October 1, 2025 • 33 mins
We’re revisiting this episode because its insights remain as powerful and relevant today as when it first aired.
Lisa shares more real-life case studies from her 30 years of experience working with people living with dementia that highlight common behavioral challenges that often accompany this condition on a day-to-day basis. In this episode, Lisa describes a variety of different challenges and situations that are so common to dementia along with intervention strategies and positive outcomes that caregivers can use with their everyday struggles.
You don’t want to miss this enlightening episode!
About the Host:
Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.
Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Lisa’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle so they can have a better-quality relationship with their loved ones through education and through her workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to respond.
So many people today are heavily impacted by Alzheimer's disease and related dementia. The Alzheimer's Association and the World Health Organization have projected that the number of people who will develop Alzheimer's disease by the year 2050 worldwide will triple if a treatment or cure is not found. Society is not prepared to care for the projected increase of people who will develop this devastating disease. In her 30 years of working with family members and caregivers who suffer from dementia, Lisa has recognized how little people really understand the complexities of what living with this disease is really like. For Lisa, it starts with knowledge, education, and training.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Lisa Skinner (00:00):
Welcome back everybody to another new episode
(00:03):
of the truth lies andAlzheimer's Show. I'm your host,
Lisa Skinner, and today I wantto share with you some more case
studies that highlight variousbehavioral challenges in people
living with Alzheimer's diseaseand dementia, and then give you
(00:26):
effective strategies in casethese situations arise. Now, one
of the things I want toemphasize, and I've mentioned
this many, many times before, onother episodes of the truth,
lies and Alzheimer's show issome of the strategies and the
(00:50):
techniques that I offer andshare with you don't necessarily
work for every given situation.And this is why I can't
overstate that we all need toassemble a really strong
(01:12):
toolbox, because what willhappen is I'll give you a
suggested strategy for asituation that comes up. You
might try it sometimes, andit'll work beautifully and
diffuse the situation fromescalating any further, but
(01:34):
other times it just won't. We'redealing with human beings here,
and they have their good daysand their bad days, just like
the rest of us. So what might beeffective in one situation, if
that same exact scenario happensagain, and you try the technique
(01:58):
I share with you, it just mightnot work that time. So the goal
here is to give you enoughstrategies that if something
doesn't work, you have othertools to choose from that are
(02:19):
already within your toolbox. Andof course, you know it stands to
reason that the more of thesetools you have to pull from, the
better chances you have ofdiffusing any given situation.
That's the entire goal here isto just be equipped and prepared
(02:41):
as best you can, because thesesituations can prove to be very
difficult, and part of thereason is is that not every
solution will always work in anygiven situation. So here is a
(03:03):
case study that the womansuffers from emotional
outbursts. And last time Ipresented this case study
episode, I mentioned that theseare all true stories of things
that actually do come up on aday to day basis at any given
(03:27):
time, unexpectedly. Not reallysure what the trigger was. They
just these behaviors just showup out of the blue. And so this
woman, I'll call her ETHEL.She's 81 years old, and she is
in moderate stage of Alzheimer'sdisease. And the challenge here
(03:53):
is she experienced a suddenemotional outburst, often crying
or becoming angry over minorfrustrations, which leaves her
caregiver unsure how to respond.And she does this frequently. So
here are some interventionstrategies for this particular
(04:16):
situation, if it happens to you.So one of the things that we'll
need to pay attention to andfocus on is identify, try to
identify what triggered thatsudden emotional outburst. It
(04:36):
could be one of many, many, manythings. So what I recommend is
that you as a family member oryou as a caregiver, start
keeping a journal to track whenand why emotion these emotional
outbursts occur, identifyspecific triggers, such as
(04:57):
changes in routine or. Unmetneeds. And this will be a little
challenging at first, until youstart to recognize patterns of
what sets off the person setsthe person off, displaying
(05:18):
whatever the behavior might be.And in this case, it's an
emotional outburst. And thenonce you start seeing patterns,
it'll be easier as time goes onto you know, if that emotional
outburst happens and go, Oh,this triggered it last time,
maybe it's the same thing today,but you're going to have to go
(05:42):
through a process of eliminationto kind of dial that in. So
first and foremost, as acaregiver, you definitely want
to offer comfort to Ethel oryour person through gentle
(06:05):
touches and reassuring words andvalidate those feelings during
the Episode activities likelistening to soothing music or
gardening, were introduced toEthel so she would be able to
