[0:06] The training we're doing today is a positive approach to care, training methodology. So positive

[0:12] approach to care is a national and international organization that works to change the way people

[0:18] living with dementia are cared for and supported to be emphasizing the positive relationship

[0:26] as the basis of the care. And we really want to be talking a lot about it as we go through

[0:32] today, understanding what's happening in the changing brain of people who are living

[0:37] with brain-changing disease processes, and understand that they're really doing the best they

[0:43] can, and what can we do as the support community with them to help support them better.

[0:51] So our positive approach to care is a very interactive type of training and educating our people

[1:00] in the community about dementia care.

[1:02] There is a proverb, one more of us saying in our culture in Hawaii, Makahana Kaike in

[1:08] doing relearn, and a lot of stuff that we're going to be doing tonight, we'll be using

[1:13] our hands, we'll be using our peering off.

[1:16] So I want you guys to do this with me.

[1:18] So Makahana Kaike means in doing relearn, so Makahana, right, so we're working, Makahana

[1:25] Kaike, the knowledge, right, we're going to learn as we do.

[1:28] So the more we makahana, the more we eke, mopopo means do we understand?

[1:35] Al-Anui.

[1:38] So that was the first time of many times you're going to be waving your arms around today and

[1:43] touching your head.

[1:44] We're going to do this a lot because it's all about our brains.

[1:48] It's all about our brains.

[1:49] So I want to start with, I mentioned a second ago, about the relationship.

[1:53] So, our core beliefs in underpinning this training method is that the relationship, and

[2:01] I'm going to have you use your hands, one is hand is you, the loving supporting hand,

[2:07] and the other person is the person that you're working to support.

[2:10] How can we form a positive connection in relationship so that we can move forward in a positive

[2:17] supportive way?

[2:18] So we're going to focus on the relationship and that we are the key to this and that people

[2:24] living with dementia with brain change are really doing the best they can every single

[2:30] moment.

[2:31] They cannot help what happened and is happening in their journey of living with any of

[2:38] the diseases that caused dementia, Alzheimer's, strokes, Parkinson's.

[2:43] And we are the ones who have touch your heads again, the healthy brains who have the capacity

[2:50] for change.

[2:51] But it's not an easy thing and we're going to look at some techniques that will help

[2:54] with that.

[2:56] I'm going to step this side a little so everybody can see.

[2:59] So we're looking at brains and we're not here just to look at people who are living with

[3:03] brain change with dementia's brains.

[3:05] We're going to look at our brains too because we're all in this together.

[3:08] So the brain on the left is that this is a PET scan, a 20-year-old, healthy, 20-year-old male.

[3:16] On the right, healthy, 80-year-old male.

[3:19] No neurodegenerative disease, no Alzheimer's, none of that.

[3:24] So PET scans will be looking at a number of PET scans together today.

[3:28] Measure glucose burn.

[3:31] So when your brain is working hard, your brain loves glucose.

[3:33] coast, the bright red that you see is high burn, like all pistons firing, and then it

[3:39] kind of goes gradually down to yellow, green, then to that dark blue.

[3:43] That is no brain activity, and that is normal.

[3:47] We have pockets of fluid in our brain that is normal, so these are two normal brands.

[3:53] So when you look at the pattern of red, the high glucose burn in the 20-year-old and the

[3:59] 80-year-old, they're lying in a PET scan machine and ask to do a cognitive task like,

[4:04] okay, name all the animals you can without repeating in one minute, ready, go.

[4:11] So you lie in tiger bear, you go through all the zoo animals, they're like, uh, pig, chicken,

[4:16] you start going through the farm animals, so your brain is like really working to try not

[4:19] to repeat the animals, so that's the kind of thing these people are doing in the brain

[4:23] scan.

[4:24] So what do you notice about the patterns of red?

[4:27] What do you, between the two, comparing and contrasting?

[4:30] What do you notice?

[4:31] Less and the older.

[4:33] Well, yet some parts have less.

[4:34] Which part exactly do you notice has less?

[4:37] The red from the bottom.

