they don't understand.
(02:21):
But I did get ugly with it, butit was just like, let me see
what I can do.
And so they go.
How do you get them to do thatstuff?
And it's like, well, I'm payingattention to them.
And yeah, I have my agenda, butmy agenda is got to come in
after we build a relationship, Ilook at their agenda and I
figure out how to make it workwhen we work together, and it
was just so surprising to peoplethat I can get people to do
(02:45):
things.
I can get people to dressthemselves, get people to
actually walk without a walker,and they go.
How did you do that?
And it's like well, I startwhere they are and we make it
interesting, we make itpurposeful, we make it fun, and
so I was finding success andothers were finding it really
challenging, so I startedworking more and more and then I
(03:06):
started going, but I can't bethe only one, and so it was all
right.
Well, how do I get more peopleexcited about this?
And it was training them intechniques that they could see
right away when you use it.
It's like, oh well, that'sdifferent.
And it's like, yep, so that'swhy we do it this way.
And they're like, oh, okay,okay.
And then there's this period oftime of learning, and then they
start recognizing oh, it doesmake a difference.
(03:27):
And some people come back andgo.
It worked.
It's like good to hear Tell memore about that yeah, Surprise,
surprise.
Speaker 1 (03:34):
When you start your training, what would you say is
the first key thing that youtrain on?
So that way they have that ahamoment, you know the next client
to go to.
Speaker 2 (03:45):
Oh great, it's a great question because catching
somebody's interest, and so whatI'll say is take your hand, put
it at the back of your head.
And what did I do?
I did it right, and so when Idid it, your brain goes.
Well, I should copy Absolutely.
So what's a technique thatmakes a difference, Instead of
just saying put your hand on theback of your head?
That doesn't have the impact.
(04:06):
When I say, oh hey, Caleb, takeyour hand, put it on the back
of your head, and I do it.
It works and so that's a step.
Now, if I said, oh, the back ofyour head is where you process
everything you see, and I say so, where in your brain do you
process visual data, then Righthere, and then I'm like that's
where it comes in.
(04:27):
Where does it get processed?
All the way back here, yeah, soit has to travel, and it means
what comes in doesn'tnecessarily always get
translated back there, and it'sbecause you have brain problems,
and so you go from being ableto see all this to only being
able to see this.
So now, caleb, put your handsaround your eyes like this and
(04:48):
look down at your shirt and tellme whether you have something
up near your collar.
Speaker 1 (04:55):
I can't see near my collar.
Speaker 2 (04:56):
Oh, but if you look like without, you can sort of
figure it out.
Speaker 1 (05:01):
Yeah.
Speaker 2 (05:02):
Yeah, so if you had something on your shirt and I
reached out and touched youthere where your collar is,
would that surprise you?
Maybe then?
With, like my hands, like thisit would oh yeah, and so instead
of I went hey caleb, if you putyour eyes up and I go, hey
caleb, you got something likeright here.
What would would you do?
(05:23):
What did you do automatically?
You automatically reach down andtry to find it Cha-ching, so
you get the recipe.
That's the recipe for the sauceis like engaging a learner,
just like I engage somebodyliving with dementia.
Speaker 1 (05:36):
That's awesome and that's something that the next
person I talk to I can just like.
It's not going to be perfect,but I can just start saying,
okay, well, now, where can Idemonstrate my thought process?
And then I see the.
I see it working.
That's so cool, how easilythat's implemented.
Speaker 2 (05:51):
Isn't it fun?
And so we start doing itmutually.
I mean, we're both benefiting,and that's what I believe is the
difference in dementia carethat works is when we both
benefit from what happens.
Speaker 1 (06:02):
Yeah, I like that.
And so with dementia care, youand I are talking for briefly,
but what's one of the mostsignificant misconceptions about
it that you've encountered?
I think there's a lot ofnegative misconceptions, but
also you mentioned one about thepeople that are struggling with
dementia care and kind of howit's broader.
Speaker 2 (06:24):
I mean one of the things is that in a building or
in a community that dementia isgoing to be in dementia, in
memory, in the memory care unit,it's like uh-oh, uh-oh.
Whether it's a generalcommunity, a residential
(06:48):
community, a area of town, itwill be hiding for anywhere from
five to eight years before thesymptoms become so pronounced
that we start recognizing it forwhat it is.
But people are going to try tostay where they are for much
longer and so what we have torecognize is wow, people living
with brain change don't likechange.
Yeah, getting people totransition to different settings
(07:11):
, to different care routines,getting them used to things we
need to think this throughbefore we introduce it or what
we end up with is a lot ofresistance and we call that that
the person's resistive and I'mgoing to say no.
Dementia makes it really hardto get excited about surprises
and differences, and we also arenot liking the surprises and
(07:34):
differences that happen withdementia.
So we've got to give everybodysome grace.
We've got to give everybodysome space and time and we also
need to get better at what we doso we can actually deliver.
People don't get agitated out ofnowhere.
When we say somebody's agitated, it's like wow, that's a
symptom of distress.
I would say someone's indistress.
(07:54):
Is it a physical distress, dowe think?
Is it an emotional distress?
Is it a social distress?
Is it a spiritual distress?
Once I start to recognizewhere's it coming from.
Is it overdoing the sound,overdoing movement, overdoing
activity, or too little or it'sunfamiliar.
(08:14):
I mean we've got to get curiousrather than sit in judgment of
people.
Speaker 1 (08:19):
Yeah, and the distress.
How long ago did it start Is itlike?
Has it been brewing?
I think a lot of the timespeople think it's just all of a
sudden out of nowhere.
We had the conversation and mymom got upset or, like this
person, this client got upset.
Speaker 2 (08:40):
It's like, well, it's been ruminating for months or,
like you said, it could be years.
First thing this morning I saidyou know, do I have an
appointment today?
And you said I don't know, I'llhave to check the calendar or
I'll have to check the schedule.
And I say okay, and I'mstanding there and you're like,
well, I can't check it right now, I'll check it and get back
with you.
And it's like I wish you coulddo this because I really need to
know.
(09:00):
And you go, Tifa, you know Iwill as soon as I can.
Well, then the next person says, well, it's not time for lunch.
And then the next person sayswe don't have tomato juice, we
only have orange juice.
And so, by two in the afternoon, so many things, nobody in this
stupid place does anything youask for.
This is ridiculous.
Speaker 1 (09:27):
I pay so much money to stay here and nobody does
anything for you and everybody'slike what is she all raving
about?
Speaker 2 (09:29):
yeah, why is she?
So mad and it's because I don'tknow any one of you could have
helped me out, and everybody'sgiving me excuses yeah, that's
so.
Speaker 1 (09:38):
it's interesting because that's not like an
extreme example either, likethat could happen any given
Wednesday morning, like by two,two o'clock, like they could be
at that point where.
Speaker 2 (09:51):
Right, and we like to call it sundowning and it's
like no, it's accumulation, it'ssort of like one thing after
another, and it's just like I'mnot finding comfort or I'm not
getting what I'm looking for.
And I was expecting that here.
I mean, that's why I came hereis to get what I was looking for
.
And I'm not getting it, and soI'm not happy.
Speaker 1 (10:12):
Yeah, and it is also hard with that, with like let me
check my calendar and get backto you and if it takes an hour
then they're just sitting therelike I'm missing something,
maybe for an hour, and thatunnecessary stress With kind of
setting so within senior livingspace, as people are, or really
(10:34):
any senior care, how would yousay?
Or what's the most importantpart of kind of setting that bar
with them so that way they comein understanding that you know
it might take a little bit forme to go and go down to the
office, grab the calendar orlike we are understaffed, or
yeah.
Speaker 2 (10:54):
So this is where, if you have the skill I mean and
again you have to build skill Ifyou have the skill to say hey,
teba, you're wanting to knowabout your appointment this
afternoon.
You think maybe there's onethis afternoon.
I'm going to check on that.
I'm going to ask you for a bigfavor, though I could use some
help here for just a few minutes.
Could you do me a big favor?
These napkins that we have toget back out, they need to get
(11:17):
folded.
Would you fold them intoquarters for me?
That would be super helpful.
I really appreciate it.
You are such an amazing humanbeing.
I so appreciate you.
So what am I doing to the timethat you're going to spend that
somebody?
I'm going to be spendingwaiting.
What happened to that?
Speaker 1 (11:35):
It just goes away because I'm busy doing.
Speaker 2 (11:38):
So now you have something to do in that time and
what you have to do gives you asense of value and purpose, and
I am so appreciative.
And now, when I come back in anhour and I say, hey, teva, you
do have an appointment.
It's at two o'clock thisafternoon and I don't know
whether anybody said anything ornot about transport, but they
(12:00):
want you to leave at 1.30.
You know what I'm going to do.
Make sure that I get up withyou before that 1.30 so you can
get back down here.
Listen, now I know they'rehaving lunch.
I wanted to let you know theyare out of tomato juice and I
know that's your usual, but Iwanted to give you a heads up so
(12:22):
you could sort of think ahead.
What would you rather haveinstead?
Speaker 1 (12:26):
Yeah.
Speaker 2 (12:27):
Now what happened to the next thing?
Because I know that you getriled, because this happens
pretty frequently you know.
Speaker 1 (12:33):
Yeah, Now you've helped get ahead of that.
So they're not surprised whenthey show up to lunch and are
not having what they want andand then needing to leave lunch
fast because they have to get totheir appointment or whatever
Like it's just sets theexpectations in the bar for the
day.
Speaker 2 (12:50):
Yeah, so it's little things that matter, and so it's
not like I changed.
I mean, I didn't changeanything.
We still had the same issues wehad, but I chose to address
them differently, and that meansI had some skill to do that.
And one of our greatestchallenges we don't build the
skills of those who are present,and so we have to clean up a
(13:10):
lot.
And so I think for leaders,monday is like their least
favorite day of the week,because you've got to come out
back and put out all the fires,you've got to deal with all
these crises and reports fromover the weekend, and the people
who work weekend are frustratedbecause they got left there
with nobody else there to helpthem.
Families are on the phonewaiting to talk, and so there
(13:31):
goes Monday you know, which isnot how you want to spend Monday
.
Speaker 1 (13:35):
How do you so with the frontline staff that are the
ones that are having theseconversations?
Is it something like somethingin the water and you just find
these great people, or is therelike emotional training and
things to find that level ofpatience, especially because
that conversation could behappening almost every day of
(13:56):
like every day?
Speaker 2 (13:57):
I mean we should look at this as basic core training,
because this is the basis andcore of people who are having
trouble keeping up with thingsand having trouble keeping up
with where and having troublekeeping up with when and who and
how.
And yet at times I'm reallyclear, but at other times I'm
not.
So what I would say is we can'tassume anything.
(14:19):
What we want to do is sort ofreally acknowledge.
