Perils of Presenting

I did a guest lecture last night at Marshall University. My talk centered on dementia and the SLP’s role. A day later, it is interesting to reflect on that brief time I spent with the class. A little nervousness came over me, far different from my typical experience presenting. I am rarely nervous for an 8 hour day and room full of therapists, but this hour lecture to a few graduate students caused me to loose the timing and fluency that I have worked hard to perfect.

So after sleeping on it I realized what my deal was. I had a room full of people who were seemingly eager to hear what I had to say. Not your standard CE course with texting, passing notes to one another, (both distractors I have learned to tune out completely), but now I had the full attention of 25ish speech-language pathologists in the making. A very different audience that my norm. They were all fully aware, took notes diligently, and the amount of motivation in that room was overwhelming. That is a different sort of pressure than I am used to. The ladies’ passion and desire to take in all of the information they possibly could was refreshing, but also a bit nerve-racking.

I did however enjoy my time with that class and their eagerness was what I appreciated most. They had a look in their eyes, apparent excitement to learn, and thoughtful questioning. Their questions were more frank and to the point than I anticipated. I talked about dementia, how we can provide services throughout the stages, as well some of the reasons I love working with this population. As I started to wrap things up, two unanticipated questions came barreling at me. The first student asked if “I felt prepared for the work I do when I started in the field”, and I answered with honesty. Maybe I even laughing a little at the thought of feeling completely equipped at any phase, new grad or seasoned professional. I didn’t and still can’t be prepared for everything I encounter. The next student asked me if “I wanted to leave them with one thing what would that be?” Now this was the question I had not thought about, and I completely veered off topic. I told students not to box themselves in, not to underestimate what they can achieve, or how their skills might provide service. She probably wanted to know the gold standard for dementia treatment, but if you know me I tend to go beyond, and wanted to bestow a grander knowledge for life fulfillment J

It’s remarkable that we ended on such a note. I was completely out of my element for the evening, and feeling less than confident about it. My guidance to these students was to push the boundaries, and believe in their abilities. You know what? I think that is sound advice. I operate that way in my clinical practice, in my life, and my career. Hopefully the students saw it that way as well, and know that there is no cookbook, there is no right way to do it, or wrong way to do it. Life, work, treating patients, we just have to take what we know and apply it to the reality at that moment.

As Memories Slip Away

Just in case you missed NPR's Morning Edition this morning. I thought I'd share a link to the StoryCorps clip aired. This clip was recorded as part of the Memory Loss Initiative.

http://www.npr.org/templates/story/story.php?storyId=129454463

The Patterson's share what they have learned about living with Alzheimer's, and really living in the present moment. They hit on a key point for sure. Like Eleanor Roosevelt said...

Yesterday is history, tomorrow is a mystery, and today is a gift; that's why they call it the present.

Listening and Loving

Many of you may know of the work I am currently doing with StoryCorps. There will be many exciting projects to come, but today something special will happen. NPR will be airing a beautiful clip that was recorded as part of the Memory Loss Initiative.

This morning at 8:20 on NPR's Morning Edition tune in to hear why I think StoryCorps is so wonderful, and its value with those we care for suffering from memory loss or dementia.

I hope you will listen and let me know what you think.

Past and Present

Each day I work with people who have dementia. I talk with them. I ask them to communicate and converse. I ask them to remember. So many of my interactions with these people begin with observation, and more often than not they are unoccupied until I initiate contact. Once dementia gets to a certain point, the person appears to be “living in the past”, and their reality shifts away from the one in which we live. No wonder they seem disengaged, they are not living in the same realm as you and I. As their disease worsens, remembering becomes increasingly difficult. At this point, we often focus with our elders, on examining the memories still left intact. Precisely recalling life’s history is valuable, but let’s consider another perspective…
The most important piece of the puzzle may be that by talking about the past we are actually helping the person with dementia be present. They are in the moment, actively engaged in narrating their life. For a person with loss of thinking and communicating abilities, the act of interacting is more valuable than remembering accurate details of life. It is an amazing gift to provide this opportunity for a person who often lives within the confines of their own world/head. Take a moment and speak those you know who don’t remember well, who can’t converse easily, and remember that the success is in the experience not the result.

Jan's Story

Last night I check my email to find a note from a person who attended one of my seminars. She referred me to last week's CBS Sunday Morning show, and simply stated that there was a segment I should see that was wonderfully done. I watched this video and was very touched. Barry Petersen when out on a limb, creating a relevant piece that is absolutely worth sharing.

Take a moment, click the link, scroll down, watch the video, and share your thoughts.