[4:38] On the bottom, on the bottom, on the aiding year old,

[4:42] there's a little less red than in the 20 year old.

[4:45] Touch the back of your head.

[4:47] This is your occipital lobe.

[4:48] This is where you process vision,

[4:51] for the, generally speaking, process vision.

[4:54] So in normal aging, there's a little change here that you've noticed.

[5:01] We're going to explore that.

[5:03] So this is the brain.

[5:05] The eyes are separate organs.

[5:07] Brains one organ.

[5:08] Eyes are different.

[5:09] Eyes are organs, right?

[5:13] People can have all kinds of problems with their eyes themselves.

[5:16] But we're going to talk about that.

[5:18] But the rest of the brain, the red,

[5:22] more similar, pretty similar, or any other big differences.

[5:26] Pretty similar, right?

[5:28] A little darker.

[5:29] Which one?

[5:31] Maybe the third.

[5:35] Despite a little bit darker, this guy's a little bit darker,

[5:37] slightly darker there.

[5:38] Yeah, yeah, pretty close though, right?

[5:41] Pretty close, yeah.

[5:42] So overall, these two brains look more similar

[5:46] than they do different.

[5:47] They're different. We all know as from looking around the audience. If you remember when you were 20,

[5:55] what your physical body looked like at 20 as opposed to wherever we are in the journey now,

[6:03] it's changed, right? So we're not just aging on the outside with gray hair and changing skin and things like that.

[6:13] that our organs are aging on the inside too.

[6:16] So we're going to look at what is, in this first part,

[6:18] what is typical aging changes for brains

[6:23] and what's atypical, atypical.

[6:27] So looking at those 20-year-old and this 80-year-old,

[6:31] the 80-year-old has not lost a lot of function

[6:33] except for maybe some changes there in the occipital area

[6:39] unless something goes wrong with our brains.

[6:41] So, the dementia itself is not a normal part of aging.

[6:48] So, something has to go wrong with our brains for it to be reached the level of dementia.

[6:54] So, we're going to take a look here at another set of pet scans.

[6:58] So, these pet scans, so this one looks pretty familiar, right?

[7:01] It looks a little more to different person, but a little more dark reds here.

[7:06] So this person is about a 75-year-old man.

[7:11] If you were to slice my head like this on the fattest part

[7:16] of my circumference, there's that part that you're seeing here.

[7:19] And then one above is a little higher up, a little higher slice.

[7:23] What was the top of my head?

[7:24] So it's the same brain twice here.

[7:27] So this person, 75, healthy brain, no demand, no neurodegenerative disease.

[7:33] I'll put that way.

[7:34] This person here living with early Alzheimer's late Alzheimer's getting close to the end of life 18

[7:45] month old child on the end here so I want you to focus your attention first we know red is high

[7:51] glucose burn to the I will look at this one versus this one so the the person who with no these are by

[7:59] By the way, the same heads are comforts.

[8:02] These are also 75-year-old men, and their skulls are the same size.

[8:06] So if you took a tape measure, it would be the same size, so this skull would be the

[8:11] same when all of them.

[8:13] So what do you notice in the red between the normal and the early?

[8:21] Less red.

[8:22] Yeah, a little less red or a lot less red.

[8:25] Yeah, a lot less red.

[8:26] We saw that the 80-old man had a little less red than a 20-year-old here in their

[8:31] occipital lobe. What's happening with the occipital lobe here? Yeah, it's a lot.

[8:38] It's like half the action going on. What other parts look significantly less

[8:42] red? The top, touch the front of your head. This is your frontal lobe, your executive

[8:48] function, right? It's okay. So, wow. And when I say early, very likely, undiagnosed. Most

[8:59] people don't get a diagnosis until it's obvious to everyone around them that there's a serious

[9:04] problem. You don't even need to be a doctor to say, oh my god, I think this person is living

[9:09] with dementia related to some kind of disease process going on. So, that's a whole another

[9:16] another topic, getting early checkup, early diagnosis, but this, someone with living

[9:21] with a, this much brain change could still be living alone, driving, right?