So if I were to do this withyou, caleb, what would happen?
So I'd say so I'm going to comeup to you and I'm going to say
I need to go home and what Iwant to do is find out what
you're going to do, because inthat moment that tells me what
your baseline skill is.
And I do that with multiplecarers.
And then I have an idea of wow,we're going to need some
(14:46):
training here, because we haveat least three people who get
turned around in where they are,when they are, why they're here
, and they ask that question alot, and they don't all live on
memory care.
Because it only happens in thelate afternoon, early evening,
for people who are out in AL ormaybe IL or living in an
apartment with their spouse butthey come to find somebody else
because the spouse went to playgolf.
(15:06):
I mean all kinds of things.
But once I know where my staffare, then I say okay.
So at change of shift we'regoing to do a very quick
introduction of the possibility.
So I introduced the skill.
So I want to go home.
Can you help me get out of here?
And the tendency is to answerthe question, yeah no, I can't.
Speaker 1 (15:25):
I want to go home.
Can you help me?
Speaker 2 (15:26):
get out of here, and the tendency is to answer the
question yeah, no, I can't, oryes, I can, and what we're going
to do instead is say so, you'rewanting to get out of here, so
what did I do to my body?
Speaker 1 (15:33):
You turned.
Speaker 2 (15:34):
I shifted it and I said you want to get out of here
, but I'm lining up with hereand I don't want to be here.
Oh, you're looking to besomewhere else Now.
Do you have something that youis there a place you'd like to
go when you aren't here?
Like where would that be?
Speaker 1 (15:54):
I want to go home.
Speaker 2 (15:56):
Ah home, yeah To your house.
Speaker 1 (15:59):
Yes, yeah.
Speaker 2 (16:00):
Yeah, yeah, now ooh.
Living room or somewhere else?
Speaker 1 (16:02):
Yeah, yeah, now ooh living room or somewhere else,
bedroom, oh your bedroom.
Ooh, yeah Is it dark or is itlight in there?
Speaker 2 (16:15):
It's pretty light in there.
It's pretty light.
Is it private?
Are you there and nobody messeswith you?
Speaker 1 (16:21):
Yes.
Speaker 2 (16:22):
I hear you, this place is pretty busy, isn't it?
Yeah?
Speaker 1 (16:27):
Yes.
Speaker 2 (16:27):
Too busy.
You know, I could use a favorfor just a second before you
head out okay now, why so?
What's happened?
What happened to need to gohome here?
Totally yeah, you de-escalatedit and then yeah, and when I
find out what you really needyeah, I need a quiet place that
feels like I can because guesswhat this is?
(16:50):
Change, a shift, guess what'shappening lots of movement.
Speaker 1 (16:54):
Everybody's out, yeah , and some people are going home
, yeah.
And a lot of people are walkingout the front door.
I need to go too, and what timedo you get up?
Speaker 2 (17:02):
You get up at 5 am.
Ah yeah, you're an early riser,so now's a good time for you to
cruise to a quiet space.
I wonder if you like music,what kind?
Speaker 1 (17:23):
So I want staff to get super curious, but we have
to start off with what's theskill set they have and what do
we build and how do we build andhow do we keep it little and
how do we check in.
That was awesome.
It really is.
I think the core attributes orthings that you train for is
like curiosity and then justpatience, because you're going
to be saying the same thing overand over again, but always be
curious as if it's the firsttime they're saying it.
Speaker 2 (17:39):
Yeah, because it may be a different reason they're
saying it this time.
I mean, I won't know.
I've got to stay engagedbecause if I don't, they're
looking for engagement.
I'm not giving it Guess what?
Elopement, frustration, anger,a sense of not being respected,
a sense of being trapped None ofthose are healthy feelings for
(18:00):
somebody living in a community,and it's going to increase the
risk that my job's going to getharder.
So I don't want my job hard.
It's hard enough.
And I also believe that ourleadership need to be able to do
this too.
I don't think they should askstaff to do something they don't
have the basic core skills ofdoing.
Speaker 1 (18:19):
Yeah, they're managing the community.
So if they run into somebodythey're like and they call
somebody and then all of asudden it does, yeah, so I can
call and I can say I'm reallystuck, I don't know what to do,
and you can say well, I'll giveit a shot.
Speaker 2 (18:32):
I mean, I'm not 100% on this, but I did take some
training and I am willing to try, because if I have a leader
who's willing to try, well thenI'll work harder for that person
in that situation.
Speaker 1 (18:48):
I like that a lot.
What switching kind of withthat approach, like how you just
immediately I mean it was alittle role play, but we got to
the bottom of what I reallyneeded in like five questions.
What are some common triggersof distress for people that have
any kind of stage of dementia?
And then how do we manage those?
Because I think, knowing thetriggers, we could potentially
(19:11):
minimize them or try to avoidthem altogether, if we can.
Speaker 2 (19:14):
Yeah.
So I'm going to give four S'sthat are often the triggers or
four F's, and then so that makesa total of eight.
So I'm overwhelmed, sensorywise.
So we've got to look at mysensory needs.
Is it too much or too little?
And it could be what I see,what I hear, what I feel, what I
do, but it's what's happening,sensory wise.
(19:36):
Am I liking, not liking?
Then it gets to social.
Am I getting a good social thatI enjoy, or is this social, not
a social interaction?
Am I missing a social that Ireally want and crave?
Then we get to the third, whichis, in this case, space.
Is this a space I'm enjoying oris this a space that I'm not
(19:57):
liking?
I want to be in another space,I want to be in an outdoor space
, I want to be in a privatespace, I want to be at the
theater, I want to go to work.
I mean, we got to figure outwhat space I'm craving or
missing.
And then, finally, what are thesurfaces that might be
bothering me?
Surface to surface contactmatters.
Could it be the chair I'msitting in?
(20:19):
Could it be the carpet on thefloor?
Could it be my glasses on myface, my dentures in my mouth.
Could it be the clothes?
I'm too hot, I'm too cold.
It's too tight.
I don't like this.
It doesn't feel good.
This brief is uncomfortable andI don't understand.
So that's my S's.
Speaker 1 (20:36):
Wow.
The fourth one was a surprisefor me.
I know that's often a surprise.
Speaker 2 (20:42):
And yet think about it.
We don't like the feeling ofstuff on us that doesn't feel
right.
Speaker 1 (20:48):
Yeah.
Speaker 2 (20:48):
Or if I'm cold, I want another layer and I may say
I got to get out of here andit's like it's cold.
It's cold, so we can raise thetemperature of the room or we
can give her something to putover her, but she's missing that
.
Yeah, the air movement on her,um, and then the four f's
friendly.
It doesn't feel friendly herefor me.
Familiar, I think I'm in anunfamiliar place, even though
(21:10):
you know so it's not feelingfamiliar, functional.
I can't figure out what to dohere.
I want to be in a place where Iknow what to do, or forgiving.
I feel like people are judgingand not liking me and I don't
like that.
I want out of here because Idon't like this feeling I'm
having right now, yeah, how onthe four Fs, I feel like that's
harder.
Speaker 1 (21:31):
Maybe it's harder to get to the bottom of, because
sensor like that one would havebeen a.
I'm trying to think which Smine like I want to get to the
bottom of it, because sensorlike that one would have been a.
I'm trying to think which Smine like.
Speaker 2 (21:42):
I want to get home because I was sensory, because
there was too much space, yeah.
You want to be in a familiarspace.
So let's look at it.
So what happens is you say thisisn't my stuff, I don't know
who brought this in here.
Then it may be time to talk tofamily and say you know what?
We're going to make it lookmore like a hotel room, because
when it looks like their place,it feels like they've been
dumped here.
So we're actually going to askI'm going to ask you to bring in
(22:04):
stuff that is not as familiarto them.
So this is temporary.
You're staying here temporarily, for right now, this is is this
, is this quilt okay?
I mean, I know it's not yourquilt, but is it okay?
And it's like yeah, cause I?
I mean, I know it's not yourquilt, but is it okay.
And it's like yeah, because Idon't want to stay here long.
And it's like okay, well,that's fine.
You know, is this onecomfortable for you?
Yeah, but I actually need it tobe less familiar.
Speaker 1 (22:26):
Because if it's familiar, it's like why is?
Speaker 2 (22:28):
all my stuff here.
Speaker 1 (22:29):
I don't like this.
I'm going to pack it up.
This isn't my house.
Speaker 2 (22:58):
Yeah, wow, that's so interesting I know that that is
definitely a shift in my mindbecause feels like you're,
you're making her stay and she'sgoing no, and so well, let's
try something different.
Speaker 1 (23:05):
I mean, let's give it a shot.
Speaker 2 (23:07):
See what happens yeah , that's yeah.
Speaker 1 (23:10):
um so, with trying to put together a question, so
yeah, I guess I would.
I'm interested in doing a quickrole play on one of the four Fs
, like how do you get to thebottom of that?
Speaker 2 (23:33):
as quickly, yeah, and so it's like, let's say, you
have crap all over your shirtand I'm trying to help you get
out of the dirty shirt and intoa clean shirt.
I mean, it's one thing that I'myou know, frequently people are
trying to figure out yeah andlet's say, without thinking
about, I said caleb, you havestuff on your shirt here.
Let's change your shirt.
This one is, you know, thisone's dirty.
(23:53):
Let me get you a clean shirthere.
See, I have clean shirt for you, clean shirt for you.
It's like this is fine, leaveit alone.
I'm not changing the shirt,this is my shirt and I'm not
doing it.
And it's like okay.
So I judged you and I didn'tmean to, but I was making you
feel really uncomfortablebecause you didn't feel like it
was okay to have that shirt on.
(24:14):
So, okay, let me shake it offand I go.
Speaker 1 (24:17):
Oh hey.
Speaker 2 (24:18):
Jacob, I have a big favor to ask of you.
I got a new shirt for myhusband and I'm really wondering
you guys are about the samesize.
Would you be willing to try iton so I can see what it looks
like?
Speaker 1 (24:36):
Yeah, would you be willing?
Speaker 2 (24:37):
to try it, yeah, okay , tell you what, undo your shirt
here and go ahead and take itoff, and I'm going to here put
it on, okay, now here's what Iwant you to do.
Let me know.
Does it feel comfortable?
Does it feel comfortable?
Cause I really wanted to feelcomfortable for him, cause he's
real picky.
Like, how's the arms?
How do the arms feel?
(24:58):
Pretty decent, okay.
How does it like?
Is it long enough for you?
Okay, would you do me a favor?
Would you keep it on for alittle bit until I can sort of
check out, because I want to seehow it feels after a little bit
, see what you think.
Okay, Okay Now in fact, not ashirt for my husband, it's a new
(25:19):
one that your daughter got foryou and she's been trying to get
you to wear something otherthan that ratty old thing.