(06:27):
express her emotions in ahealthier way, and then the
outcome, hopefully for you, willbe similar to this one, because
by understanding triggers andproviding emotional support, the
frequency of Ethel's outburstsactually decreased, leading to a
(06:50):
much more peaceful environmentand positive outcome for both
Ethel and her caregiver. So thiscase study is a sample or an
example of a person withvascular dementia. He's 874,
(07:14):
years old, and he just has lostinterest in doing any
activities. His name's Joe. SoJoe was once an avid golfer and
socializer, but he started toshow disinterest in activities
(07:37):
that he previously enjoyed,leading to social isolation. So
some intervention strategies forthis situation include
reintroducing the activities hiscaregiver gradually reintroduced
Joe to golf by visiting thedriving range, allowing him to
(08:01):
engage without the pressure of afull game. Now, this gentleman
had vascular dementia, if thecaregivers taking him to a golf
course to the driving range,he's probably early on with his
(08:21):
cognitive impairments. But thisis just an example of an
intervention that worked, andyou can modify it to the stage
that the person you care for isin at the time they organize
small gatherings with friendsfrom the golf club, providing
(08:44):
familiar social interactionsthat did spark his interest or
renewed interest, and thenexploring new activities such as
painting or puzzles helped Joediscover New interests that he
could enjoy at his own pace, andthat is an operative statement.
(09:07):
At his own pace, he just doesn'thave the cognitive abilities
that he once had, and sometimeswe forget that about our people
that we care for so we have tomeet them where they are in
their stage. So the outcome forJoe was with gentle
(09:31):
encouragement and socialsupport, Joe did begin to
participate in activities,again, significantly enhancing
his mood and reducing hisfeelings of isolation, which is
so incredibly important forpeople living with dementia.
(09:54):
The next story, the scenario isdifficulty with personal care.
Care, and we see this a lot inpeople living with Alzheimer's
disease and dementia. And thislady, Sarah, she's 79 years old,
and she's just in her earlystage of Alzheimer's disease,
(10:16):
but the behavioral challenge isthat Sarah resisted assistance
with personal care tasks such asbathing and dressing, leading to
hygiene issues and caregiverfrustration. So a great
intervention strategy. And Ihave seen this work over and
(10:41):
over and over again, and I'veactually talked about it pretty
frequently, is creating aregular routine, a consistent
daily routine was establishedFor Sarah, incorporating
personal task care tasks at thesame time each day to foster
(11:06):
predictability, and this is suchan important approach to people
with cognitive impairment,because they thrive on
familiarity, and a routinerepresents familiarity. So
really important to toincorporate a consistent daily
(11:28):
routine. But what the kid whather caregivers did was they
offered her choices in clothingand grooming products, which
ended up empowering her andultimately reduced her
resistance. It gave her back alittle bit of her independence,
(11:50):
and felt like she had a say inthings. And then they praised
Sarah for her cooperation andindependence during personal
care, which reinforced positivebehavior. So the outcome for
Sarah was with a structuredroutine and choices, she became
(12:14):
more willing to engage inpersonal care, improving her her
hygiene and overall well being.Is that going to work every
single time somebody becomesresistant to wanting to take a
bath or a shower, get dressed orbrush their teeth or all the
other personal hygiene serviceswe provide for the people we're
(12:37):
taking care of no but this is afundamental, proven technique
that has shown to work, but youmight need to have a few other
strategies and techniques inyour toolbox to pull out if that
doesn't work in at any giventime. Michael is a 77 year old
(13:03):
man with Alzheimer's disease inhis moderate stage, and the
behavioral challenge here wasdue to his cognitive decline and
his frequent forgetfulness. NowMichael routinely and frequently
(13:27):
forgot names of family membersand significant events, and that
led to tremendous frustrationand embarrassment during family
gatherings. So the caregiver,their intervention strategy for
this particular episode, createda memory book filled with photos
(13:53):
and names of his family members,along with significant events
for Michael to reference, gavegentle reminders about family
members and events duringconversations, using cues to jog
his memory, and it waseffective. Then they encouraged
(14:18):
Michael to share stories abouthis life, and this helped
reinforce connections with hisfamily, allowing for cognitive
engagement, and that's anultimate goal for us. The
outcome for Michael was in usingthese memory aids and
storytelling not only helped himremember his family members
(14:42):
better, but also strengthenedhis emotional connections with
them. This lady, she's 80 yearsold, and she has Lewy body
dementia, and she has beenhaving some. Some reactions to
medications that she's on. Sothe behavioral challenge was in
(15:09):
that she was having paradoxicalreactions to certain
medications, which stands toreason why she had was showing
and displaying increasedagitation and anxiety instead of
relief. So what that caregiverdid was monitor these negative
(15:32):
reactions by maintainingdetailed notes on every time she