[9:28] Well, we're going to explore what's happening.

[9:30] So this is early, so when I do this training with caregivers, I say, and I work at a memory

[9:36] care home, this isn't, they're not living in a care home yet, right?

[9:42] That's a little further down between these next two.

[9:45] So we can see there's significant change even in the early stages.

[9:51] So how about between early and late?

[9:54] What do you notice there?

[9:56] Like night and day.

[9:57] Night and day.

[9:58] So what's the difference that you notice specifically?

[10:01] Well, there's hardly any yellow, right, so there's no middle ground.

[10:05] There's still red?

[10:06] Little bit, yeah.

[10:08] Yeah, back here again, right?

[10:09] It's not all gone.

[10:10] More purple.

[10:11] And more purple, right?

[10:12] a lot less red than the other parts which we'll discuss later, but this little center everybody has this red in the center all the way through.

[10:22] If you were to take your fingers, take your two fingers, put them up to your temples and don't actually do it and just jam them into your head and then you're in the center of your head.

[10:30] That's your deep primitive center of your brain, your primal thrive to survive center.

[10:36] there, that's working hard for us all the way through our lives from the beginning, all

[10:41] the way through the end, right?

[10:44] Thrive to survive, that is, that is always there, you're amygdala in there.

[10:48] So a lot has changed, and there's certainly a lot of loss, but it's not all gone.

[10:55] They are who they were, but they're different.

[10:58] And now the 18-month-old child, let's take a look at that.

[11:02] What do you notice comparing those two?

[11:05] Very similar, right?

[11:06] Yeah, very similar. We're not born with this brain on the left. We grow into it. We grow

[11:13] into it. So we start out and grow into it. It takes a lot of time. Our brain is not fully

[11:21] developed until 25, 26, so for boys, yeah, girls maybe a little younger, but yeah, it takes a

[11:29] long time. But when I want to think about, when you think of an 18-month-old child, how advanced

[11:35] is their language? Not very well. Is it hard to understand them sometimes? Do they

[11:40] sometimes not understand what you're saying? No. How's their toileting habits?

[11:47] Not very

[11:48] well. Are they in continent? Yeah, yeah. How about their safety awareness? None. Who's

[11:55] in charge of safety? Somebody else, not them, right? But can you connect and communicate

[12:01] with an 18-month-old child. What do you have to do?

[12:05] Touch them. What do you have to do with your language?

[12:09] You have to get on their level. You have to simplify your language.

[12:12] You have to use a lot of sign language visuals.

[12:16] But you can still connect. No one says,

[12:20] that kid can hardly talk and it just uses diapers.

[12:24] Why should I even bother to connect with them?

[12:28] But there's a lot there, and I kind of want to challenge our conception of late Alzheimer's

[12:36] disease.

[12:37] Yes, there's a lot of loss, but there's still a lot there if we know how to connect.

[12:44] And we can connect and be together in that moment, and we'll be doing a lot more on communications

[12:49] as we go through.

[12:50] I go through.

[12:52] So how can we know when it's normal aging, or typical aging,

[12:58] versus a possible dementia?

[13:00] How do we know?

[13:02] I know for myself, if I'm sitting in, let's say, the living

[13:06] room, and I think I want to get up and get a cup of coffee.

[13:09] I'll get up and start going to get the coffee.

[13:11] And then if I get a phone call, when I'm done with the phone

[13:14] call, I'll put it down and be like, wait a minute.

[13:18] Why did I come in here?

[13:22] I hear some left. How many of you? Does this happen to you? You go into all the time today?

[13:28] Has it happened today? Yeah, it's just probably happened today. What do you have to do to figure out

[13:33] what it was you came in here for? Backtrack. Backtrack. You gotta go all the way back,

[13:38] something you have to sit back right in the same seat, put your butt right where it was,

[13:41] and then you're like, oh, and you think, oh my God, am I losing it?