And but did it feel at all likeyou were unacceptable?
And and you it's like?
Speaker 1 (25:35):
Oh, wow.
And then I go about my day andI'm just wearing this new shirt,
and you're just wearing a shirt, I mean, and that's me
understanding how dementia works.
Speaker 2 (25:43):
I mean, when you see me, you go what do you think of
my shirt?
And it's like, I think it'sgorgeous, you look great in it.
How's it feel, feels great, youknow.
And if you say, oh, this is foryour husband, right?
I go.
You know what it looks like.
You're really enjoying it.
When you get done with it, I'mjust going to get him another
one.
You know what?
Speaker 1 (26:04):
Yeah, there's more at the store, I'll go grab it.
There's more to the store.
Speaker 2 (26:07):
There are more in the store, and so the idea of
building a relationship of trust, of like, of non-judgment so I
don't tell people you're wet,you need to get cleaned up ever
I will say Ooh, feel this?
What do you think?
And if the person goes, oh, oh,my heavens, and if I say I
(26:31):
must've spilled something, I'llgo, sure enough, it looks like,
wow, let's go get that.
Oh, my heavens, how awful Ihate.
That happened for you, you know, rather than you didn't spill
anything, you peed on yourself.
That moment where, withoutthinking, your brain goes well,
that's not true.
Me, I didn't spill anything.
I want to tell truth.
(26:52):
And it's like the truth issomething spilled.
It spilled out of her.
She wasn't aware of it.
If she was aware of it, shewouldn't have done that.
She'd go in the bathroom, shecould have gotten there.
Speaker 1 (27:09):
Do I really need her to feel incompetent for me to do
my job?
Yeah, that's exactly true, wehad a guy on, had a guy on.
He is really he's a reallysuccessful um just entrepreneur
and and influence in thecommunity here in utah and his
mom is struggling with dementiaand has been, and he kind of had
this realization where he'slike I can tell you within 30
(27:33):
minutes of picking my mom up totake her home for sunday dinner,
were what the 10 questions are,what I will say in response,
and he's like it was hard,really hard in the beginning
because like it'd be, like mom,you already asked me that
question five minutes ago andhe's like but then I had to
realize you know she's not beingmalicious or like and it's like
(27:54):
she wants to have aconversation, she wants to
connect and he's like I had torealize that everything was her
attempt at connecting.
And we're going to answer thosesame questions, you know, 15
times over the course of ourdinner and and it's going to be
a beautiful moment.
Speaker 2 (28:10):
You know like it is, or you have another choice and
that's what folks get, it's likeOK.
So you asked me to say so youknow, are we going to go back
soon.
So go ahead and say and you'veprobably asked me multiple
times- yeah, are we going to goback soon.
You're wanting to know if we'regoing back soon.
We are, oh, but before we go,oh, I want you to look at
something.
Look at this picture.
(28:30):
What do you think?
You like it.
I think it's pretty, it'scolorful, I think it's pretty,
yeah, sort of not the bestrainbow you've ever seen, huh.
Speaker 1 (28:44):
It's, it's pretty, it's good, it's pretty.
Well, you know what.
Speaker 2 (28:48):
What do you think of this one?
Speaker 1 (28:51):
That one.
I like it a lot, you like thatone a lot.
Speaker 2 (28:55):
Yeah, now that's cool .
What about this one with thelittle girl over here?
What do you think of that?
Speaker 1 (29:01):
I think that's fun, I don't know.
That's fine, yeah, okay.
Speaker 2 (29:04):
Cool.
So you know what's cool aboutyou.
You have all this artbackground.
Huh, you like art.
That's cool.
I have a book.
I want to show you Now whathappened.
Speaker 1 (29:14):
To repeat, repeat now we're back into it's a uh kind
of like what did I use a lot ofa lot of visual.
Like I said, it all comes inright here and then back and
forth but it feels better anddifferent when I can sort of
(29:36):
make it flow better.
Yeah.
Speaker 2 (29:38):
But that takes skill and you know otherwise.
You know I have to have thesame exact conversation over and
over again and it is hard tokeep that interesting.
But that's where my skill setis a little different and I go
well, let's expand, because youknow what the heck.
Speaker 1 (29:54):
It's cool how you always are able to take some
request or like a direct.
I need to do this and totallyredirect to something that's
meaningful.
Speaker 2 (30:05):
Yeah, and so I believe I mean it's sort of like
.
I guess people would say it'slike improv, it's a yes, and so
I answer you yes, and and thenwe can figure out where can we
go next.
Speaker 1 (30:15):
Yeah, and then we can figure out where can we go next
.
Yeah, so with people like him,I mean, you have a substantial
social media following and thething that's cool we've had
different dementia carespecialists on, but their
following is all.
It really is mostly likeLinkedIn with other senior care
(30:36):
professionals.
It really is mostly likeLinkedIn with other senior care
professionals, but you've beenable to reach a larger
demographic with TikTok and likemore commonly used as general
social media Instagram, facebook.
Speaker 2 (30:47):
TikTok.
We have LinkedIn, but we also Imean we try really hard YouTube
.
I mean we are available in somany different ways.
We work with Rude, which is anew app.
We have some apps that peopleare using and I'm active on that
because we know that so manypeople learn in different ways,
(31:09):
so many audiences are connectedin different things podcasts,
because you know, however,you're able in that moment to
grab something and take it.
We'd like you to have somethingto take because this is a it's
a rough journey, it's a longjourney, it's a hard job that
people are trying to do, and ifyou catch something in a moment
and it's something you can use,then you tend to come back If
(31:32):
you know.
If it's not there, you can'tfind it.
So you know.
Speaker 1 (31:37):
So with that, with your social media presence and
what you're posting, what Iguess what topics have gone I
guess you say the most viral orhad the biggest large spread
impact Cause I think that'ssomething that the management of
these communities can use aslike a huge value add.
(31:59):
People coming in.
I don't know what to do with mymom.
Like you said, it's beenbuilding up for five, seven
years.
They didn't know and nowthey're at this point like oh
crap, um, being able to say yes,we can help her and you know
when, like this, this gentleman,if he, the community that his
mom is staying at, was like youknow, you should do all these
things when you take her out andlike what are the things that
(32:21):
just the general population ofcaregivers caring for their
family has found valuable?
Speaker 2 (32:26):
Yeah, I think the most important thing is that
we're going to need new skills.
And we've got to go into this,realizing if their brain is
changing and some of their brainis dying and it's going to
continue onward is changing andsome of their brain is dying and
it's going to continue onward.
I want to get on board soonrather than late, because I'm
going to have to pick up speedreally quick.
So, whether I'm a professionalor family member, wow, it would
(32:47):
be a really good idea.
If I'm paying attention to thechanges and I start to notice,
wow, we're having a littlefriction here where we've never
had that, or I'm getting a blanklook when I used to get a
question.
There's a hesitation.
So if we could get people tolike sort of go huh, how can I,
you know?
And so what we do is we try tobe available and so you can chat
(33:13):
a question you can ask.
We'll try to do something aboutit.
I think the biggest mistakepeople make is not asking
questions and so ways that wecan get people to generate a
question I don't even know whatto ask.
Well, let me ask you how areyou doing?
Are you feeling here, here orhere, about what's going on?
And so that's a starting place,and so we'll start.
(33:35):
And I think we have to bewilling to start with where we
are, regardless and I thinkthat's what we work hard on is
being present, so that in thatmoment, somebody feels listened
to and heard.
And once they get that, theyget their agenda met.
Then we can go to differentplaces, and it can be little
(33:57):
baby things or it could be hugethings.
It's like cause I'll get a lotof questions about how do you
know when it's time?
Yeah, and I'll say well, by the,the, the fact that you're
asking about three months ago bythe time you're willing to ask
the question.
You've been in crisis for awhile.
In general, I mean peoplehesitate to ask the question
because it feels like giving upon somebody and I would say
(34:20):
you're just letting go of someof the job you have.
You have too many jobs andyou're letting go of something,
but you're not giving up.
I don't want you giving up, butI do want you to think about
letting go of some things,because things are so different
than they used to be.
You need more support to dothat.
Speaker 1 (34:37):
I love talking on that vein.
When people you know they feellike I'm letting my mom down or
I'm letting my wife or husbanddown, it's not, it's.
You're getting back to being adaughter or a husband or a son,
like you're just letting go of alot of these other duties that
are beyond.
You know, we want it so thatway, when you come to visit mom,
(34:58):
your daughter, you're not.
You know, here's the trickypart.
Speaker 2 (35:04):
That's really scary for folks, cause I don't know
how to do that anymore, and sothen we want to support them in
doing that.
So here's what that might looklike.
Tell me what your mom'sfavorite music is.
What's her favorite artist?
The Beatles, beatles.
Speaker 1 (35:24):
Ooh Like early, early or more John and Ringo and that
guy after, yeah, a little lateron.
Speaker 2 (35:27):
A little later, like yesterday.
Does she like yesterday?
Speaker 1 (35:30):
Yes.
Speaker 2 (35:32):
Oh, cool, all right.
So here's what I want you to do.
I want you to preload yesterdayand two other Beatles songs on
your cell phone and when youcome in, I want you to go hey,
mom, check this out and startplaying one and sing along with
her, and you might even see ifyou can get it on YouTube, where
the words come up so that, whenyou come, in.
Speaker 1 (35:54):
That'd be so fun with my mom when you come in.
Speaker 2 (35:56):
That'd be so fun with my mom.
Ah, yeah, because I thinksometimes one of the reasons
people keep trying to do taskswith people is because they have
lost.
They've lost the relationship.
They don't have to get it back,and that's where we can come in
handy.
Not not to say out loud youknow, you're, you don't know how
to be a daughter anymore.
I mean that's, that's not fair.
(36:18):
It's like you don't know whatthat level of dementia, how to
engage, and it's really hard andit is really hard, um, which is
why many people stop visiting,because it gets so scary and
hard and I don't know what to doand we just it never works.
I feel, horrible at the end andshe cries and I'm upset and and
(36:39):
it's hard, and so I thinkhelping people navigate that is
is important, because I they doneed help often and sometimes
people are spectacular, but Iknow a lot of people who aren't
yeah, um, there was something soswitching a little bit.
Speaker 1 (36:57):
Um you mentioned you know you have like, is it
physical, emotional, mental, buteven spiritual?
I am curious, what role doesspirituality have in your
approach to?
Speaker 2 (37:07):
dementia care whole.
They're hidden, and the hardpart for us is to accept not my
job to dig them out, my job tosupport them as they appear and
know that they're whole.
(37:27):
I'm here to hold that space, tooffer that opportunity, to
create that moment where we canbe together or you need to be
alone, but I'm not going toforce it.
And so everything I do must bedone with permission, because
when I don't seek and receivepermission, I've got to learn
how to get permission.
