teepasnow.com€¦ · Web viewThis day is a chance to practice your PAC Skills in many different situations with many different people. While this should NOT be new information,

Positive Approach to CareCertified Independent Preceptor

PAC Care Skills – Day of Skill BuildingBrief Agenda

While all of the skills below will be covered on this first day, the timing of each component will depend on the group dynamics and skill-sets. Please connect with your PAC Mentor if you need more information in one of these categories.

PAC principles

Relationships First

Dynamic Assessments

Three Zones of Human Awareness

Taking in Data and Processing

Dementia Review

Amygdala and Unmet Needs

Positive Physical Approach™ (PPA)

Hand under Hand™ (HuH)

GEMS® Introduction and Adaptations

This day is a chance to practice your PAC Skills in many different situations with many different people. While this should NOT be new information, this day covers new ways to use your skills and make changes that will help with struggles that you may experience while consulting with others.

Educational content provided ©Teepa Snow, Positive Approach, LLC- to be reused with permission only.

[1]


[2]


[3]

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What do you believe about relationships and language?

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

PAC Positive LanguagePositive Approach to Care Language

Key Phrases and Ways of Talking About Dementia and Care

Commonly Used Phrase or Word

PAC Language Reasoning

Demented person Person Living with Dementia (PLWD)

People who are living with dementia and are able to let others know have asked for this to be used – at an international level

Alzheimers patient Person who has Alzheimers (if accurately diagnosed ORPerson who has dementia if not sure of type)

A person is a PERSON, not a patient, unless being treated and seen by a medical professional in a medical setting and even then that person is still a person first and a patient second and has dementia/Alzheimers but should not be defined by that diagnosis

Dementia Sufferer or Victim

Doing the best he or she can while living life with dementia (Alzheimers, Lewy body dementia, Fronto-temporal dementia, Alcohol related dementia, Vascular dementia, etc.) Sometimes struggling and sometimes finding joy and pleasure.

People living with various forms of dementia may at times experience challenges and frustrations emotionally, physically, intellectually, socially, etc. It is NOT our job or role to label that person as suffering – only that person can say where he or she is at that moment. There will also be moments of joy and celebration when living with this condition. Being a victim implies you are not able to do anything about it. We are able to guide, assist, and support so that challenges are addressed and needs are met.

Hand-over-hand or doing it for the person

Hand-under-Hand TM Hand-under-Hand™ uses body to body communication. It helps the PLWD by giving them a sense of what is happening, what is expected, and what is going to happen next. It also provides an opportunity for body to body feedback that is gentle and subtle, rather than having the person hit, grab, or refuse.

Feeding, Bathing, Changing someone

We do tasks WITH people, Supporting the PLWD and helping them in doing the activity/task may include partial or full


[4]

“She’s my feeder”

“He’s my shower”

not TO people.

Care supports the person’s living of their life.

“Help her eat” “Help him shower”

assistance with set-up, prompts, guidance, and physical support.

Caregiver or Carer or Caretaker

Care Partner Care partners are here to SUPPORT and help the person, not to GIVE them something they may not want or need. When we work in partnership, there is a mutual benefit to be achieved. Everything we do with a PLWD should include permission, shared tasks, and appreciation for their help. The role of the care partner will continuously change as the condition changes, but it must always be a partnership.

Burden Choose to Support If at any time the care partner begins to feel or sense that caring is becoming a BURDEN, then a PAUSE and TIME OUT is essential to maintain positive relationships and sound physical/ mental health.


[5]


[6]

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[7]

How do we take in DATA?1. ________________________________2. ________________________________3. ________________________________4. ________________________________5. ________________________________

Example Cues I found helpful:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[8]

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[9]

________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[10]

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What are some cues that your amygdala is turned on?

What cues should you look for in others?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[11]

Role Play when the PLWD has an unmet need:

1. What did you notice? _____________________________________________

2. Why do you think that happened? ___________________________________

3. Can you think of a time where this has happened before? _________________

___________________________________________________________________


[12]

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[13]

What does it feel like to have scuba, binocular, and monocular vision?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________How will you show others the importance of vision change with dementia?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[14]

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Don’t you think unless someone like cares a whole awful, nothing is going to get it’s not? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Teepa Snow’s Five ApologiesTeepa Snow’s Five I’m Sorry Phrases…

Sometimes as Care Partners, we make mistakes and need to apologize. Sometimes as Care Partners, we don’t make mistakes, but we still need to

apologize. We must look at situations from the point of view of the person living with dementia to understand when and where Teepa Snow’s five, “I’m Sorry,”

phrases will be needed to keep the relationship strong and valuable. (CP = Care Partner, PLWD = Person Living With Dementia)

INTENT – “I’m sorry, I was trying to help.”