was given the medication and thereaction that followed, and then
shared this information with herhealth care provider. The
caregiver, worked closely withhealth care professionals to
(15:52):
adjust her dosages and switchmedications, finding
alternatives that better suitedher needs. And then by trying
some different holisticapproaches versus pharmaceutical
approaches, and she triedaromatherapy and relaxation
(16:16):
techniques like hand massages,those were introduced to help
manage her anxiety withoutrelying solely on medication. So
the outcome for in this scenariowas through careful monitoring
and collaboration with thiswoman's health care providers,
(16:39):
her medication regimen wasoptimized, leading to decreased
agitation and improved overallwell being. Here is a study that
looks at or case scenario thatlooks at compulsive behaviors,
(17:02):
which happen a lot. This isSteve. He's 82 years old, and he
has Frontotemporal dementia. Andif you don't, if you're not
aware, Frontotemporal dementiais the brain disease that
(17:23):
attacks the temporal lobe of ourbrain, which is in the front
part of our head, and it reallywill impact our emotions, our
thought processes, our abilityto reason situations out, and in
(17:46):
most cases, in a lot of cases ofFrontotemporal dementia, the
person ends up reacting on pure,raw emotion because they've lost
a lot of the ability todifferentiate between a big deal
and something that's not thatbig a deal, like we do when we
(18:07):
have a healthy brain, everythingtends to be a big deal to them
in a lot of situations. So Stevedeveloped compulsive behavior,
and some of the things that hewas doing was he was repeatedly
checking doors and windows,which of course, created
(18:29):
distress for both himself andhis caregivers. So the
intervention strategy that hiscaregivers try was to offer a
structured routine, which againis a consistent daily routine
(18:49):
established to providestructure. It worked in this
particular behavioral situation,and it actually ended up
reducing his need for compulsivechecking behaviors, the
caregivers provided reassurancethat the doors and the windows
were secure and that reduced hisanxiety related to his safety,
(19:15):
He was concerned about hissafety
when these compulsive behaviorsdo emerge, caregivers redirected
Steve to engaging activitiessuch as playing cards or doing
puzzles to get his mind onsomething else. And the outcome
(19:38):
for Steve with the interventionsthat his caregivers implemented
was with a structured routineand reassurance Steve's
compulsive behaviors wereminimized, leading to a much
calmer environment. So again,flexing a. Variety of tools to
(20:02):
assemble in your toolbox thatany of these situations, if they
might arise, and the chancesthat they will are pretty good,
you have more than one option totry to try to diffuse the
situation. So let me give you afew more. This one happens
(20:24):
frequently, and this woman, hername's Joan. I'll call her Joan.
She's 78 and she suffers fromincontinence, and as a result,
extreme embarrassment, which isunderstandable. She's aware
(20:46):
she's incontinent, and she's inthe moderate stage of
Alzheimer's disease. And whathappened to Joan is she began
experiencing incontinence,leading to feel feelings of
embarrassment and reluctance toparticipate in social
activities. So what thecaregivers did for her was they
(21:11):
established a regular bathroomschedule and encouraged Joan to
use the restroom at set times,which ultimately reduced the
frequency of accidents. Thecaregivers also provided
discreet and comfortableincontinence products, which
(21:32):
helped Joan feel more secureduring outings, and also
reassured her that incontinenceis common in people living with
dementia, encouraging her toparticipate in social activities
without fear of embarrassment.So the outcome for Joan was
(21:54):
positive. So by engaging orimplementing a consistent
schedule and supportiveproducts, Joan felt much more
confident and engaged socially,experiencing fewer accidents and
a greater enjoyment inparticipating in activities. She
(22:16):
wasn't just completelyoverwhelmed with the worry of,
am I going to have an accident?I've seen this strategy used so
many times in care homes wherepeople who do have incontinence
problems are put on a toiletingschedule. And it's effective. So
(22:39):
that's one thing that y'all cantry. Adam is an 83 year old man,
and he lives with vasculardementia, so he's had strokes or
mini strokes, and his behavioralchallenge is that he is often
fixated on past eventsfrequently reliving memories of
(23:04):
his military service, whichsometimes leads to distressing
emotions for him. So theintervention strategy that
worked for Adam was that thecaregivers facilitated
discussions about Adam'smilitary experiences. This is
(23:29):
called memory sharing, allowinghim to express his feelings and
thoughts by talking about hismilitary experiences and
processing those feelings andthoughts, then they created a
Memory Box, which containedphotos and memorabilia from his
(23:51):
service in the military, whichprovided for Adam a tangible way
to engage with his pastpositively when fixation leads
to distress, caregivers cangently redirect conversations to
more current topics oractivities that the person has
(24:16):
enjoyed, and the outcome ForAdam was by allowing him to
share his memories in asupportive environment, the
caregivers helped him processhis emotions, leading to
reduction in distressingfixations. The next example is
(24:40):
in displaying anger andfrustration. And this is Lola.