When somebody is like not ableto tell me and not able to show
(37:49):
me a whole lot, I will knowwhether I have permission.
Whether the person is, that'snot permission.
And so I've got to pause andrealize, wow, I'm pushing the
spirit too hard.
That person's spirit is thereand they're giving me messages
of distress and so, okay, that'sa spiritual distress, not just
(38:11):
a physical distress.
That means I'm not listeningand I need to pause and get
super curious about how tolisten.
And so I'll often start oh,this is not okay.
I'll say out loud what they'reshowing me to see if I'm on
target and they'll go.
yeah, it's not, and it's likeokay, window just opened.
Speaker 1 (38:33):
Okay, that's interesting, just mirroring.
Speaker 2 (38:34):
Window just opened.
Speaker 1 (38:37):
Window into the spiritual.
That's cool.
Speaker 2 (38:39):
Yeah, so it's really for me, and what we teach is
it's always about really stayingsuper curious, having
incredible compassion, Alsoreally truly seeking the mutual
benefit each of us can have whenwe are together and do work
together, and realizing it isabout relationships and you've
(39:03):
got to authentically care.
I mean, it can't be a surface.
Yeah, yeah, yeah, here, let meget your pants off.
I mean it's like because yeah,you're a really sweet guy here,
let me get your pants off.
I mean you're going to figurethat out real quick.
So it really is being committedto the relationship and it
means as part of my job, I'vegot to be able to recognize at
(39:25):
the end people got to go homeand I'm not talking about to a
physical place, I'm talkingabout leaving this earth, and
I've got to be reallycomfortable with the idea of
releasing someone into theirnext space and not grieving the
loss but celebrating the lifeand celebrating that transition.
Speaker 1 (39:47):
Or it can be really dark sometimes.
Speaker 2 (39:49):
Yeah, and it's hard, especially in the industry where
that can happen prettyregularly, yeah, and so,
whatever I've done, have I donewhat I could to make that
journey complete?
And if I did, then let'scelebrate what an amazing human
being and what a gift to get togo um, having done what you were
(40:11):
needing to do.
Speaker 1 (40:12):
Yeah, that's.
I love that.
Um, we're getting.
Time has flown.
I have one more question beforeI ask the last few.
I am curious your opinion ontechnology for those with
dementia.
I know that that is somethingthat, again kind of anecdotally,
(40:33):
you can protect bank accounts,you can protect all these things
.
Is there a space for?
Specifically on loneliness,that's something that I'm really
curious about.
Is there a way to incorporatesocial platforms and things like
that for people going throughdementia safely?
Speaker 2 (40:49):
I think we are just getting to the front edge of
really effective platforms.
I think there's been a wholelot of before.
I think we were just reallystarting to appreciate the
skills of people living withdementia, the limitations of
people living with dementia, themisunderstandings of engineers
and creators who thought theyhad a simple answer to a complex
(41:11):
situation, and we're startingto look at how to use technology
in more effective ways, becausewe're getting better at
recognizing its boundaries andits need for support.
I think technology needs asmuch support as the person
living with dementia I mean.
So often we think, oh yeah, thetech will be the answer and
(41:32):
it's like no, it's a piece ofthe puzzle.
But we've got to figure out howand when to deploy it and how
to monitor it and to modify itas needed.
I love music, but putting it on24-7 isn't an answer.
It's sort of like noiseFiguring out what is up music
for somebody and what isrelaxing music for somebody, and
(41:55):
then employing the technologyto monitor heart rate,
respiratory rate to see whetherwhat's working.
Is it going with that person orare we fighting it?
If so, do I need to bump theenergy up so we can catch their
energy and then help them comeon down.
There are lots of ways thattechnology can be a gift, but it
(42:16):
can also turn into a weapon.
Speaker 1 (42:19):
If.
Speaker 2 (42:19):
I think it's going to do something it's not doing and
I get frustrated with theperson or the technology.
You know everybody's alwayslooking for that.
How can we have a control, a TVcontrol that they can use, and
it's like you know let's look athow often we should be using
the TV and you know how do weuse it as a tool, not a
(42:41):
babysitter.
I mean, if you're looking for ababysitter, tvs may not be the
best babysitters in the world,um, you know, but it's.
It's a challenge because I haveto know the person, I have to
know the technology and then Ihave to know the situation yeah
um, and people want it to besimpler.
But there's great ways to usetechnology, but there's also
(43:02):
messy ways to try and and youbuy it and it's not used and
it's expensive and it's hard tomaintain and whether it's a
documentation system or whetherit's some, you know, a support
to engage, how you use what yougot really matters, and if we
don't prepare people for how todo it, it can really be a
mistake frequently yeah, yeah,and really the that is
(43:25):
insightful.
Speaker 1 (43:25):
Like the technology or the tool itself can be
amazing, or like the example ofmusic itself is always good, but
how you use the technology, youknow if you have 100 different
people, you might need to use100 different micro variations
of this technology and you can'tjust like here and otherwise
(43:45):
and what I use in the morningmay not be what I need in the
afternoon.
Speaker 2 (43:49):
And when I bring everybody together, what's the
volume?
I've got to adapt it foreverybody.
But do I need a set ofheadphones on certain folks or
modifications, because they havesignificant hearing problems or
they have hypersensitivity?
Because people have lived withautism a long time and now
they're getting old and so youknow we may still have issues.
Speaker 1 (44:11):
Yeah, so really technology can be.
I would say it's a potentialsupplementer and not the answer.
Most times.
Speaker 2 (44:22):
I do not believe it will ever be the answer to
things.
I think it will be part of ananswer or part of a solution or
part of an experiment and Ithink if we look at it that way,
then we're more respectful ofwhat it could offer but also
what it probably is not doing.
I mean, I would use the exampleof chair alarms.
(44:44):
I think we've finally gotten toa place where people realize
the only people listening tochair alarms are other residents
who are tired of hearing themBecause the person who's getting
up out of the chair is ignoringthe chair alarm.
The people who are down thehall are too far away from the
chair alarm to be there whenthey need it and they get.
(45:05):
They get so over tired of itthat they quit actually hearing
it.
There's evidence they quit yeah, they don't register it as an
alarm.
It's just sort of a noise that'shappening and the people nearby
are yelling sit down, sit down,alarm's going off.
She's getting up again.
She's getting up.
So that's your chair alarm isthe resident sitting next to
(45:32):
them.
Speaker 1 (45:33):
What the last two questions?
What are some of the mostrewarding moments that you've
experienced in your career thathave fed you to keep going?
I think those ones that keepyou going are ones that people
should strive for.
Speaker 2 (45:48):
They're called aha moments.
There are moments when someone,when I've done something and
somebody has an aha, you can seeit.
Their brain goes, oh, and thenthey try it and they come back
my favorite moments.
They come back, they go you'renot going to believe this,
you're not going to believe this.
It worked and it's like it did.
Tell me about that Because forthem, it was such a disbelief to
(46:10):
belief when they figured it out.
They actually have the power tochange things and it's so funny
when people do it and they'relike you're not going to believe
this and it's like probably do,but go ahead, I've got to give
you the energy back or that'ssort of it's like I'm sure I
will.
You know that's not helpful butit's really great, it gives me
great joy and pleasure andsatisfaction to find people
(46:33):
opening their eyes, openingtheir hearts, their, their,
their spirits to the idea ofsomething different and
realizing, oh, I can choosesomething different.
And it's like, yeah, how coolis that.
Speaker 1 (46:45):
I love that.
Um last question is what advicewould you give to someone just
starting their career indementia care that wants to be
in it for the long haul?
Speaker 2 (46:56):
Yeah, um, spend time with people living with dementia
from the very not even knowingthey have it till the very end
of life.
Get really super curious aboutyourself and figure out are you
somebody who likes to beflexible or do you like
structure and patterns and doyou need things to be right?
(47:16):
Because if that's who you are,this is probably a very
uncomfortable place to get intoand I'd recommend thinking of
something else.
If you love to be creative andhave the ingredients and not
know for sure what you're goingto make for dinner, because you
have to sort of see what's inthe refrigerator and what else
is happening and what's the daybeen like, then this is the
(47:38):
right place for you and whatyou'll want to do is get some
training with somebody who isreally excited about you
learning and not excited abouttelling you a bunch of stuff,
but really wants to engage withyou.
Speaker 1 (47:55):
Yeah, all right.
What's next for TIPA Snow?
Who should find you?
Where do they find you, allthose fun questions?
Speaker 2 (48:03):
We're on tipasnowcom, we're on all the social media.
I mean, if you could put myname so unusual, if you just put
that in, it'll pop up a lot ofdifferent stuff.
Positive approach certainly does, but TIPA Snow tends to be
teaching.
That approach certainly does,but tip of snow tends to be a
teaching that'll pop up.
The next thing for us is we'rereally hoping that over the
course of the next five yearsthere is a radical change in
(48:27):
acknowledging the need toprepare people for this work and
that we don't need to havepeople in trauma trying to do
care because they haven't beenprepared ahead of time, and that
making sure people have whatthey need before they walk into
situations makes all thedifference in the world and the
(48:47):
outcome for everybody involved.
And it's worth establishingsome baseline of ability before
we start throwing people to thewolves of care.
And that's what we're hopingfor the next five years is let's
make a difference.
Speaker 1 (49:02):
And you're on track for sure, just helping everybody
.
So I've loved this today.
It's been a pleasure and anhonor to spend the last 45, 50
minutes with you, so thank youso much, and I know people are
gonna get a lot of value out ofit.
Speaker 2 (49:17):
So my pleasure.
Thanks for having me.
Speaker 1 (49:20):
Yeah.
Speaker 2 (49:21):
Take care.
Welcome to Senior Care Academy.
We are honored to welcome TipaSnow today, a true luminary in
dementia care and the visionaryfounder of Positive Approach.
With over 40 years ofexperience in occupational
therapy and dementia care, tipahas revolutionized how we
understand and approachcognitive challenges.
Her positive approach to caremethodology is a cornerstone in
the field, providing care withpractical, empathetic strategies
(00:26):
to improve the lives of thosewith dementia.
Tipa's work has been recognizedglobally and her educational
resources have reached millionsthrough her books, videos and
viral social media content.
From her widely acclaimedtraining programs to her
groundbreaking GEM model, tipa'scontributions have profoundly
shaped dementia care, offeringhope, dignity and a better care
(00:50):
for countless individuals andfamilies.
Speaker 2 (00:52):
TIPA welcome and it's an honor to have you on.
Oh, caleb, I'm so glad to beback with you.
I mean we met up, I guess, inUtah, but it's good to be back
with you virtually, even if notin person.
Speaker 1 (00:59):
Yeah, I'm really excited for this episode.