[13:48] my grandma had dementia. Do I have this thing? I want everybody to take a deep breath because

[13:56] I saw you almost all raised your hand to say that this happens to you. Typical, normal,

[14:02] aging. Right? We have a lot of input. Things change. So I want to take a look at these two columns

[14:09] here. The one on the left says typical aging and just focus on that one first. So it's slower

[14:14] the things, lower to do, hesitate, pause. What do you notice about the language on that side in

[14:21] these descriptions? What's kind of a commonality that you see? Slow, pause, okay? Wait a minute,

[14:32] wait a minute, give me a minute, I'm going to remember the actor's name, Cheryl, the actor's name,

[14:38] he's kind of tall, he's in that new show, he's in that new show, the Hawaiian show, the one

[14:43] Jason Mahmoud, yeah, yeah, yeah, yeah.

[14:47] Someone young.

[14:49] Someone young.

[14:50] Young people like to help us older people out before we need it.

[14:55] Right?

[14:56] I would have that there.

[14:57] I would have described him like, oh, he's like.

[15:03] I would get so close, but not quite there. And then maybe a step away, and I'd be like, oh, it's Jason

[15:16] And this is a specific noun, a name of something, your name, Jason Memorial's name, a specific

[15:24] name of something, O-L-O, a specific name.

[15:27] And if we use a different name, it doesn't work, it's not the right label, kind of go

[15:32] like this.

[15:33] I talked around that name, it's called Circumlocution, I can talk around it, and that helps my brain

[15:40] I'll eventually get there, look at there, or I talk around it enough that some young person

[15:44] blurt it out.

[15:46] Right?

[15:46] It's like, ah, because his brain is quicker than mine.

[15:52] So that's, it takes me a while, so I know the person, but not the name.

[15:57] But that's very different than, look at the atypical side.

[16:00] What kind of language do you notice on that side?

[16:03] Can't, can't, can't, can't, doesn't, won't.

[16:07] Right? Those are all not, cannot, will not. So not just that I'm slower or that I need

[16:16] to pause. It said, I can't get there at all. We want to keep in mind, when we, this,

[16:24] today, as we go through, this a typical side, when we start to see signs that it's not just

[16:30] that they're not remembering the name, they're not recognizing, they just cannot do it, cannot

[16:35] new things they used to do before. I love to cook and there's certain things I can cook without

[16:40] even looking at a recipe. But now it's something I used to make all the time. I'm making like major

[16:45] mistakes. That's a sign. Not just the occasional. Like, oh, I forgot to put the salt in. It's very

[16:52] different than putting in a cup of salt instead of a tablespoon. Something like that. So, okay. So,

[17:01] Oh, notice that these say typical and atypical,

[17:04] and not normal and dementia, because we don't know

[17:09] what these symptoms mean yet.

[17:14] If you're seeing these, you want to get it checked out

[17:16] because it could be something else that is not dementia.

[17:20] It could be medication side effect.

[17:22] It could be hearing or vision loss because that happens.

[17:24] A lot of people get older.

[17:26] It could be depression, pain, a lot of different things.

[17:29] So if you notice any of those things, get them checked out.

[17:33] Well, want to focus on what we call the three Ds.

[17:36] So put your three fingers up.

[17:38] The first one here on the left, depression, say with me.

[17:43] Depression.

[17:44] Take a look at these symptoms.

[17:46] Can't think, can't remember.

[17:47] Kind of looks familiar to the similar to the other one.

[17:51] There's a lot of overlap in symptoms

[17:53] between depression and dementia.

[17:56] So you, things you might say, oh, I think they're getting dementia.

[17:59] maybe it's depression. You need to get a full clinical workup to figure that out.

[18:03] Number two, put your second finger up. Delirium. Say, Delirium with me. Delirium.

[18:09] Swift. Swift changes. Not gradually getting worse, but like

[18:14] my baseline is here. Go like this. Go like this is your baseline.

[18:18] I can dress myself pretty well. If you lay the food out, I can eat it.

[18:22] And then all of a sudden, like in a couple days, I'm like a lot more confused.

[18:27] I'm putting things on backwards.

[18:29] I'm just like, I'm lost.