She's 78 years old, and she's inher early stage of Alzheimer's
disease. And what Lola wasdisplaying. Is expressed anger
(25:03):
and frustration, particularlywhen a task became overwhelming
or challenging, impacting herinteractions with her
caregivers. So theirintervention strategy was to
provide supportive, empathy andpatience, invalidating her
(25:27):
feelings, and this is important,without dismissing them, they
validated them, theyacknowledged they understood
what she was feeling and why shewas feeling the way she was
feeling. Then they broke hertasks down into smaller,
manageable steps, providingassistance as needed, to reduce
(25:52):
frustration during during dailyactivities, and that worked for
Lola. Then they praised Lola forher efforts and successes, no
matter how small they were,which boosted her confidence and
her motivation. So in thisscenario, the outcome was with
(26:16):
placing these supportivestrategies in putting them in
place, Lola's outburst of angerdecreased, and she actually
became more willing to engage indaily tasks with a positive
attitude, because the way theywent about structuring the tasks
(26:40):
lifted her concern of failing,which just is a constant
reminder of her cognitivechallenges. So that was
effective. This gentleman namedClark, he's 80 years old, and he
(27:01):
also lives with Frontotemporaldementia, and he socially
withdrew as a result of theimpact that the brain disease
was having on The temporal lobeof his brain. He became
completely withdrawn. Hepreferred to isolate himself
(27:24):
rather than engage with familyor friends. So the caregivers,
what they did for him was he,they personally invited him to
small family gatherings,emphasizing the importance of
His presence and the enjoymentof his company, that's sweet.
(27:46):
Then they planned activitiesthat align with his interests,
such as gardening or watchingsports, to encourage his
participation. The caregiversthen facilitated connections
with familiar faces, ensuringthat interactions were
(28:07):
comfortable and enjoyable toClark. So the outcome in this
example was it gradually, Clarkbegan to engage more with his
family and friends, thusreducing his feelings of
isolation and enhancing hisoverall quality of life. I'm
(28:32):
going to share one more withyou. This is a little unusual,
but it does happen. I've seen itmyself. And this woman, I'm
going to call her Emily, she's82 years old, and she suffers
from Alzheimer's disease, andher behavioral expression is in
(28:59):
overeating and compulsiveeating. That's what she
exhibited, compulsive eatingbehaviors, often consuming
excessive amounts of food andthen becoming angry and
irritable and distressed if shewas denied the food.
(29:21):
So the intervention strategy forher was to implement structured
meal times, establish regularmeal and snack times to create a
predictable eating schedule,helping to manage her cravings.
(29:41):
They made healthy snacks readilyavailable for her, and they also
allowed her to snack betweenmeals without over indulging. So
the other strategy they usedwas. Is they involved her in
(30:03):
meal preparation by providingher with a sense of purpose and
distraction from her compulsiveeating habits. I've seen this
implemented so many times, andit's it's very effective. So the
outcome for her was with thesestructured meal times and
healthier options, herovereating and compulsive
(30:28):
behaviors decreased, which forher, promoted better nutrition
and better overall health. Seemslike she was afraid that if she
didn't eat something and indulgein it, then that was probably
(30:49):
the last meal she might everget. And with the strategies
they implemented, she realizedthere would always be food for
her, and it kind of, you know,helped with those behavioral
expressions. So I don't want tooverwhelm you by giving you too
many tools and too manystrategies. It's a lot to
(31:12):
digest, but I'm going tocontinue providing these for
you, so eventually you will havean arsenal of tools in your
toolbox to use when thesesituations arise. So that'll be
our episode for the truth, liesand Alzheimer's today. I'm Lisa
(31:37):
Skinner, your host, and I wantto take a moment to thank
everybody for spending part ofyour day with me. And as always,
I look forward to having youback for next week's episode of
(31:57):
the truth lies and Alzheimer'sshow. So till then, I'm Lisa
Skinner, your host, and I hopeyou all have a wonderful and
positive and blessed week. Seeyou next week, bye, bye.
