.png)
"Contented Dementia" book by Oliver James SPOT method to deal with Dementia clients
I read this book but was so confused I had to keep rereading it. The author uses acronyms and analogies to explain activities. which makes this program confusing. I would not be confident enough with the SPECAL or SPOT method to implement the process. The author uses patients' situations as examples to describe methods to implement. This is even more confusing.
There are three parts to this book. Part one describes Dorothy's story. It gives you the story of Dorothy, a real person, and how her daughter helped to take care of her. Part two describes basically 24-hour wraparound care. The author explains there are 3 things to do for your dementia patient
1. you don't ask questions
2. never contradict your client.
3. Always agree with everything your client says and never interrupt them.
Part 3 is the SPOT program.
https://amzn.to/3jo4dQB
According to Oliver James, the definition of dementia is memory loss, short attention, span, disorientation, impaired judgment, inability to use abstract thoughts, emotional responses are inappropriate, cannot to perform daily activities independently, and might not be able to live alone.
The author focuses on the program SPOT (SPECAL Observational Tracking), which was founded by Penny Garner. Penny Garner uses an analogy between your memory and a photo album to illustrate how memory works what she wants you to do is get pictures from your clients, childhood teenage years, adulthood, and middle adulthood, and put them in a physical photo album. Then, go back and repeat memories of what happened in that picture. Have the dementia patient tell you what's in the picture. Pay attention to the dementia patient as they describe the activity in the picture. If the patient seems annoyed make note of it. For additional information on SPECAL care, you can go to www.contenteddementiatrust.org
Basically, they want the caregiver to follow these rules.
Do not ask questions
Pose everything as a statement
Use verbal ping pong where you as a caregiver pick three topics and bring up the conversation and you get the person to converse instead of asking questions
examples are Weather, shopping, clothes, chores, and cooking.
You could also choose from their expertise or something that makes them happy. For example, my father is a retired, carpenter so we could discuss carpentry and tools that are used and buildings that he built. I find it hard to use statements but it is something I am committed to implementing every day.
As the caregiver be persistent, you can continue the conversation with
'perhaps...'
'I wonder... '
'I suppose...'
'I've heard..'
so that way you're not asking questions you're posing a statement
Next, if the patient participates, you respond with enthusiasm.
You can say, "I didn't know that". This has been working for me. I also try to redirect his attention to the television when they show a big city because my dad loves Philadelphia.
You should act very amazed. Then wait a minute or two, and repeat back and forth what they said, repeat Word for Word what they told you actually use it as a mirror delivery back, match their body language, and use facial expressions to show your excitement. I know this might take some practice not to ask questions, but it can work. Repetition is a sense of well-being for your client and you can get it to work for you or you can get it to work against you.
There are four basic conditions for the well-being of dementia. Patient or any adult number one the client
needs to feel personal worth. I can sense this from my father. He wants to help clean. He always asks me if there is anything he can do to help us. He gets mad when my husband goes into his bedroom and moves anything.
1. We all need to feel that were valued
2. We need to Have a sense of control and authority to be able to make decisions for ourselves. This is why I have my dad keep a wallet in his pocket. We have cash in it, an identification card, his old business cards, my brother's business card, and an old credit card. He feels secure and confident having it in his pocket but if he loses it, it would be a big problem. The credit card is not current.
3. We need to be proactive and create a situation that diminishes social anxiety. Social anxiety is when they don't feel nervous in a public event or situation. For example, I don't take my dad to places that are loud because he doesn't like the noise and commotion. He likes to walk the store and push a shopping cart but when he has had enough we have to leave. If we eat out, I ask for a quiet table away from the entrance door.
4. We need to have trust and confidence that all will be OK with ourselves at the end of the day. People with dementia are constantly reminded of their lack of value. Often people ignore them. They're sitting quietly and sometimes their home health aides ignore their questions or don't even give a response to them. They don't have as many friends as before when they went out to social events. They lose their independence and ability to drive or travel alone. This combination of nervous feelings and anxiety makes the Dementia patient feel sad, alone, agitated, or angry.
How do use the program SPOT
First, draw a line down the middle of a notebook page on the left side and write a list of the questions that your client asks you the most often. Be discreet. Pick a day and listen to those questions, and every time the client asks you one of those questions put a little tally mark on the right side next to the question. Until you get a list of the most frequently asked questions. Identifying the questions that are asked the most frequently will help you. When you have time, on the right-hand side of the paper, write down potential answers to some of those questions.
Your answer should be very short. For example, if your client says, where is Antonio? is Antonio home? who lives in the apartment behind you? have some answers ready like Antonio's at work, Antonio's playing golf, Antonio's shopping. Keep it short and simple but awesome thing your client might not be talking about the present Antonio it could be in Antonio from their childhood or even their brother or another nephew or grandson named Antonio once you've spotted a list of answers for these questions, now you can start testing your predictions on another day when the client says what's Antonio doing? try your list out, oh Antonio is shopping.
Next, make a list of things that you do or the facial expressions you have when you're happy or when you're not happy. Now you have a list of your own indicators do the same for your client make a list of things they do say or facial expressions when they're being happy or in a positive mood make a list of things they do say or facial expressions for when they're very upset.
KNOW YOUR CLIENT'S MOODS
Your client's moods if they're happy, sad, or upset, can help you provide remedies to fix the problem before it becomes a bigger problem.
Once you start answering the questions and you can come up with an answer to the question that seems like it puts your client at ease continue with verbal Pinkpop.
For example, if your client says, where is Antonio?
Your response is, "He is shopping" then your client says, "I wonder what he's buying?" You can say, "you used to like to go shopping. You built that mall in Philadelphia. Yes, dad, you were a Carpenter and you love building things. We can think back to when you built that big mall in Philadelphia.
You continue the conversation about building and construction and other things that he built.
Mostly, when your client or in my case, my dad asks me questions, I want to come up with a possible list of answers that don't upset him. I need to keep looking at the expression on his face or his hand gestures. When I give an answer to one of his questions and find the answer that makes him happy, I make a note of it.
That's an answer I want to keep using so that way they're not getting agitated. They might be repeating the questions but when you give an answer and then they respond back, you wanna get into that verbal ping pong where you are making a conversation into a story. A story that's relevant to them.
This book is very confusing. I would like to implement the ideas from this book but I don't feel confident enough to do it. I don't like the acronyms and analogies used within the pages of this book. The author writes the book for caregivers at a home or in a facility. The author assumes the caregiver is not a family member. The author uses the term 'carer' for the caregiver. I tried to answer some of my dad's questions when answers but he continued with the questions. I tried to engage him in verbal ping pong but I was unsuccessful. I am trying to interact with my dad with his happy topics, construction, carpentry, building buildings, Philadelphia, hammers, tools, his shed, fishing, golfing, and sports.
I constructed a family photo album starting with pictures from my dad's childhood, his teen years, marriage, his 6 children, construction jobs, awards in construction, his 13 grandchildren, retirement, and beach house, to the present day.
I am glad I bought this book. I need to reread it and take notes to comprehend the program better. I learned about redirecting and using statements instead of questions.
I will use this photo album to create discussions with my dad.
isbn 9780091901813
Comments