What if Jan's story was your family's?

http://www.cbsnews.com/stories/2010/06/20/sunday/main6600364.shtml?tag=cbsnewsTwoColUpperPromoArea

10 Mountains 10 Years

They may not be moving mountains, but pretty close to it…

The Mountains
A small group of ordinary people, “ The Regulars” as they call themselves, are breaking new ground in awareness for Alzheimer’s and Parkinson’s Disease. Enzo Simone and his team of climbers are anything but regular. They are on a quest to summit 10 of the world’s most challenging and amazing mountains. Not only will they conquer the mountains, but also bring a level of unprecedented awareness to 2 horrible diseases afflicting over 92 million families in our country.

The Movie
10 Mountains 10 Years is a documentary feature film by Back Light Productions which chronicles the summit of Kilimanjaro with this group. The climbers make their way up the mountain and along the way receive inspiration, reading letters written by caregivers for those with Alzheimer’s or Parkinson’s. The film intertwines their climbing journey with medicinal accomplishments in fighting these diseases. All proceeds from the film go to medical research and caregiver programs. Check out the trailer. It is phenomenal!!

10 Mountains 10 Years Movie Trailer from Vancan Design Studio on Vimeo.

The Motivation
Optimism and inspiration resonate in Jennifer Yee’s (writer/director/producer) voice when she talks about the movie. She calls it an “underdog journey” which began with her friend’s project of climbing mountains to bring attention to Alzheimer’s and Parkinson’s, and with a “giant leap of faith” became 10 Mountains 10 Years. Their desire for the film is worldwide distribution, but not for the reason you may think. The motivation for staying with the movie for the long haul is according to Yee, “to make a difference with people, so they see there are others out there fighting for them…there is hope when maybe they have lost hope”

A few with a dream CAN make a difference…
Thank you to Back Light Productions and “The Regulars”, keep up the battle.

Reminisce Resurrect

Easter Sunday, brings us to see our elders, a family dinner, baskets, eggs, church, a new dress or a nice suit. Easter sparks many memories for the neurotypical person like one of us. For instance, I can recall the exact shade of pink in the stripes on my dress one Easter, the scratchy knee socks, and the bright sun shining on my face while I posed for Easter photos in the nicely manicured lawn with my cousins. The patient with dementia will not have these memorable details easily accessible. So asking the person with memory and cognitive impairment about their favorite Easter, or what their Easter traditions are may be a great way to begin a conversation, without very fruitful discussion.

What we know about memory is that short term recall is the first to disappear, and then long term recall slips away more slowly. It manifests like this in the early stages…The person with dementia gets up and dressed in their Sunday’s best, the family leaves for church and no slip up yet. They go to service, sing the songs, read the scripture, and then time for family dinner. But this year family dinner is at the granddaughter’s home, and the driver is relying on the one with dementia to give directions, as he is in from another town. Travel there is not so easy, despite many visits prior to this one, wrong turns are made, even pulling into the wrong home, but thankfully noticing another family in the drive. Talking about the sermon this date is impossible, even though the person with dementia was present and participated during the service, no recollection of information so new exists. So, with a lack of interaction regarding current happenings, the family begins to dig back into days past. Reminiscing about the year that one lost egg from the hunt wasn’t found for a week, and only did the stench of the decorated egg lead them to find it. The person with dementia may remember this humorous event. Perhaps they break out the photo album. The senior with memory loss sees a photo of their children 20 years ago, outside the church after Easter, and with a quick comment from the daughter regarding the fun had that day, comments flow easily and memories though long lost begin surfacing.
Now how can we make this Easter, and everyday special? How do we help preserve memories and interactions in life while dementia is trying to take those skills away? Stick with tradition, and keep the events of the holiday as recognizable as possible. People with dementia will remember the familiar, and function optimally when provided with stimulation that is not constantly changing. Memory loss will often not attack the prayers that were repeated throughout life, the common routine of cooking the same recipe for the Easter ham will be intact, and even knowledge of the normal attire, or typical events of the day are tools to use to help the person with dementia live life as normally as possible. When it comes to remembering and conversing, use items and pictures from the past to elicit recall, and keep the demand simple. Allow the senior to recall what they easily can and keep the conversation flowing by feeding in missing details. Familiar smells, tastes, places, routines, and providing stimulus with emotional content will retrieve memories from places hidden.

Not only this Easter, or on special holidays, but everyday, we can draw from this knowledge to help those we love with memory loss have meaningful interactions. Keep routine intact, use familiar ritual, and pull in concrete items to stimulate memories and conversation. Fill the day with success driven interactions. We can tap into emotions, feelings of love, joy, and peace to promote pleasant contact with the senior suffering from dementia, and through these moments preserve quality of life in the face of a terrible disease.

Happy Easter!