Welcome back everybody to another new episode
(00:03):
of the truth lies andAlzheimer's Show. I'm your host,
Lisa Skinner, and today I wantto share with you some more case
studies that highlight variousbehavioral challenges in people
living with Alzheimer's diseaseand dementia, and then give you
(00:26):
effective strategies in casethese situations arise. Now, one
of the things I want toemphasize, and I've mentioned
this many, many times before, onother episodes of the truth,
lies and Alzheimer's show issome of the strategies and the
(00:50):
techniques that I offer andshare with you don't necessarily
work for every given situation.And this is why I can't
overstate that we all need toassemble a really strong
(01:12):
toolbox, because what willhappen is I'll give you a
suggested strategy for asituation that comes up. You
might try it sometimes, andit'll work beautifully and
diffuse the situation fromescalating any further, but
(01:34):
other times it just won't. We'redealing with human beings here,
and they have their good daysand their bad days, just like
the rest of us. So what might beeffective in one situation, if
that same exact scenario happensagain, and you try the technique
(01:58):
I share with you, it just mightnot work that time. So the goal
here is to give you enoughstrategies that if something
doesn't work, you have othertools to choose from that are
(02:19):
already within your toolbox. Andof course, you know it stands to
reason that the more of thesetools you have to pull from, the
better chances you have ofdiffusing any given situation.
That's the entire goal here isto just be equipped and prepared
(02:41):
as best you can, because thesesituations can prove to be very
difficult, and part of thereason is is that not every
solution will always work in anygiven situation. So here is a
(03:03):
case study that the womansuffers from emotional
outbursts. And last time Ipresented this case study
episode, I mentioned that theseare all true stories of things
that actually do come up on aday to day basis at any given
(03:27):
time, unexpectedly. Not reallysure what the trigger was. They
just these behaviors just showup out of the blue. And so this
woman, I'll call her ETHEL.She's 81 years old, and she is
in moderate stage of Alzheimer'sdisease. And the challenge here
(03:53):
is she experienced a suddenemotional outburst, often crying
or becoming angry over minorfrustrations, which leaves her
caregiver unsure how to respond.And she does this frequently. So
here are some interventionstrategies for this particular
(04:16):
situation, if it happens to you.So one of the things that we'll
need to pay attention to andfocus on is identify, try to
identify what triggered thatsudden emotional outburst. It
(04:36):
could be one of many, many, manythings. So what I recommend is
that you as a family member oryou as a caregiver, start
keeping a journal to track whenand why emotion these emotional
outbursts occur, identifyspecific triggers, such as
(04:57):
changes in routine or. Unmetneeds. And this will be a little
challenging at first, until youstart to recognize patterns of
what sets off the person setsthe person off, displaying
(05:18):
whatever the behavior might be.And in this case, it's an
emotional outburst. And thenonce you start seeing patterns,
it'll be easier as time goes onto you know, if that emotional
outburst happens and go, Oh,this triggered it last time,
maybe it's the same thing today,but you're going to have to go
(05:42):
through a process of eliminationto kind of dial that in. So
first and foremost, as acaregiver, you definitely want
to offer comfort to Ethel oryour person through gentle
(06:05):
touches and reassuring words andvalidate those feelings during
the Episode activities likelistening to soothing music or
gardening, were introduced toEthel so she would be able to
(06:27):
express her emotions in ahealthier way, and then the
outcome, hopefully for you, willbe similar to this one, because
by understanding triggers andproviding emotional support, the
frequency of Ethel's outburstsactually decreased, leading to a
(06:50):
much more peaceful environmentand positive outcome for both
Ethel and her caregiver. So thiscase study is a sample or an
example of a person withvascular dementia. He's 874,
(07:14):
years old, and he just has lostinterest in doing any
activities. His name's Joe. SoJoe was once an avid golfer and
socializer, but he started toshow disinterest in activities
(07:37):
that he previously enjoyed,leading to social isolation. So
some intervention strategies forthis situation include
reintroducing the activities hiscaregiver gradually reintroduced
Joe to golf by visiting thedriving range, allowing him to
(08:01):
engage without the pressure of afull game. Now, this gentleman
had vascular dementia, if thecaregivers taking him to a golf
course to the driving range,he's probably early on with his
(08:21):
cognitive impairments. But thisis just an example of an
intervention that worked, andyou can modify it to the stage
that the person you care for isin at the time they organize
small gatherings with friendsfrom the golf club, providing
(08:44):
familiar social interactionsthat did spark his interest or
renewed interest, and thenexploring new activities such as
painting or puzzles helped Joediscover New interests that he
could enjoy at his own pace, andthat is an operative statement.
