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Demystifying Resistance




                      Caring for Someone with Dementia:
                       How You Help Makes a Difference

                                      Teepa Snow, MS, OTR/L, FAOTA
                            Dementia Care & Training Specialist, Positive Approach, LLC
                             Counseling Associate – Duke University School of Nursing




© 2010 Teepa Snow. All rights reserved. Use only with permission. Handout at Home Instead Senior Care of Sonoma County
sponsored Dementia and Alzheimer’s event, March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA.         P a g e |1
How Can We Help With Resistive Behaviors ?

                                      FIRST – Describe the Behavior
                                    Use OBJECTIVE words
           What happens? Where does it happen? Who is involved? When does it happen?
                          What else has been going on during the day?



                 THEN… Figure out what you know and what you don’t know!
                     Take the time to fill in ALL the pieces of the puzzle!



                                                   Who is the
                                                    Person?
                                                    History &
                                                 Life Patterns &               Level of
                                                  Preferences
                                                                              Dementia?
                        Health Issues?                                      Memory, language,
                     Problems with senses,
                        movement, pain,                                       understanding,
                           emotions,                                          impulsiveness,
                     temperature, fatigue…                                  sensory awareness


                          Other people?                                      Environment?
                          Approach, words,                                     What’s going on all
                                                                                   around?
                         actions & reactions                                 How does it look, sound,
                                                        Patterns &                   feel?
                                                        Routines?
                                                    How does this fit in with
                                                      the rest of the day?
                                                      Is this related to old
                                                   personal habits or rituals?




                                          NOW --- BRAINSTORM –
                Given all the pieces of the puzzle… What do you think is going on?
                       How would you explain the behavior of this person?




                         THEN --- COME UP WITH AN ACTION PLAN!
                                              What will you try?
                                         How do you think it might help?
                                         How will you know if it works?
                                           Who will be doing what?

© 2010 Teepa Snow. All rights reserved. Use only with permission. Handout at Home Instead Senior Care of Sonoma County
sponsored Dementia and Alzheimer’s event, March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA.         P a g e |2
First – Describe the Behavior – Be Objective
  What happens?

  Where does it happen?

  When does it happen?

  Who is involved?

  What is said? Done?

  How does it start? Stop?

  What makes it better? Worse?
               Then - Review what you know and don’t know. Fill in all the parts of the puzzle.




© 2010 Teepa Snow. All rights reserved. Use only with permission. Handout at Home Instead Senior Care of Sonoma County
sponsored Dementia and Alzheimer’s event, March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA.         P a g e |3
NOW --- BRAINSTORM –
            Given all the pieces of the puzzle… What do you think is going on?
                   How would you explain the behavior of this person?




                       THEN --- COME UP WITH AN ACTION PLAN!

                                            What will you try?
                                       How do you think it might help?
                                       How will you know if it works?
                                         Who will be doing what?




© 2010 Teepa Snow. All rights reserved. Use only with permission. Handout at Home Instead Senior Care of Sonoma County
sponsored Dementia and Alzheimer’s event, March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA.         P a g e |4

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Teepa Snow Dementia Demystifing Resistance Handout

  • 1. Demystifying Resistance Caring for Someone with Dementia: How You Help Makes a Difference Teepa Snow, MS, OTR/L, FAOTA Dementia Care & Training Specialist, Positive Approach, LLC Counseling Associate – Duke University School of Nursing © 2010 Teepa Snow. All rights reserved. Use only with permission. Handout at Home Instead Senior Care of Sonoma County sponsored Dementia and Alzheimer’s event, March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA. P a g e |1
  • 2. How Can We Help With Resistive Behaviors ? FIRST – Describe the Behavior Use OBJECTIVE words What happens? Where does it happen? Who is involved? When does it happen? What else has been going on during the day? THEN… Figure out what you know and what you don’t know! Take the time to fill in ALL the pieces of the puzzle! Who is the Person? History & Life Patterns & Level of Preferences Dementia? Health Issues? Memory, language, Problems with senses, movement, pain, understanding, emotions, impulsiveness, temperature, fatigue… sensory awareness Other people? Environment? Approach, words, What’s going on all around? actions & reactions How does it look, sound, Patterns & feel? Routines? How does this fit in with the rest of the day? Is this related to old personal habits or rituals? NOW --- BRAINSTORM – Given all the pieces of the puzzle… What do you think is going on? How would you explain the behavior of this person? THEN --- COME UP WITH AN ACTION PLAN! What will you try? How do you think it might help? How will you know if it works? Who will be doing what? © 2010 Teepa Snow. All rights reserved. Use only with permission. Handout at Home Instead Senior Care of Sonoma County sponsored Dementia and Alzheimer’s event, March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA. P a g e |2
  • 3. First – Describe the Behavior – Be Objective What happens? Where does it happen? When does it happen? Who is involved? What is said? Done? How does it start? Stop? What makes it better? Worse? Then - Review what you know and don’t know. Fill in all the parts of the puzzle. © 2010 Teepa Snow. All rights reserved. Use only with permission. Handout at Home Instead Senior Care of Sonoma County sponsored Dementia and Alzheimer’s event, March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA. P a g e |3
  • 4. NOW --- BRAINSTORM – Given all the pieces of the puzzle… What do you think is going on? How would you explain the behavior of this person? THEN --- COME UP WITH AN ACTION PLAN! What will you try? How do you think it might help? How will you know if it works? Who will be doing what? © 2010 Teepa Snow. All rights reserved. Use only with permission. Handout at Home Instead Senior Care of Sonoma County sponsored Dementia and Alzheimer’s event, March 22, 2010, at the Scottish Rite Masonic Center in Santa Rosa, CA. P a g e |4