[18:31] You're like, oh, my God, they've heard a bunch of get this bad,

[18:33] that fast.

[18:34] Oh, ho, ho, swift changes mean something

[18:37] possibly could be going on underneath some sort

[18:40] of infection that could become toxic.

[18:42] The most common, I know we have a lot

[18:45] of different kinds of caregivers here today.

[18:49] The most common cause of infection for older people,

[18:53] but also older, especially living with dementia,

[18:57] is UTIs, bladder infections, yay, top, top, yep, top most wanted list of things that happen.

[19:05] So, if you notice a swift change, don't wait, get it checked out.

[19:09] You might have to go to, you know, the urgent care clinic or something, but get it checked

[19:12] out right away, because you and I know when we have a bladder infection, I'm not going

[19:17] to ask you to raise your hand if you've ever had a bladder infection, but if you have,

[19:21] you know, right? Pain, you know where the pain is? Yes, you do. Can you describe it

[19:28] to other people? Yes, you can. But I'm living with brain change. That you saw

[19:33] those PET scans, right, with the change advancing, with, say, of mid-stage

[19:36] dementia. I am also feeling that pain, but I can't articulate it. And it comes out

[19:42] in other ways. And we'll get into that, but break them out in different behaviors,

[19:46] mood, things like that. So, very important. So that's one D. So, depression,

[19:51] Go ahead and move with me, depression, delirium, you get that checked out.

[19:54] Oh, it's not either of these three, the third-dead dementia.

[19:59] What's your three fingers together?

[20:01] These three loved hang out together.

[20:03] They loved hang out through there.

[20:05] So you can have dementia and have depression and have delirium.

[20:11] You can have all three at once.

[20:13] So it's very important to have a good, as part of your care team, a good medical connections

[20:20] as well, geriatrician, or interdistered and possibly geriatric psychiatry to really get

[20:27] down to the bottom of it, because usually the things that cause delirium and depression

[20:33] they are treatable.

[20:34] You can't improve someone's quality of life and possibly save their life through treatment

[20:39] of the delirium.

[20:42] Dementia is a little bit different.

[20:44] So this term dementia, the most common question that I get asked, and I'm sure Cheryl too,

[20:48] is what's the difference between Alzheimer's disease and dementia?

[20:52] Or I hear my mom has Alzheimer's, but she doesn't have dementia.

[20:55] Or the other way around, I would dementia, but not here.

[20:58] So we throw these words around, and I think it's very helpful

[21:02] for us to understand what it is actually.

[21:04] So the word dementia, it's not actually a disease.

[21:08] It's the word that describes a set of symptoms that have one

[21:13] of which is often memory changes, memory impairment,

[21:15] but could be others usually two or more parts of the brain function are affected and it's gotten to the point where it defects you cannot live independently anymore.

[21:24] So it's not mild for getting forgetfulness, it's to the point where you need help, you cannot function independently anymore.

[21:32] So I'm going to have you make a big go hit your neighbor, make a big umbrella, big umbrella because it's an umbrella term, umbrella term.

[21:41] And under that umbrella are the causes of these brain change.

[21:46] Alzheimer's disease, frontal temporal dementia, vascular dementia,

[21:50] Lewy body disease, and then there's over 100 different causes.

[21:54] Basically, it's neurodegenerative diseases that over time

[21:59] change the damage of the brain.

[22:02] Or you can have something sudden happen like poor NFL football players

[22:07] with too many concussions, bad for your brain.

[22:09] you know, over time, so add the actual brain damage.

[22:13] Alcoholism, the other cause.

[22:15] And you can have more than one,

[22:17] so you can have Alzheimer's disease

[22:18] and have a history of alcoholism.

[22:21] So we're going to take a look at actual brains,

[22:23] because what we want to get behind,

[22:25] now we've looked at what's normal,

[22:27] what's typical aging,

[22:28] and we really are now looking hard at what's atypical.

[22:32] And I want to kind of look at the whole brain

[22:34] and a couple different parts of the brain first,

[22:37] about where we're going to start to see early changes,

[22:40] that you can recognize and tie to the specific brain part.