I think a lot of our listenersthey work directly or all of our
listeners work directly withseniors and dementia care.
I think, even though much morestudied in recent years, there's
still so much unknown andthere's still a lot of just
misconceptions about how to helpthose with dementia Not only
(01:26):
how to help but how to help themthrive even with it.
So my first question is whatinspired you originally to focus
on dementia care as your lifework, coming from occupational
therapy?
Speaker 2 (01:36):
Yeah, I was working in long-term care and there were
so many therapists.
This was back in the day whenwe could pick people up, treat
people, care for people and thenhave them be in the day when we
could pick people up, treatpeople, care for people and then
have them be in the facilityand we could do a follow-up
program and then turn them backover to staff.
And what I found is the peoplewho were in the therapy
department whether it was PT, otspeech they dreaded picking
(01:58):
people up living with dementia.
Number one because they weren'tsure they'd be covered under
the guidelines of Medicare.
But the other reason is theysaid, well, they're just going
to plateau and they don'tremember anyway, why would you
do that?
And it's like, whoa, well, theydon't actually plateau so much
as you guys get boring andthey're not interested in doing
it or you keep asking them to dothings they don't understand.
(02:21):
But I did get ugly with it, butit was just like, let me see
what I can do.
And so they go.
How do you get them to do thatstuff?
And it's like, well, I'm payingattention to them.
And yeah, I have my agenda, butmy agenda is got to come in
after we build a relationship, Ilook at their agenda and I
figure out how to make it workwhen we work together, and it
was just so surprising to peoplethat I can get people to do
(02:45):
things.
I can get people to dressthemselves, get people to
actually walk without a walker,and they go.
How did you do that?
And it's like well, I startwhere they are and we make it
interesting, we make itpurposeful, we make it fun, and
so I was finding success andothers were finding it really
challenging, so I startedworking more and more and then I
(03:06):
started going, but I can't bethe only one, and so it was all
right.
Well, how do I get more peopleexcited about this?
And it was training them intechniques that they could see
right away when you use it.
It's like, oh well, that'sdifferent.
And it's like, yep, so that'swhy we do it this way.
And they're like, oh, okay,okay.
And then there's this period oftime of learning, and then they
start recognizing oh, it doesmake a difference.
(03:27):
And some people come back andgo.
It worked.
It's like good to hear Tell memore about that yeah, Surprise,
surprise.
Speaker 1 (03:34):
When you start your training, what would you say is
the first key thing that youtrain on?
So that way they have that ahamoment, you know the next client
to go to.
Speaker 2 (03:45):
Oh great, it's a great question because catching
somebody's interest, and so whatI'll say is take your hand, put
it at the back of your head.
And what did I do?
I did it right, and so when Idid it, your brain goes.
Well, I should copy Absolutely.
So what's a technique thatmakes a difference, Instead of
just saying put your hand on theback of your head?
That doesn't have the impact.
(04:06):
When I say, oh hey, Caleb, takeyour hand, put it on the back
of your head, and I do it.
It works and so that's a step.
Now, if I said, oh, the back ofyour head is where you process
everything you see, and I say so, where in your brain do you
process visual data, then Righthere, and then I'm like that's
where it comes in.
(04:27):
Where does it get processed?
All the way back here, yeah, soit has to travel, and it means
what comes in doesn'tnecessarily always get
translated back there, and it'sbecause you have brain problems,
and so you go from being ableto see all this to only being
able to see this.
So now, caleb, put your handsaround your eyes like this and
(04:48):
look down at your shirt and tellme whether you have something
up near your collar.
Speaker 1 (04:55):
I can't see near my collar.
Speaker 2 (04:56):
Oh, but if you look like without, you can sort of
figure it out.
Speaker 1 (05:01):
Yeah.
Speaker 2 (05:02):
Yeah, so if you had something on your shirt and I
reached out and touched youthere where your collar is,
would that surprise you?
Maybe then?
With, like my hands, like thisit would oh yeah, and so instead
of I went hey caleb, if you putyour eyes up and I go, hey
caleb, you got something likeright here.
What would would you do?
(05:23):
What did you do automatically?
You automatically reach down andtry to find it Cha-ching, so
you get the recipe.
That's the recipe for the sauceis like engaging a learner,
just like I engage somebodyliving with dementia.
Speaker 1 (05:36):
That's awesome and that's something that the next
person I talk to I can just like.
It's not going to be perfect,but I can just start saying,
okay, well, now, where can Idemonstrate my thought process?
And then I see the.
I see it working.
That's so cool, how easilythat's implemented.
Speaker 2 (05:51):
Isn't it fun?
And so we start doing itmutually.
I mean, we're both benefiting,and that's what I believe is the
difference in dementia carethat works is when we both
benefit from what happens.
Speaker 1 (06:02):
Yeah, I like that.
And so with dementia care, youand I are talking for briefly,
but what's one of the mostsignificant misconceptions about
it that you've encountered?
I think there's a lot ofnegative misconceptions, but
also you mentioned one about thepeople that are struggling with
dementia care and kind of howit's broader.
Speaker 2 (06:24):
I mean one of the things is that in a building or
in a community that dementia isgoing to be in dementia, in
memory, in the memory care unit,it's like uh-oh, uh-oh.
Whether it's a generalcommunity, a residential
(06:48):
community, a area of town, itwill be hiding for anywhere from
five to eight years before thesymptoms become so pronounced
that we start recognizing it forwhat it is.
But people are going to try tostay where they are for much
longer and so what we have torecognize is wow, people living
with brain change don't likechange.
Yeah, getting people totransition to different settings
(07:11):
, to different care routines,getting them used to things we
need to think this throughbefore we introduce it or what
we end up with is a lot ofresistance and we call that that
the person's resistive and I'mgoing to say no.
Dementia makes it really hardto get excited about surprises
and differences, and we also arenot liking the surprises and
(07:34):
differences that happen withdementia.
So we've got to give everybodysome grace.
We've got to give everybodysome space and time and we also
need to get better at what we doso we can actually deliver.
People don't get agitated out ofnowhere.
When we say somebody's agitated, it's like wow, that's a
symptom of distress.
I would say someone's indistress.
(07:54):
Is it a physical distress, dowe think?
Is it an emotional distress?
Is it a social distress?
Is it a spiritual distress?
Once I start to recognizewhere's it coming from.
Is it overdoing the sound,overdoing movement, overdoing
activity, or too little or it'sunfamiliar.
(08:14):
I mean we've got to get curiousrather than sit in judgment of
people.
Speaker 1 (08:19):
Yeah, and the distress.
How long ago did it start Is itlike?
Has it been brewing?
I think a lot of the timespeople think it's just all of a
sudden out of nowhere.
We had the conversation and mymom got upset or, like this
person, this client got upset.
Speaker 2 (08:40):
It's like, well, it's been ruminating for months or,
like you said, it could be years.
First thing this morning I saidyou know, do I have an
appointment today?
And you said I don't know, I'llhave to check the calendar or
I'll have to check the schedule.
And I say okay, and I'mstanding there and you're like,
well, I can't check it right now, I'll check it and get back
with you.
And it's like I wish you coulddo this because I really need to
know.
(09:00):
And you go, Tifa, you know Iwill as soon as I can.
Well, then the next person says, well, it's not time for lunch.
And then the next person sayswe don't have tomato juice, we
only have orange juice.
And so, by two in the afternoon, so many things, nobody in this
stupid place does anything youask for.
This is ridiculous.
Speaker 1 (09:27):
I pay so much money to stay here and nobody does
anything for you and everybody'slike what is she all raving
about?
Speaker 2 (09:29):
yeah, why is she?
So mad and it's because I don'tknow any one of you could have
helped me out, and everybody'sgiving me excuses yeah, that's
so.
Speaker 1 (09:38):
it's interesting because that's not like an
extreme example either, likethat could happen any given
Wednesday morning, like by two,two o'clock, like they could be
at that point where.
Speaker 2 (09:51):
Right, and we like to call it sundowning and it's
like no, it's accumulation, it'ssort of like one thing after
another, and it's just like I'mnot finding comfort or I'm not
getting what I'm looking for.
And I was expecting that here.
I mean, that's why I came hereis to get what I was looking for
.
And I'm not getting it, and soI'm not happy.
Speaker 1 (10:12):
Yeah, and it is also hard with that, with like let me
check my calendar and get backto you and if it takes an hour
then they're just sitting therelike I'm missing something,
maybe for an hour, and thatunnecessary stress With kind of
setting so within senior livingspace, as people are, or really
(10:34):
any senior care, how would yousay?
Or what's the most importantpart of kind of setting that bar
with them so that way they comein understanding that you know
it might take a little bit forme to go and go down to the
office, grab the calendar orlike we are understaffed, or
yeah.
Speaker 2 (10:54):
So this is where, if you have the skill I mean and
again you have to build skill Ifyou have the skill to say hey,
teba, you're wanting to knowabout your appointment this
afternoon.
You think maybe there's onethis afternoon.
I'm going to check on that.
I'm going to ask you for a bigfavor, though I could use some
help here for just a few minutes.
Could you do me a big favor?
These napkins that we have toget back out, they need to get
(11:17):
folded.
Would you fold them intoquarters for me?
That would be super helpful.
I really appreciate it.
You are such an amazing humanbeing.
I so appreciate you.
So what am I doing to the timethat you're going to spend that
somebody?
I'm going to be spendingwaiting.
What happened to that?
Speaker 1 (11:35):
It just goes away because I'm busy doing.
Speaker 2 (11:38):
So now you have something to do in that time and
what you have to do gives you asense of value and purpose, and
I am so appreciative.
And now, when I come back in anhour and I say, hey, teva, you
do have an appointment.
It's at two o'clock thisafternoon and I don't know
whether anybody said anything ornot about transport, but they
(12:00):
want you to leave at 1.30.
You know what I'm going to do.
Make sure that I get up withyou before that 1.30 so you can
get back down here.
Listen, now I know they'rehaving lunch.
I wanted to let you know theyare out of tomato juice and I
know that's your usual, but Iwanted to give you a heads up so
(12:22):
you could sort of think ahead.
What would you rather haveinstead?
Speaker 1 (12:26):
Yeah.
Speaker 2 (12:27):
Now what happened to the next thing?
Because I know that you getriled, because this happens
pretty frequently you know.
Speaker 1 (12:33):
Yeah, Now you've helped get ahead of that.
So they're not surprised whenthey show up to lunch and are
not having what they want andand then needing to leave lunch
fast because they have to get totheir appointment or whatever
Like it's just sets theexpectations in the bar for the
day.
Speaker 2 (12:50):
Yeah, so it's little things that matter, and so it's
not like I changed.
I mean, I didn't changeanything.
We still had the same issues wehad, but I chose to address
them differently, and that meansI had some skill to do that.