(09:07):
At his own pace, he just doesn'thave the cognitive abilities
that he once had, and sometimeswe forget that about our people
that we care for so we have tomeet them where they are in
their stage. So the outcome forJoe was with gentle
(09:31):
encouragement and socialsupport, Joe did begin to
participate in activities,again, significantly enhancing
his mood and reducing hisfeelings of isolation, which is
so incredibly important forpeople living with dementia.
(09:54):
The next story, the scenario isdifficulty with personal care.
Care, and we see this a lot inpeople living with Alzheimer's
disease and dementia. And thislady, Sarah, she's 79 years old,
and she's just in her earlystage of Alzheimer's disease,
(10:16):
but the behavioral challenge isthat Sarah resisted assistance
with personal care tasks such asbathing and dressing, leading to
hygiene issues and caregiverfrustration. So a great
intervention strategy. And Ihave seen this work over and
(10:41):
over and over again, and I'veactually talked about it pretty
frequently, is creating aregular routine, a consistent
daily routine was establishedFor Sarah, incorporating
personal task care tasks at thesame time each day to foster
(11:06):
predictability, and this is suchan important approach to people
with cognitive impairment,because they thrive on
familiarity, and a routinerepresents familiarity. So
really important to toincorporate a consistent daily
(11:28):
routine. But what the kid whather caregivers did was they
offered her choices in clothingand grooming products, which
ended up empowering her andultimately reduced her
resistance. It gave her back alittle bit of her independence,
(11:50):
and felt like she had a say inthings. And then they praised
Sarah for her cooperation andindependence during personal
care, which reinforced positivebehavior. So the outcome for
Sarah was with a structuredroutine and choices, she became
(12:14):
more willing to engage inpersonal care, improving her her
hygiene and overall well being.Is that going to work every
single time somebody becomesresistant to wanting to take a
bath or a shower, get dressed orbrush their teeth or all the
other personal hygiene serviceswe provide for the people we're
(12:37):
taking care of no but this is afundamental, proven technique
that has shown to work, but youmight need to have a few other
strategies and techniques inyour toolbox to pull out if that
doesn't work in at any giventime. Michael is a 77 year old
(13:03):
man with Alzheimer's disease inhis moderate stage, and the
behavioral challenge here wasdue to his cognitive decline and
his frequent forgetfulness. NowMichael routinely and frequently
(13:27):
forgot names of family membersand significant events, and that
led to tremendous frustrationand embarrassment during family
gatherings. So the caregiver,their intervention strategy for
this particular episode, createda memory book filled with photos
(13:53):
and names of his family members,along with significant events
for Michael to reference, gavegentle reminders about family
members and events duringconversations, using cues to jog
his memory, and it waseffective. Then they encouraged
(14:18):
Michael to share stories abouthis life, and this helped
reinforce connections with hisfamily, allowing for cognitive
engagement, and that's anultimate goal for us. The
outcome for Michael was in usingthese memory aids and
storytelling not only helped himremember his family members
(14:42):
better, but also strengthenedhis emotional connections with
them. This lady, she's 80 yearsold, and she has Lewy body
dementia, and she has beenhaving some. Some reactions to
medications that she's on. Sothe behavioral challenge was in
(15:09):
that she was having paradoxicalreactions to certain
medications, which stands toreason why she had was showing
and displaying increasedagitation and anxiety instead of
relief. So what that caregiverdid was monitor these negative
(15:32):
reactions by maintainingdetailed notes on every time she
was given the medication and thereaction that followed, and then
shared this information with herhealth care provider. The
caregiver, worked closely withhealth care professionals to
(15:52):
adjust her dosages and switchmedications, finding
alternatives that better suitedher needs. And then by trying
some different holisticapproaches versus pharmaceutical
approaches, and she triedaromatherapy and relaxation
(16:16):
techniques like hand massages,those were introduced to help
manage her anxiety withoutrelying solely on medication. So
the outcome for in this scenariowas through careful monitoring
and collaboration with thiswoman's health care providers,
(16:39):
her medication regimen wasoptimized, leading to decreased
agitation and improved overallwell being. Here is a study that