Why am I saying, doing, or not doing what the other person wants

PLWD – I think you are being mean, frustrating, intrusive, bossy CP – I am trying to get you to see that I want to help you and that

what you are doing is not OK, safe, what you mean, etc…

EMOTION – “I’m sorry I made you angry.”

How I feel about what is happening

PLWD – I am (ANGRY, frustrated, embarrassed, sad, etc…) about how you are treating me. I do NOT like how you are making me feel. But I may not be AWARE that I am showing you exactly what I’m feeling because I can’t tell you or don’t know what I am feeling.

CP – I am frustrated because I am only trying to help you and you are getting very upset and yelling or ignoring me, or crying, and I didn’t do anything to cause you to be like this. It is the situation you are in!

INTELLECTUAL CAPACITY – “I’m sorry, I had no right to make you feel that way. You are absolutely right and you are one of the smartest people I know.”

Changing roles and abilities – sense of being “disrespected” or less

PLWD – You think I am stupid, an idiot, that I don’t know what I am doing or how to manage my life. I do not think I deserve to be treated like this. I have never been treated like this by you before. I was the


[15]

boss and the leader before! I KNOW what I am doing! I am a smart and capable adult.

CP – I see that you are behaving like a child, you are being irresponsible, you are NOT as capable as you were. It is clear that you are wrong about what you can and can’t do anymore! Can’t you see that you aren’t safe to manage your life, house, driving, money, medications, health, bathing, walking, eating, etc… on your own? Really, I am scared of this change.

DIFFERENT EXPERIENCES – “I’m sorry, that should NOT have happened.”

Same experience – having different memories and beliefs about what happened or has transpired causes different reactions or responses

PLWD – Someone or something happened that was WRONG. Since they don’t understand what I saw, no one cares, and no one believes me. Someone thinks they are going to get away with something that is not OK. I know that you think you can ignore me and what I KNOW is true!

CP – The reality is that it DID NOT HAPPEN the way she or he thinks it did. They are wrong. If they would just listen to and trust me or think logically about it, they could get it! I am just trying to help them understand why they are wrong.

CHANGE – “I’m sorry this is HARD, I hate this for you.”

What comes next? – what once was okay is no longer what is OK for someone – not safe, not working, not an option

PLWD – People are trying to tell what to do and how to do it, and I don’t think they have any right to do that. They think they know better than I do, what I need and what I should do. I think people are trying to take away my freedom, personhood, and rob me of who I have always been, for NO GOOD REASON. I don’t have a problem, or I don’t want you to know about it.

CP- I am trying to help you stay safe, keep out of trouble, take care of your wealth, health, or life. You are not recognizing the need for a CHANGE and I have to get you to do it, whether you like it or not! This isn’t you.


[16]


[17]

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[18]

Why is the order of the cues so important?

______________________________________________________________________________________________________________________________________________________________________________________________________

How will you get others to see this?

______________________________________________________________________________________________________________________________________________________________________________________________________


[19]


[20]

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[21]

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[22]

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Remember – If you can’t get LOW, bring a chair or stool, stay out of personal space, and/or try connecting visually and verbally.


[23]

BUT… What if…?The person is standing up

You enter their room

The person approaches you/ starts the interaction

The person is blind

The person is at a table

The person is in a corner or facing a door

The person is asleep

The person doesn’t offer their hand back

The person tells you to stay out…

How is PPA a dynamic assessment when done well?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What are your strengths and goals for growth in your own PPA practice?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[24]

What uses do you see for Hand-under-Hand?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What are your strengths and goals for growth in your own HuH practice?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


[25]


[26]

Reflect on your PAC Skills Day…How will you find 5 minutes a day to practice?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Documents

teepasnow.com€¦ · Web viewThis day is a chance to practice your PAC Skills in many different situations with many different people. While this should NOT be new information,