And one of our greatestchallenges we don't build the
skills of those who are present,and so we have to clean up a
(13:10):
lot.
And so I think for leaders,monday is like their least
favorite day of the week,because you've got to come out
back and put out all the fires,you've got to deal with all
these crises and reports fromover the weekend, and the people
who work weekend are frustratedbecause they got left there
with nobody else there to helpthem.
Families are on the phonewaiting to talk, and so there
(13:31):
goes Monday you know, which isnot how you want to spend Monday
.
Speaker 1 (13:35):
How do you so with the frontline staff that are the
ones that are having theseconversations?
Is it something like somethingin the water and you just find
these great people, or is therelike emotional training and
things to find that level ofpatience, especially because
that conversation could behappening almost every day of
(13:56):
like every day?
Speaker 2 (13:57):
I mean we should look at this as basic core training,
because this is the basis andcore of people who are having
trouble keeping up with thingsand having trouble keeping up
with where and having troublekeeping up with when and who and
how.
And yet at times I'm reallyclear, but at other times I'm
not.
So what I would say is we can'tassume anything.
(14:19):
What we want to do is sort ofreally acknowledge.
So if I were to do this withyou, caleb, what would happen?
So I'd say so I'm going to comeup to you and I'm going to say
I need to go home and what Iwant to do is find out what
you're going to do, because inthat moment that tells me what
your baseline skill is.
And I do that with multiplecarers.
And then I have an idea of wow,we're going to need some
(14:46):
training here, because we haveat least three people who get
turned around in where they are,when they are, why they're here
, and they ask that question alot, and they don't all live on
memory care.
Because it only happens in thelate afternoon, early evening,
for people who are out in AL ormaybe IL or living in an
apartment with their spouse butthey come to find somebody else
because the spouse went to playgolf.
(15:06):
I mean all kinds of things.
But once I know where my staffare, then I say okay.
So at change of shift we'regoing to do a very quick
introduction of the possibility.
So I introduced the skill.
So I want to go home.
Can you help me get out of here?
And the tendency is to answerthe question, yeah no, I can't.
Speaker 1 (15:25):
I want to go home.
Can you help me?
Speaker 2 (15:26):
get out of here, and the tendency is to answer the
question yeah, no, I can't, oryes, I can, and what we're going
to do instead is say so, you'rewanting to get out of here, so
what did I do to my body?
Speaker 1 (15:33):
You turned.
Speaker 2 (15:34):
I shifted it and I said you want to get out of here
, but I'm lining up with hereand I don't want to be here.
Oh, you're looking to besomewhere else Now.
Do you have something that youis there a place you'd like to
go when you aren't here?
Like where would that be?
Speaker 1 (15:54):
I want to go home.
Speaker 2 (15:56):
Ah home, yeah To your house.
Speaker 1 (15:59):
Yes, yeah.
Speaker 2 (16:00):
Yeah, yeah, now ooh.
Living room or somewhere else?
Speaker 1 (16:02):
Yeah, yeah, now ooh living room or somewhere else,
bedroom, oh your bedroom.
Ooh, yeah Is it dark or is itlight in there?
Speaker 2 (16:15):
It's pretty light in there.
It's pretty light.
Is it private?
Are you there and nobody messeswith you?
Speaker 1 (16:21):
Yes.
Speaker 2 (16:22):
I hear you, this place is pretty busy, isn't it?
Yeah?
Speaker 1 (16:27):
Yes.
Speaker 2 (16:27):
Too busy.
You know, I could use a favorfor just a second before you
head out okay now, why so?
What's happened?
What happened to need to gohome here?
Totally yeah, you de-escalatedit and then yeah, and when I
find out what you really needyeah, I need a quiet place that
feels like I can because guesswhat this is?
(16:50):
Change, a shift, guess what'shappening lots of movement.
Speaker 1 (16:54):
Everybody's out, yeah , and some people are going home
, yeah.
And a lot of people are walkingout the front door.
I need to go too, and what timedo you get up?
Speaker 2 (17:02):
You get up at 5 am.
Ah yeah, you're an early riser,so now's a good time for you to
cruise to a quiet space.
I wonder if you like music,what kind?
Speaker 1 (17:23):
So I want staff to get super curious, but we have
to start off with what's theskill set they have and what do
we build and how do we build andhow do we keep it little and
how do we check in.
That was awesome.
It really is.
I think the core attributes orthings that you train for is
like curiosity and then justpatience, because you're going
to be saying the same thing overand over again, but always be
curious as if it's the firsttime they're saying it.
Speaker 2 (17:39):
Yeah, because it may be a different reason they're
saying it this time.
I mean, I won't know.
I've got to stay engagedbecause if I don't, they're
looking for engagement.
I'm not giving it Guess what?
Elopement, frustration, anger,a sense of not being respected,
a sense of being trapped None ofthose are healthy feelings for
(18:00):
somebody living in a community,and it's going to increase the
risk that my job's going to getharder.
So I don't want my job hard.
It's hard enough.
And I also believe that ourleadership need to be able to do
this too.
I don't think they should askstaff to do something they don't
have the basic core skills ofdoing.
Speaker 1 (18:19):
Yeah, they're managing the community.
So if they run into somebodythey're like and they call
somebody and then all of asudden it does, yeah, so I can
call and I can say I'm reallystuck, I don't know what to do,
and you can say well, I'll giveit a shot.
Speaker 2 (18:32):
I mean, I'm not 100% on this, but I did take some
training and I am willing to try, because if I have a leader
who's willing to try, well thenI'll work harder for that person
in that situation.
Speaker 1 (18:48):
I like that a lot.
What switching kind of withthat approach, like how you just
immediately I mean it was alittle role play, but we got to
the bottom of what I reallyneeded in like five questions.
What are some common triggersof distress for people that have
any kind of stage of dementia?
And then how do we manage those?
Because I think, knowing thetriggers, we could potentially
(19:11):
minimize them or try to avoidthem altogether, if we can.
Speaker 2 (19:14):
Yeah.
So I'm going to give four S'sthat are often the triggers or
four F's, and then so that makesa total of eight.
So I'm overwhelmed, sensorywise.
So we've got to look at mysensory needs.
Is it too much or too little?
And it could be what I see,what I hear, what I feel, what I
do, but it's what's happening,sensory wise.
(19:36):
Am I liking, not liking?
Then it gets to social.
Am I getting a good social thatI enjoy, or is this social, not
a social interaction?
Am I missing a social that Ireally want and crave?
Then we get to the third, whichis, in this case, space.
Is this a space I'm enjoying oris this a space that I'm not
(19:57):
liking?
I want to be in another space,I want to be in an outdoor space
, I want to be in a privatespace, I want to be at the
theater, I want to go to work.
I mean, we got to figure outwhat space I'm craving or
missing.
And then, finally, what are thesurfaces that might be
bothering me?
Surface to surface contactmatters.
Could it be the chair I'msitting in?
(20:19):
Could it be the carpet on thefloor?
Could it be my glasses on myface, my dentures in my mouth.
Could it be the clothes?
I'm too hot, I'm too cold.
It's too tight.
I don't like this.
It doesn't feel good.
This brief is uncomfortable andI don't understand.
So that's my S's.
Speaker 1 (20:36):
Wow.
The fourth one was a surprisefor me.
I know that's often a surprise.
Speaker 2 (20:42):
And yet think about it.
We don't like the feeling ofstuff on us that doesn't feel
right.
Speaker 1 (20:48):
Yeah.
Speaker 2 (20:48):
Or if I'm cold, I want another layer and I may say
I got to get out of here andit's like it's cold.
It's cold, so we can raise thetemperature of the room or we
can give her something to putover her, but she's missing that
.
Yeah, the air movement on her,um, and then the four f's
friendly.
It doesn't feel friendly herefor me.
Familiar, I think I'm in anunfamiliar place, even though
(21:10):
you know so it's not feelingfamiliar, functional.
I can't figure out what to dohere.
I want to be in a place where Iknow what to do, or forgiving.
I feel like people are judgingand not liking me and I don't
like that.
I want out of here because Idon't like this feeling I'm
having right now, yeah, how onthe four Fs, I feel like that's
harder.
Speaker 1 (21:31):
Maybe it's harder to get to the bottom of, because
sensor like that one would havebeen a.
I'm trying to think which Smine like I want to get to the
bottom of it, because sensorlike that one would have been a.
I'm trying to think which Smine like.
Speaker 2 (21:42):
I want to get home because I was sensory, because
there was too much space, yeah.
You want to be in a familiarspace.
So let's look at it.
So what happens is you say thisisn't my stuff, I don't know
who brought this in here.
Then it may be time to talk tofamily and say you know what?
We're going to make it lookmore like a hotel room, because
when it looks like their place,it feels like they've been
dumped here.
So we're actually going to askI'm going to ask you to bring in
(22:04):
stuff that is not as familiarto them.
So this is temporary.
You're staying here temporarily, for right now, this is is this
, is this quilt okay?
I mean, I know it's not yourquilt, but is it okay?
And it's like yeah, cause I?
I mean, I know it's not yourquilt, but is it okay.
And it's like yeah, because Idon't want to stay here long.
And it's like okay, well,that's fine.
You know, is this onecomfortable for you?
Yeah, but I actually need it tobe less familiar.
Speaker 1 (22:26):
Because if it's familiar, it's like why is?
Speaker 2 (22:28):
all my stuff here.
Speaker 1 (22:29):
I don't like this.
I'm going to pack it up.
This isn't my house.
Speaker 2 (22:58):
Yeah, wow, that's so interesting I know that that is
definitely a shift in my mindbecause feels like you're,
you're making her stay and she'sgoing no, and so well, let's
try something different.
Speaker 1 (23:05):
I mean, let's give it a shot.
Speaker 2 (23:07):
See what happens yeah , that's yeah.
Speaker 1 (23:10):
um so, with trying to put together a question, so
yeah, I guess I would.
I'm interested in doing a quickrole play on one of the four Fs
, like how do you get to thebottom of that?
Speaker 2 (23:33):
as quickly, yeah, and so it's like, let's say, you
have crap all over your shirtand I'm trying to help you get
out of the dirty shirt and intoa clean shirt.
I mean, it's one thing that I'myou know, frequently people are
trying to figure out yeah andlet's say, without thinking
about, I said caleb, you havestuff on your shirt here.
Let's change your shirt.
This one is, you know, thisone's dirty.
(23:53):
Let me get you a clean shirthere.
See, I have clean shirt for you, clean shirt for you.
It's like this is fine, leaveit alone.
I'm not changing the shirt,this is my shirt and I'm not
doing it.
And it's like okay.
So I judged you and I didn'tmean to, but I was making you
feel really uncomfortablebecause you didn't feel like it
was okay to have that shirt on.
(24:14):
So, okay, let me shake it offand I go.