[22:44] So when you think of dementia or Alzheimer's disease,

[22:48] what's the first symptom that comes to mind?

[22:50] Like I said, oh my grandma had Alzheimer's.

[22:52] What do you think her major symptom was?

[22:56] Forgetfulness, yep.

[22:58] Memory, memory impairment.

[22:59] That's like the first thing.

[23:01] So a lot of times can take your finger,

[23:03] we're going to write in the air.

[23:04] People say dementia, so dementia, you can write messy equals Alzheimer's, equals memory loss.

[23:14] So we wrote that, and I'm going to put a big fat extra like this.

[23:17] But that's the common equation that we have. You have dementia, you have memory loss.

[23:22] Yes, you can have dementia and have memory loss, but it's much, much, much more than that.

[23:28] So here's, we looked at the PET scan of this normal brain before, and fortunately this individual is passed away, passed away, and kindly donated his brain, again another male,

[23:39] um, diagnosed car accident, no neurodegenerative disease. So this is a actual healthy brain, um, no disease process.

[23:47] So his skull would be right around here, and we have fluid in our brains, it keeps our brain from like, bashing up against the side of the skull, right?

[23:56] This individual passed away 10 years after diagnosis of Alzheimer's disease.

[24:01] What do you think was the disease working on this brain before he got diagnosed?

[24:05] Absolutely, because generally diagnosis is late, and his skull is the same size as this guy's skull.

[24:13] So up here.

[24:15] So looking at these two brains, so this would be the PET scan of the late Alzheimer's that we saw.

[24:21] That was mostly blue, and this is the PET scan that had tons of red.

[24:24] So what do you notice by looking at these two actual brains?

[24:28] The size.

[24:29] Yeah.

[24:30] Huge difference in size.

[24:32] So go like this.

[24:33] The cells are shrinking and dying.

[24:36] Shrinking.

[24:36] So there's actual physiological cellular change.

[24:40] What else do you notice?

[24:41] Color.

[24:42] So what about the color?

[24:44] One stark girl.

[24:45] Yeah.

[24:45] Pretty dark.

[24:46] Somebody said to me once,

[24:47] this looks like an old bruise.

[24:49] I think that's a good way of thinking about it because our brains

[24:52] our vascular organs. We want to have good blood flow to our brains. And as that

[24:58] brain is shrinking, what else is shrinking in there? What do we have with blood vessels?

[25:04] How good is the blood flow in that brain? Not very good. Not very good. So we can see

[25:10] the real cellular shrinking and dying. So we talked about where the memory center,

[25:17] the memory center in the brain was. I had you like drive your fingers into the

[25:20] very center, but looking at that one on the right, is there any part of this individual's

[25:26] brain function that is not affected by the changes that they experienced?

[25:34] You're the very center.

[25:36] Oh, that's good because we're going to look at that.

[25:39] We're going to see what the very center looks like because yeah, we're seeing the outside,

[25:42] what's happening on the inside.

[25:44] So we know it's smaller.

[25:45] We know it's smaller.

[25:47] Okay.

[25:48] Here we go.

[25:49] We're going to look at the very center, the very center, because as we said, memory is

[25:53] the first thing we think of, right?

[25:56] Mom, I'm not asking the same question over and over and over again.

[25:59] With my grandma, she would come out of her room every five minutes.

[26:02] What time does the van come for senior citizens at ten o'clock?

[26:05] Go back to her room, five minutes later. What time does the van come?

[26:07] Ten o'clock. We had the sign that had van comes ten o'clock, picture of a van,

[26:12] the big Alzheimer's clock, all those things.

[26:14] It's like, oh, yeah. So what's happening?

[26:17] She was giving me a signal, not signal, a clue, and this is where I'm going to have us pause for a moment.

[26:23] And you know Sherlock Holmes? What the Sherlock Holmes hat looks like?

[26:27] Go ahead and imagine yourself putting on a Sherlock Holmes hat, like that.