looks at or case scenario thatlooks at compulsive behaviors,
(17:02):
which happen a lot. This isSteve. He's 82 years old, and he
has Frontotemporal dementia. Andif you don't, if you're not
aware, Frontotemporal dementiais the brain disease that
(17:23):
attacks the temporal lobe of ourbrain, which is in the front
part of our head, and it reallywill impact our emotions, our
thought processes, our abilityto reason situations out, and in
(17:46):
most cases, in a lot of cases ofFrontotemporal dementia, the
person ends up reacting on pure,raw emotion because they've lost
a lot of the ability todifferentiate between a big deal
and something that's not thatbig a deal, like we do when we
(18:07):
have a healthy brain, everythingtends to be a big deal to them
in a lot of situations. So Stevedeveloped compulsive behavior,
and some of the things that hewas doing was he was repeatedly
checking doors and windows,which of course, created
(18:29):
distress for both himself andhis caregivers. So the
intervention strategy that hiscaregivers try was to offer a
structured routine, which againis a consistent daily routine
(18:49):
established to providestructure. It worked in this
particular behavioral situation,and it actually ended up
reducing his need for compulsivechecking behaviors, the
caregivers provided reassurancethat the doors and the windows
were secure and that reduced hisanxiety related to his safety,
(19:15):
He was concerned about hissafety
when these compulsive behaviorsdo emerge, caregivers redirected
Steve to engaging activitiessuch as playing cards or doing
puzzles to get his mind onsomething else. And the outcome
(19:38):
for Steve with the interventionsthat his caregivers implemented
was with a structured routineand reassurance Steve's
compulsive behaviors wereminimized, leading to a much
calmer environment. So again,flexing a. Variety of tools to
(20:02):
assemble in your toolbox thatany of these situations, if they
might arise, and the chancesthat they will are pretty good,
you have more than one option totry to try to diffuse the
situation. So let me give you afew more. This one happens
(20:24):
frequently, and this woman, hername's Joan. I'll call her Joan.
She's 78 and she suffers fromincontinence, and as a result,
extreme embarrassment, which isunderstandable. She's aware
(20:46):
she's incontinent, and she's inthe moderate stage of
Alzheimer's disease. And whathappened to Joan is she began
experiencing incontinence,leading to feel feelings of
embarrassment and reluctance toparticipate in social
activities. So what thecaregivers did for her was they
(21:11):
established a regular bathroomschedule and encouraged Joan to
use the restroom at set times,which ultimately reduced the
frequency of accidents. Thecaregivers also provided
discreet and comfortableincontinence products, which
(21:32):
helped Joan feel more secureduring outings, and also
reassured her that incontinenceis common in people living with
dementia, encouraging her toparticipate in social activities
without fear of embarrassment.So the outcome for Joan was
(21:54):
positive. So by engaging orimplementing a consistent
schedule and supportiveproducts, Joan felt much more
confident and engaged socially,experiencing fewer accidents and
a greater enjoyment inparticipating in activities. She
(22:16):
wasn't just completelyoverwhelmed with the worry of,
am I going to have an accident?I've seen this strategy used so
many times in care homes wherepeople who do have incontinence
problems are put on a toiletingschedule. And it's effective. So
(22:39):
that's one thing that y'all cantry. Adam is an 83 year old man,
and he lives with vasculardementia, so he's had strokes or
mini strokes, and his behavioralchallenge is that he is often
fixated on past eventsfrequently reliving memories of
(23:04):
his military service, whichsometimes leads to distressing
emotions for him. So theintervention strategy that
worked for Adam was that thecaregivers facilitated
discussions about Adam'smilitary experiences. This is
(23:29):
called memory sharing, allowinghim to express his feelings and
thoughts by talking about hismilitary experiences and
processing those feelings andthoughts, then they created a
Memory Box, which containedphotos and memorabilia from his
(23:51):
service in the military, whichprovided for Adam a tangible way
to engage with his pastpositively when fixation leads
to distress, caregivers cangently redirect conversations to
more current topics oractivities that the person has
(24:16):
enjoyed, and the outcome ForAdam was by allowing him to
share his memories in asupportive environment, the
caregivers helped him processhis emotions, leading to
reduction in distressingfixations. The next example is
(24:40):
in displaying anger andfrustration. And this is Lola.