Speaker 1 (24:17):
Oh hey.
Speaker 2 (24:18):
Jacob, I have a big favor to ask of you.
I got a new shirt for myhusband and I'm really wondering
you guys are about the samesize.
Would you be willing to try iton so I can see what it looks
like?
Speaker 1 (24:36):
Yeah, would you be willing?
Speaker 2 (24:37):
to try it, yeah, okay , tell you what, undo your shirt
here and go ahead and take itoff, and I'm going to here put
it on, okay, now here's what Iwant you to do.
Let me know.
Does it feel comfortable?
Does it feel comfortable?
Cause I really wanted to feelcomfortable for him, cause he's
real picky.
Like, how's the arms?
How do the arms feel?
(24:58):
Pretty decent, okay.
How does it like?
Is it long enough for you?
Okay, would you do me a favor?
Would you keep it on for alittle bit until I can sort of
check out, because I want to seehow it feels after a little bit
, see what you think.
Okay, Okay Now in fact, not ashirt for my husband, it's a new
(25:19):
one that your daughter got foryou and she's been trying to get
you to wear something otherthan that ratty old thing.
And but did it feel at all likeyou were unacceptable?
And and you it's like?
Speaker 1 (25:35):
Oh, wow.
And then I go about my day andI'm just wearing this new shirt,
and you're just wearing a shirt, I mean, and that's me
understanding how dementia works.
Speaker 2 (25:43):
I mean, when you see me, you go what do you think of
my shirt?
And it's like, I think it'sgorgeous, you look great in it.
How's it feel, feels great, youknow.
And if you say, oh, this is foryour husband, right?
I go.
You know what it looks like.
You're really enjoying it.
When you get done with it, I'mjust going to get him another
one.
You know what?
Speaker 1 (26:04):
Yeah, there's more at the store, I'll go grab it.
There's more to the store.
Speaker 2 (26:07):
There are more in the store, and so the idea of
building a relationship of trust, of like, of non-judgment so I
don't tell people you're wet,you need to get cleaned up ever
I will say Ooh, feel this?
What do you think?
And if the person goes, oh, oh,my heavens, and if I say I
(26:31):
must've spilled something, I'llgo, sure enough, it looks like,
wow, let's go get that.
Oh, my heavens, how awful Ihate.
That happened for you, you know, rather than you didn't spill
anything, you peed on yourself.
That moment where, withoutthinking, your brain goes well,
that's not true.
Me, I didn't spill anything.
I want to tell truth.
(26:52):
And it's like the truth issomething spilled.
It spilled out of her.
She wasn't aware of it.
If she was aware of it, shewouldn't have done that.
She'd go in the bathroom, shecould have gotten there.
Speaker 1 (27:09):
Do I really need her to feel incompetent for me to do
my job?
Yeah, that's exactly true, wehad a guy on, had a guy on.
He is really he's a reallysuccessful um just entrepreneur
and and influence in thecommunity here in utah and his
mom is struggling with dementiaand has been, and he kind of had
this realization where he'slike I can tell you within 30
(27:33):
minutes of picking my mom up totake her home for sunday dinner,
were what the 10 questions are,what I will say in response,
and he's like it was hard,really hard in the beginning
because like it'd be, like mom,you already asked me that
question five minutes ago andhe's like but then I had to
realize you know she's not beingmalicious or like and it's like
(27:54):
she wants to have aconversation, she wants to
connect and he's like I had torealize that everything was her
attempt at connecting.
And we're going to answer thosesame questions, you know, 15
times over the course of ourdinner and and it's going to be
a beautiful moment.
Speaker 2 (28:10):
You know like it is, or you have another choice and
that's what folks get, it's likeOK.
So you asked me to say so youknow, are we going to go back
soon.
So go ahead and say and you'veprobably asked me multiple
times- yeah, are we going to goback soon.
You're wanting to know if we'regoing back soon.
We are, oh, but before we go,oh, I want you to look at
something.
Look at this picture.
(28:30):
What do you think?
You like it.
I think it's pretty, it'scolorful, I think it's pretty,
yeah, sort of not the bestrainbow you've ever seen, huh.
Speaker 1 (28:44):
It's, it's pretty, it's good, it's pretty.
Well, you know what.
Speaker 2 (28:48):
What do you think of this one?
Speaker 1 (28:51):
That one.
I like it a lot, you like thatone a lot.
Speaker 2 (28:55):
Yeah, now that's cool .
What about this one with thelittle girl over here?
What do you think of that?
Speaker 1 (29:01):
I think that's fun, I don't know.
That's fine, yeah, okay.
Speaker 2 (29:04):
Cool.
So you know what's cool aboutyou.
You have all this artbackground.
Huh, you like art.
That's cool.
I have a book.
I want to show you Now whathappened.
Speaker 1 (29:14):
To repeat, repeat now we're back into it's a uh kind
of like what did I use a lot ofa lot of visual.
Like I said, it all comes inright here and then back and
forth but it feels better anddifferent when I can sort of
(29:36):
make it flow better.
Yeah.
Speaker 2 (29:38):
But that takes skill and you know otherwise.
You know I have to have thesame exact conversation over and
over again and it is hard tokeep that interesting.
But that's where my skill setis a little different and I go
well, let's expand, because youknow what the heck.
Speaker 1 (29:54):
It's cool how you always are able to take some
request or like a direct.
I need to do this and totallyredirect to something that's
meaningful.
Speaker 2 (30:05):
Yeah, and so I believe I mean it's sort of like
.
I guess people would say it'slike improv, it's a yes, and so
I answer you yes, and and thenwe can figure out where can we
go next.
Speaker 1 (30:15):
Yeah, and then we can figure out where can we go next
.
Yeah, so with people like him,I mean, you have a substantial
social media following and thething that's cool we've had
different dementia carespecialists on, but their
following is all.
It really is mostly likeLinkedIn with other senior care
(30:36):
professionals.
It really is mostly likeLinkedIn with other senior care
professionals, but you've beenable to reach a larger
demographic with TikTok and likemore commonly used as general
social media Instagram, facebook.
Speaker 2 (30:47):
TikTok.
We have LinkedIn, but we also Imean we try really hard YouTube
.
I mean we are available in somany different ways.
We work with Rude, which is anew app.
We have some apps that peopleare using and I'm active on that
because we know that so manypeople learn in different ways,
(31:09):
so many audiences are connectedin different things podcasts,
because you know, however,you're able in that moment to
grab something and take it.
We'd like you to have somethingto take because this is a it's
a rough journey, it's a longjourney, it's a hard job that
people are trying to do, and ifyou catch something in a moment
and it's something you can use,then you tend to come back If
(31:32):
you know.
If it's not there, you can'tfind it.
So you know.
Speaker 1 (31:37):
So with that, with your social media presence and
what you're posting, what Iguess what topics have gone I
guess you say the most viral orhad the biggest large spread
impact Cause I think that'ssomething that the management of
these communities can use aslike a huge value add.
(31:59):
People coming in.
I don't know what to do with mymom.
Like you said, it's beenbuilding up for five, seven
years.
They didn't know and nowthey're at this point like oh
crap, um, being able to say yes,we can help her and you know
when, like this, this gentleman,if he, the community that his
mom is staying at, was like youknow, you should do all these
things when you take her out andlike what are the things that
(32:21):
just the general population ofcaregivers caring for their
family has found valuable?
Speaker 2 (32:26):
Yeah, I think the most important thing is that
we're going to need new skills.
And we've got to go into this,realizing if their brain is
changing and some of their brainis dying and it's going to
continue onward is changing andsome of their brain is dying and
it's going to continue onward.
I want to get on board soonrather than late, because I'm
going to have to pick up speedreally quick.
So, whether I'm a professionalor family member, wow, it would
(32:47):
be a really good idea.
If I'm paying attention to thechanges and I start to notice,
wow, we're having a littlefriction here where we've never
had that, or I'm getting a blanklook when I used to get a
question.
There's a hesitation.
So if we could get people tolike sort of go huh, how can I,
you know?
And so what we do is we try tobe available and so you can chat
(33:13):
a question you can ask.
We'll try to do something aboutit.
I think the biggest mistakepeople make is not asking
questions and so ways that wecan get people to generate a
question I don't even know whatto ask.
Well, let me ask you how areyou doing?
Are you feeling here, here orhere, about what's going on?
And so that's a starting place,and so we'll start.
(33:35):
And I think we have to bewilling to start with where we
are, regardless and I thinkthat's what we work hard on is
being present, so that in thatmoment, somebody feels listened
to and heard.
And once they get that, theyget their agenda met.
Then we can go to differentplaces, and it can be little
(33:57):
baby things or it could be hugethings.
It's like cause I'll get a lotof questions about how do you
know when it's time?
Yeah, and I'll say well, by the,the, the fact that you're
asking about three months ago bythe time you're willing to ask
the question.
You've been in crisis for awhile.
In general, I mean peoplehesitate to ask the question
because it feels like giving upon somebody and I would say
(34:20):
you're just letting go of someof the job you have.
You have too many jobs andyou're letting go of something,
but you're not giving up.
I don't want you giving up, butI do want you to think about
letting go of some things,because things are so different
than they used to be.
You need more support to dothat.
Speaker 1 (34:37):
I love talking on that vein.
When people you know they feellike I'm letting my mom down or
I'm letting my wife or husbanddown, it's not, it's.
You're getting back to being adaughter or a husband or a son,
like you're just letting go of alot of these other duties that
are beyond.
You know, we want it so thatway, when you come to visit mom,
(34:58):
your daughter, you're not.
You know, here's the trickypart.
Speaker 2 (35:04):
That's really scary for folks, cause I don't know
how to do that anymore, and sothen we want to support them in
doing that.
So here's what that might looklike.
Tell me what your mom'sfavorite music is.
What's her favorite artist?
The Beatles, beatles.
Speaker 1 (35:24):
Ooh Like early, early or more John and Ringo and that
guy after, yeah, a little lateron.
Speaker 2 (35:27):
A little later, like yesterday.
Does she like yesterday?
Speaker 1 (35:30):
Yes.
Speaker 2 (35:32):
Oh, cool, all right.
So here's what I want you to do.
I want you to preload yesterdayand two other Beatles songs on
your cell phone and when youcome in, I want you to go hey,
mom, check this out and startplaying one and sing along with
her, and you might even see ifyou can get it on YouTube, where
the words come up so that, whenyou come, in.
Speaker 1 (35:54):
That'd be so fun with my mom when you come in.
Speaker 2 (35:56):
That'd be so fun with my mom.
Ah, yeah, because I thinksometimes one of the reasons
people keep trying to do taskswith people is because they have
lost.
They've lost the relationship.
They don't have to get it back,and that's where we can come in
handy.
Not not to say out loud youknow, you're, you don't know how
to be a daughter anymore.