[26:31] And what's that called? A deer hunter? Is that right? A deer hunter hat? Anyway.

[26:35] Because we're going to become dementia detectives now.

[26:38] Because everything we see and hear and experience in our interactions with those we love living with dementia

[26:43] is a clue for us to what's happening under underlying in their brains, because unlike

[26:51] other disease processes, so other organs get the general diseases too, right?

[26:56] Heart disease, lung disease, kidney disease, so like if someone has heart disease, what are

[27:03] the symptoms you might see that on the external that you would know that they have heart

[27:06] disease?

[27:09] Yeah, labored breathing, maybe swelling, lack of energy.

[27:13] So if I see someone sitting with a lot of edema swelling and heavy breathing, I'm not going

[27:18] to say, hey, hurry up, all right, I'm not okay.

[27:22] But that shrinking brain that you just saw, the skull stays the same size.

[27:28] Their heads don't shrink, so it's hard to know what's happening.

[27:32] So again, we have to be those detectives and look at what's underneath.

[27:36] So the hippocampus, this is deep inside your brain and it is our learning and memory center.

[27:42] So the description I did of my grandmother asking the same question, but it does a lot

[27:47] more than that.

[27:48] And very early on, you might start seeing problems with these.

[27:51] I'm going to have you take your hands, go like this, and so you have fingers in the front.

[27:57] I think that does look like this, actually, deep inside the brain, little hippocampus you

[28:01] have here.

[28:01] Here's what it looks like there, like that.

[28:04] So the first thing your hippocampus does for you, the three things, is called wayfinding.

[28:09] So I'm going to have you put your hands close to you and say familiar, familiar, so you

[28:15] can get from some place familiar to some place unfamiliar, unfamiliar, and back to familiar.

[28:21] So if I told you how to get to the bathroom, oh, you go out that door, you go left, you go

[28:26] right, you go right, and then you go left, like okay, you just made a mental map, that's

[28:31] your hip, thank your hippocampus.

[28:33] And you go there, you find your way, you go to the bathroom, then you do it backwards and

[28:39] And you come back and you find your way back to your seat.

[28:42] It's an amazing feat, honestly.

[28:45] Some people have better wayfinders than others, but you start to notice someone living with

[28:50] brain change, this is the healthy hippocampus, this is someone what's happening on the inside,

[28:55] getting lost in familiar places, driving to lungs in here on a Wahoo, you know, I live in

[29:03] town driving down to Polly Longs and I end up in Wainai.

[29:07] that's a sign. It's more than just getting lost. It's a clue. My wayfinder, my

[29:14] hippocampus, is broken, right? It's broken. So it's a sign of not normal atypical

[29:22] changes. The next one, take your hand again. Oops, sorry, like this. So you're here to

[29:28] learn something today, right? Right? So you've got to take in information, bring it

[29:32] I didn't say learn, learn, and remember, remember, that's the goal, learn, and remember,

[29:39] because remembering part is great to learn stuff but it's even more helpful to remember.

[29:44] So all these things that Sheryl and I are doing with you with your hands and arms and are

[29:50] designed to help your hippocampus learn something new and remember.

[30:00] People who are living with changing hippocampuses are going to have trouble. They might learn something. So let's say Cheryl has a fall and ends up in the hospital, ends up in rehab. And now they're going to teach her how to use a walker. So make like you're using a walker. So I'm the OT, the PT, and she's a very cooperative patient, and she uses, oh, Mrs. Diaz, you're doing really great. You know, stand up straight. Oh, great. She's doing really great. I think I'm going to be able to discharge her now because she's got this.

[30:28] the minute she's left alone sitting in a chair without the walker with the walker

[30:34] to the side and she wants to get up somewhere what's gonna happen she's living

[30:37] with dementia she's gonna fall but is she gonna use the walker she's not gonna

[30:42] use the walker she's not gonna use the walker or she might pick it up because maybe

[30:47] you said okay she didn't use it last time so I'm gonna put it right in front of her

[30:51] right so oh what might you do with it move it to the side use it backwards what

[30:57] happened to all that training that the nice PT lady gave her. She did try to learn.

