Recently at one of our support group meetings a caregiver asked about the stages of dementia. It is hard to put a number on the stages of dementia. However, you can look at each stage with as a gemstone (a precious stone) rather than a number.
I have something I would like to share with you. Teepa Snow created a model to help us see the retained abilities of a person living with dementia. They are known as “Teepa’s GemsTM “, Sapphire, Diamond, Emerald, Amber, Ruby and Peral. Teepa states that people, like gemstones are precious and unique needing different settings and care to show their best characteristics and shine. She further states focusing on what is possible instead of what has been lost allows us to engage the person in an appropriate manner and help them live life well.
The following are directly from my “Positive Approach to CareTM “ manual, the one I was given for my certification. Each listing is written as the person living with dementia would be saying.
The Sapphire — “My brain is healthy, if am aging normally or distressed, it may be hard for me to find words. I can describe what I am thinking so you understand. I may talk to myself because I am giving myself cues and prompts. I can learn new things and change habits, but it takes time and effort. Honoring my choices and preferences, when possible, is important. I need more time to make decisions. Give me the details and let me think about it before you need an answer. I am able to remember plans and information but supports are helpful. I may like specific prompts such as notes, calendars, and reminder calls. Health changes in vision, hearing, balance, coordination, depression, anxiety, pain or medication may impact my behavior, but my cognitive abilities remain the same.”
The Diamond — “My overall cognition is clear and sharp. When happy and supported, I am capable and shine in my abilities. When distressed, I can be cutting and rigid and may see your help as a threat. I have trouble seeing other points of view and may become less aware of boundaries or more possessive about my relationships, personal space, and belongings. I have many facets so people see me differently depending on the situation. This can cause conflict among my family, friends, or care team as it’s hard to tell if I am choosing my behavior or truly have limits in my ability. I can socially engage and have good cover skills. People will vary in their awareness of what is happening to me. I want to keep habits and environments as they have always been even if they are problematic for me or others. I am often focused on the past, personal values, or finances, I will need help to make changes in my life; it’s hard for me. I can be in a Diamond state for reasons other than dementia.”
The Emerald — “I am flawed; it is part of being a natural emerald. I tend to be focused on what I want or need in this moment and may not be aware of my own safety or changing abilities. I can chat socially but I typically miss one out of every four words and cannot accurately follow the meaning of longer conversations. I won’t remember the details or our time together, but I will remember how your body language and tone of voice made me feel. I may hide or misplace things and believe someone has taken them. My brain will make up information to fill in the blanks which makes you think I am lying. If you try to correct me or argue I may become resentful or suspicious of you. I am not always rational, but I don’t want to be made feel incompetent. My brain plays tricks on me. taking me to different times and places in my life. When I a struggling I may tell you “I want to go home.” To provide the help and assistance I need you must go with my flow, use a positive, partnered approach, and modify my environment.”
There are three more gemstones I will continue next week. Teepa Snow is a great resource, just key in her name and you will have so much information you can tap into. She created this model for families living with dementia! What a great tool or stone my I say. Live well and assist your loved one that lives with dementia to live well. Keep in touch, I do not want you to miss anything. Hope you have a “Best Day Ever!’