She's 78 years old, and she's inher early stage of Alzheimer's
disease. And what Lola wasdisplaying. Is expressed anger
(25:03):
and frustration, particularlywhen a task became overwhelming
or challenging, impacting herinteractions with her
caregivers. So theirintervention strategy was to
provide supportive, empathy andpatience, invalidating her
(25:27):
feelings, and this is important,without dismissing them, they
validated them, theyacknowledged they understood
what she was feeling and why shewas feeling the way she was
feeling. Then they broke hertasks down into smaller,
manageable steps, providingassistance as needed, to reduce
(25:52):
frustration during during dailyactivities, and that worked for
Lola. Then they praised Lola forher efforts and successes, no
matter how small they were,which boosted her confidence and
her motivation. So in thisscenario, the outcome was with
(26:16):
placing these supportivestrategies in putting them in
place, Lola's outburst of angerdecreased, and she actually
became more willing to engage indaily tasks with a positive
attitude, because the way theywent about structuring the tasks
(26:40):
lifted her concern of failing,which just is a constant
reminder of her cognitivechallenges. So that was
effective. This gentleman namedClark, he's 80 years old, and he
(27:01):
also lives with Frontotemporaldementia, and he socially
withdrew as a result of theimpact that the brain disease
was having on The temporal lobeof his brain. He became
completely withdrawn. Hepreferred to isolate himself
(27:24):
rather than engage with familyor friends. So the caregivers,
what they did for him was he,they personally invited him to
small family gatherings,emphasizing the importance of
His presence and the enjoymentof his company, that's sweet.
(27:46):
Then they planned activitiesthat align with his interests,
such as gardening or watchingsports, to encourage his
participation. The caregiversthen facilitated connections
with familiar faces, ensuringthat interactions were
(28:07):
comfortable and enjoyable toClark. So the outcome in this
example was it gradually, Clarkbegan to engage more with his
family and friends, thusreducing his feelings of
isolation and enhancing hisoverall quality of life. I'm
(28:32):
going to share one more withyou. This is a little unusual,
but it does happen. I've seen itmyself. And this woman, I'm
going to call her Emily, she's82 years old, and she suffers
from Alzheimer's disease, andher behavioral expression is in
(28:59):
overeating and compulsiveeating. That's what she
exhibited, compulsive eatingbehaviors, often consuming
excessive amounts of food andthen becoming angry and
irritable and distressed if shewas denied the food.
(29:21):
So the intervention strategy forher was to implement structured
meal times, establish regularmeal and snack times to create a
predictable eating schedule,helping to manage her cravings.
(29:41):
They made healthy snacks readilyavailable for her, and they also
allowed her to snack betweenmeals without over indulging. So
the other strategy they usedwas. Is they involved her in
(30:03):
meal preparation by providingher with a sense of purpose and
distraction from her compulsiveeating habits. I've seen this
implemented so many times, andit's it's very effective. So the
outcome for her was with thesestructured meal times and
healthier options, herovereating and compulsive
(30:28):
behaviors decreased, which forher, promoted better nutrition
and better overall health. Seemslike she was afraid that if she
didn't eat something and indulgein it, then that was probably
(30:49):
the last meal she might everget. And with the strategies
they implemented, she realizedthere would always be food for
her, and it kind of, you know,helped with those behavioral
expressions. So I don't want tooverwhelm you by giving you too
many tools and too manystrategies. It's a lot to
(31:12):
digest, but I'm going tocontinue providing these for
you, so eventually you will havean arsenal of tools in your
toolbox to use when thesesituations arise. So that'll be
our episode for the truth, liesand Alzheimer's today. I'm Lisa
(31:37):
Skinner, your host, and I wantto take a moment to thank
everybody for spending part ofyour day with me. And as always,
I look forward to having youback for next week's episode of
(31:57):
the truth lies and Alzheimer'sshow. So till then, I'm Lisa
Skinner, your host, and I hopeyou all have a wonderful and
positive and blessed week. Seeyou next week, bye, bye.
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