Joshua Freitas, author of “The Dementia Concept”, spoke to a crowd of ninety plus at North Shore Elder Services on Wednesday, June 8th. He had the audience glued to his every word, keeping them engaged with his personal stories and quick wit. This is one man truly dedicated to changing society’s pre-conceived ideas of dementia and its treatment. Josh’s mission is to spread the word and educate all of us and by doing so, improve the care of those with dementia.
Joshua Freitas is an award-winning memory care program developer and researcher. His cutting-edge training philosophy is pushing the dementia care industry forward. The “dementia concept” is very simple; the better we understand dementia, the better we can connect and the better we can engage. Josh holds five certifications related to dementia care and has studied at some of the world’s most renowned colleges and universities, including Lesley University, Harvard University, and Berklee College of Music.
Dementia is not a disease. Rather it is a classification of symptoms and signs. It is a syndrome. There are over 100 types of dementia. World-wide, three out of ten people are misdiagnosed. This fact alone underscores the importance of getting an accurate diagnosis when dementia is suspected. A diagnosis will help to determine the most appropriate care practice. There are dementias that are reversible and so it is imperative to not rely on just one test or just one opinion. Josh says there are eight tests that someone should typically be administered, although what he more commonly sees is three administered tests.
As examples, Josh described how if someone has vascular dementia, one that can be affected by factors like diet and hydration, too much exercise actually has a negative effect but that is not true of other types of dementia. Another type of dementia, Lewy Body, brings about hallucinations so it becomes important to monitor what television programs someone may be watching. To the person with Lewy Body, they can mistake something they see on the news as something that is happening to someone they know. Also, with Lewy Body, the person will mimic what they see. This can be helpful in working with someone. For example, if you are trying to have someone take a seat, the task will be made simpler by demonstrating sitting, as opposed to physically moving the person into that position. A mix of dementias is not uncommon.
Fortunately the brain is able to constantly rewire itself. Someone may have dementia but it does not mean they cannot do a task any longer. Josh emphasized that by assuming someone can’t do anything, we are enabling them to decline faster. The more independent we allow people to be, the more the brain continues to develop. The focus should be on what people can still do and for us as caregivers, to think outside the box to help people be successful. It is in error to think someone with dementia cannot still learn; it simply takes longer to learn something new. It is a five week learning process for those with dementia, which is important to keep in mind when allowing time for someone to acclimate to a new situation or environment.
Josh shared several examples of thinking outside the box in order to keep people engaged so that they feel they have some value. Music, for example, is processed in every lobe of the brain which explains why some people who lose their ability to speak can recall the words of a song or melody. “Maybe someone does not have the ability to say ‘Good Morning’ but when we take a simple song like ‘Happy Birthday’ and replace the words with ‘good morning to you’, they are able to sing the greeting.”
Another example of thinking outside the box in providing care is particularly useful when dealing with showering. Typical for those with dementia is an aversion to water coming down upon them in the shower. What often works is handing the person a luffa, which can act as a stress ball. The instinct to turn inwards and squeeze when the water hits them will release melatonin to help relax and dopamine to help focus. Instead of an anti-anxiety drug, you can help reduce the combative experience with a non-pharmacological approach.
Josh left the audience with so many interesting and helpful pieces of information. Here are just a few;
- Lime green is the color we remember the longest.
- Red is a color that encourages people to overeat.
- Yellow is a color that holds attention the longest and makes us salivate. It also provides the most contrast so yellow plates become a good choice in encouraging someone to eat.
- Black is the color least paid attention to. The black rug looks like a hole to avoid and the black trash barrel may be mistaken for a hole to be used as a toilet.
- White is the most difficult color to see. The white toilet seat does not contrast enough with the white toilet but using a glow-in-the-dark green toilet seat can work as a night light and enable the person to successfully find the toilet.
- Dark blue will suppress appetite.
- The last skill we lose is the ability to grab and squeeze. Making physical connection through touch helps the brain in processing.
- As dementia progresses, people drop the words you are speaking. Fifty to seventy-five percent of our sentences are lost but the first word and the last word will be remembered.
- Due to common vision problems associated with dementia, it is important to get down on eye level when speaking to the person with dementia.
- If someone wanders, they will naturally walk in the direction of their dominant hand.
- The average attention span for someone with dementia is fifteen minutes. You can avoid agitation or fear by not saying ‘goodbye’ but by saying, ‘I’ll be right back’. After fifteen minutes, the person will forget.
In keeping with Josh’s mission and passion to understand, connect and engage, at the end of the session, Josh asked people to pull out their phones if they had one with them. He wanted each of us to post to FaceBook or send an email to a friend telling them one thing they had just learned about dementia. It was a simple but brilliant request and one with such potentially huge impact. Let’s spread the word and help in his mission to educate everyone. Thanks to Joshua Freitas for enlightening us on better care of those with dementia.
If you would like to know more about Josh’s research and experiences, check out his book, “The Dementia Concept”. To learn more about other resources pertaining to dementia, call Information Services at North Shore Elder Services. We can guide you through the maze of information and assist you with options counseling and caregiver support.