I mean that's, that's not fair.
(36:18):
It's like you don't know whatthat level of dementia, how to
engage, and it's really hard andit is really hard, um, which is
why many people stop visiting,because it gets so scary and
hard and I don't know what to doand we just it never works.
I feel, horrible at the end andshe cries and I'm upset and and
(36:39):
it's hard, and so I thinkhelping people navigate that is
is important, because I they doneed help often and sometimes
people are spectacular, but Iknow a lot of people who aren't
yeah, um, there was something soswitching a little bit.
Speaker 1 (36:57):
Um you mentioned you know you have like, is it
physical, emotional, mental, buteven spiritual?
I am curious, what role doesspirituality have in your
approach to?
Speaker 2 (37:07):
dementia care whole.
They're hidden, and the hardpart for us is to accept not my
job to dig them out, my job tosupport them as they appear and
know that they're whole.
(37:27):
I'm here to hold that space, tooffer that opportunity, to
create that moment where we canbe together or you need to be
alone, but I'm not going toforce it.
And so everything I do must bedone with permission, because
when I don't seek and receivepermission, I've got to learn
how to get permission.
When somebody is like not ableto tell me and not able to show
(37:49):
me a whole lot, I will knowwhether I have permission.
Whether the person is, that'snot permission.
And so I've got to pause andrealize, wow, I'm pushing the
spirit too hard.
That person's spirit is thereand they're giving me messages
of distress and so, okay, that'sa spiritual distress, not just
(38:11):
a physical distress.
That means I'm not listeningand I need to pause and get
super curious about how tolisten.
And so I'll often start oh,this is not okay.
I'll say out loud what they'reshowing me to see if I'm on
target and they'll go.
yeah, it's not, and it's likeokay, window just opened.
Speaker 1 (38:33):
Okay, that's interesting, just mirroring.
Speaker 2 (38:34):
Window just opened.
Speaker 1 (38:37):
Window into the spiritual.
That's cool.
Speaker 2 (38:39):
Yeah, so it's really for me, and what we teach is
it's always about really stayingsuper curious, having
incredible compassion, Alsoreally truly seeking the mutual
benefit each of us can have whenwe are together and do work
together, and realizing it isabout relationships and you've
(39:03):
got to authentically care.
I mean, it can't be a surface.
Yeah, yeah, yeah, here, let meget your pants off.
I mean it's like because yeah,you're a really sweet guy here,
let me get your pants off.
I mean you're going to figurethat out real quick.
So it really is being committedto the relationship and it
means as part of my job, I'vegot to be able to recognize at
(39:25):
the end people got to go homeand I'm not talking about to a
physical place, I'm talkingabout leaving this earth, and
I've got to be reallycomfortable with the idea of
releasing someone into theirnext space and not grieving the
loss but celebrating the lifeand celebrating that transition.
Speaker 1 (39:47):
Or it can be really dark sometimes.
Speaker 2 (39:49):
Yeah, and it's hard, especially in the industry where
that can happen prettyregularly, yeah, and so,
whatever I've done, have I donewhat I could to make that
journey complete?
And if I did, then let'scelebrate what an amazing human
being and what a gift to get togo um, having done what you were
(40:11):
needing to do.
Speaker 1 (40:12):
Yeah, that's.
I love that.
Um, we're getting.
Time has flown.
I have one more question beforeI ask the last few.
I am curious your opinion ontechnology for those with
dementia.
I know that that is somethingthat, again kind of anecdotally,
(40:33):
you can protect bank accounts,you can protect all these things
.
Is there a space for?
Specifically on loneliness,that's something that I'm really
curious about.
Is there a way to incorporatesocial platforms and things like
that for people going throughdementia safely?
Speaker 2 (40:49):
I think we are just getting to the front edge of
really effective platforms.
I think there's been a wholelot of before.
I think we were just reallystarting to appreciate the
skills of people living withdementia, the limitations of
people living with dementia, themisunderstandings of engineers
and creators who thought theyhad a simple answer to a complex
(41:11):
situation, and we're startingto look at how to use technology
in more effective ways, becausewe're getting better at
recognizing its boundaries andits need for support.
I think technology needs asmuch support as the person
living with dementia I mean.
So often we think, oh yeah, thetech will be the answer and
(41:32):
it's like no, it's a piece ofthe puzzle.
But we've got to figure out howand when to deploy it and how
to monitor it and to modify itas needed.
I love music, but putting it on24-7 isn't an answer.
It's sort of like noiseFiguring out what is up music
for somebody and what isrelaxing music for somebody, and
(41:55):
then employing the technologyto monitor heart rate,
respiratory rate to see whetherwhat's working.
Is it going with that person orare we fighting it?
If so, do I need to bump theenergy up so we can catch their
energy and then help them comeon down.
There are lots of ways thattechnology can be a gift, but it
(42:16):
can also turn into a weapon.
Speaker 1 (42:19):
If.
Speaker 2 (42:19):
I think it's going to do something it's not doing and
I get frustrated with theperson or the technology.
You know everybody's alwayslooking for that.
How can we have a control, a TVcontrol that they can use, and
it's like you know let's look athow often we should be using
the TV and you know how do weuse it as a tool, not a
(42:41):
babysitter.
I mean, if you're looking for ababysitter, tvs may not be the
best babysitters in the world,um, you know, but it's.
It's a challenge because I haveto know the person, I have to
know the technology and then Ihave to know the situation yeah
um, and people want it to besimpler.
But there's great ways to usetechnology, but there's also
(43:02):
messy ways to try and and youbuy it and it's not used and
it's expensive and it's hard tomaintain and whether it's a
documentation system or whetherit's some, you know, a support
to engage, how you use what yougot really matters, and if we
don't prepare people for how todo it, it can really be a
mistake frequently yeah, yeah,and really the that is
(43:25):
insightful.
Speaker 1 (43:25):
Like the technology or the tool itself can be
amazing, or like the example ofmusic itself is always good, but
how you use the technology, youknow if you have 100 different
people, you might need to use100 different micro variations
of this technology and you can'tjust like here and otherwise
(43:45):
and what I use in the morningmay not be what I need in the
afternoon.
Speaker 2 (43:49):
And when I bring everybody together, what's the
volume?
I've got to adapt it foreverybody.
But do I need a set ofheadphones on certain folks or
modifications, because they havesignificant hearing problems or
they have hypersensitivity?
Because people have lived withautism a long time and now
they're getting old and so youknow we may still have issues.
Speaker 1 (44:11):
Yeah, so really technology can be.
I would say it's a potentialsupplementer and not the answer.
Most times.
Speaker 2 (44:22):
I do not believe it will ever be the answer to
things.
I think it will be part of ananswer or part of a solution or
part of an experiment and Ithink if we look at it that way,
then we're more respectful ofwhat it could offer but also
what it probably is not doing.
I mean, I would use the exampleof chair alarms.
(44:44):
I think we've finally gotten toa place where people realize
the only people listening tochair alarms are other residents
who are tired of hearing themBecause the person who's getting
up out of the chair is ignoringthe chair alarm.
The people who are down thehall are too far away from the
chair alarm to be there whenthey need it and they get.
(45:05):
They get so over tired of itthat they quit actually hearing
it.
There's evidence they quit yeah, they don't register it as an
alarm.
It's just sort of a noise that'shappening and the people nearby
are yelling sit down, sit down,alarm's going off.
She's getting up again.
She's getting up.
So that's your chair alarm isthe resident sitting next to
(45:32):
them.
Speaker 1 (45:33):
What the last two questions?
What are some of the mostrewarding moments that you've
experienced in your career thathave fed you to keep going?
I think those ones that keepyou going are ones that people
should strive for.
Speaker 2 (45:48):
They're called aha moments.
There are moments when someone,when I've done something and
somebody has an aha, you can seeit.
Their brain goes, oh, and thenthey try it and they come back
my favorite moments.
They come back, they go you'renot going to believe this,
you're not going to believe this.
It worked and it's like it did.
Tell me about that Because forthem, it was such a disbelief to
(46:10):
belief when they figured it out.
They actually have the power tochange things and it's so funny
when people do it and they'relike you're not going to believe
this and it's like probably do,but go ahead, I've got to give
you the energy back or that'ssort of it's like I'm sure I
will.
You know that's not helpful butit's really great, it gives me
great joy and pleasure andsatisfaction to find people
(46:33):
opening their eyes, openingtheir hearts, their, their,
their spirits to the idea ofsomething different and
realizing, oh, I can choosesomething different.
And it's like, yeah, how coolis that.
Speaker 1 (46:45):
I love that.
Um last question is what advicewould you give to someone just
starting their career indementia care that wants to be
in it for the long haul?
Speaker 2 (46:56):
Yeah, um, spend time with people living with dementia
from the very not even knowingthey have it till the very end
of life.
Get really super curious aboutyourself and figure out are you
somebody who likes to beflexible or do you like
structure and patterns and doyou need things to be right?
(47:16):
Because if that's who you are,this is probably a very
uncomfortable place to get intoand I'd recommend thinking of
something else.
If you love to be creative andhave the ingredients and not
know for sure what you're goingto make for dinner, because you
have to sort of see what's inthe refrigerator and what else
is happening and what's the daybeen like, then this is the
(47:38):
right place for you and whatyou'll want to do is get some
training with somebody who isreally excited about you
learning and not excited abouttelling you a bunch of stuff,
but really wants to engage withyou.
Speaker 1 (47:55):
Yeah, all right.
What's next for TIPA Snow?
Who should find you?
Where do they find you, allthose fun questions?
Speaker 2 (48:03):
We're on tipasnowcom, we're on all the social media.
I mean, if you could put myname so unusual, if you just put
that in, it'll pop up a lot ofdifferent stuff.
Positive approach certainly does, but TIPA Snow tends to be
teaching.
That approach certainly does,but tip of snow tends to be a
teaching that'll pop up.
The next thing for us is we'rereally hoping that over the
course of the next five yearsthere is a radical change in
(48:27):
acknowledging the need toprepare people for this work and
that we don't need to havepeople in trauma trying to do
care because they haven't beenprepared ahead of time, and that
making sure people have whatthey need before they walk into
situations makes all thedifference in the world and the
(48:47):
outcome for everybody involved.
And it's worth establishingsome baseline of ability before
we start throwing people to thewolves of care.
And that's what we're hopingfor the next five years is let's
make a difference.
Speaker 1 (49:02):
And you're on track for sure, just helping everybody
.
So I've loved this today.
It's been a pleasure and anhonor to spend the last 45, 50
minutes with you, so thank youso much, and I know people are
gonna get a lot of value out ofit.
Speaker 2 (49:17):
So my pleasure.
Thanks for having me.
Speaker 1 (49:20):
Yeah.
Speaker 2 (49:21):
Take care.
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