[31:07] She

[31:07] couldn't, didn't have any place to put it. I want to challenge the concept of forgetting

[31:12] and not remembering. Because if you're unable to form the memory in the first place, have

[31:18] you truly forgotten? No amount of, don't you remember? If I have the memory I would, but

[31:24] But it's not that you can, look, look, we had birth date, we were here for your birth

[31:28] they see.

[31:29] Here's a picture.

[31:31] It's like, oh, because I desperately with all my heart want her to remember.

[31:34] But she's giving me a clue that hippocampus is not working properly.

[31:39] The last one, if you don't have to wear a watch, if you imagine you do, time, time awareness.

[31:47] So the kind of time that we keep track of is go like this the day sunrise to sunset and

[31:52] nighttime.

[31:53] time. Right, so we have a 24-hour clock. What time is it? Is it the afternoon? What's

[31:57] dark in here? But is it the afternoon or night or morning? Your brain knows, even though

[32:02] you can't see the sun right now. But your hippocamp is something you keep track of that. But

[32:07] that might get turned around for someone living with dementia. Night is day and day is night.

[32:12] Those days stack up into weeks. Right? Go like this. Stack up into weeks. 365 year. We keep

[32:20] track of what month is this, what day is this, what day of the week is this, I can keep

[32:25] your hippocampus, how to keep track of that. I might lose certain making errors, you

[32:29] notice errors in that time. And the last one is, imagine you're looking at the rear view mirror,

[32:36] all those years stacked up like this, look back there. I don't know how old you are, but how

[32:40] many years that time when you got behind you in the rear view mirror, and you have a concept

[32:45] generally, what, where you are in that timeline, right? I know my grandmother and my parents

[32:53] have passed away, but if I'm living with dementia, hopefully much more down the line, I might

[33:00] think they're still living. My grandmother was always looking for her parents, and she was

[33:04] like 85, and I thought in my kind heart, and I didn't know anything about dementia, that

[33:10] But if I used rational logic that it would, she would be, so grandma, how old are you?

[33:15] 85.

[33:15] How old do you think your parents would be?

[33:17] Well, they'll tell you they would be like a hundred.

[33:20] So do you think they could still be like, I wasn't trying to be cruel, but I didn't, I wanted

[33:25] so desperately to drag her into this timeline.

[33:29] I didn't understand that she can't be here with me in this time at the moment.

[33:35] She's remembering her parents.

[33:37] So those, again, signs.

[33:38] So when you start to see those kinds of changes, just take a deep breath because the first

[33:45] time you actually notice them, it's alarming.

[33:49] But take notes.

[33:50] I encourage caregivers to take notes, take a keep a drone, something to keep track because

[33:55] it's hard to remember.

[33:57] So when you do talk to professionals, you'll be able to describe accurately what you're

[34:02] seeing because that's so helpful to them.

[34:04] And the other part of the brain we want to look at, which you also would see early changes

[34:08] is you noticed in that normal to early Alzheimer's

[34:12] that there was a lot, almost no red in the front.

[34:16] So touch the front of your head.

[34:17] This is your frontal lobe.

[34:18] This is the part that, for boys,

[34:19] develops quite late, well, it's not late.

[34:21] It's right on time, 25, that on time.

[34:24] But a little later than girls.

[34:26] So when you think of teenagers and how well

[34:29] they have underdeveloped frontal lobes,

[34:31] that's why rena-car companies won't rent to them, right?

[34:35] How good is their impulse control?

[34:37] Are they very logical?

[34:39] Did they make great choices?

[34:40] You know, they have a hole in their frontal lobe.

[34:42] It's not their fault, right?

[34:44] It will come in time.

[34:46] But this is our grown-up part of our brain.

[34:48] And before you might even see any memory problems,

[34:51] be like, oh, my mom doesn't have Alzheimer's.

[34:54] Her memory is just fine.

[34:57] But she can't stop eating all the chocolates that are in the house.

[35:00] She's coming to irrational conclusions by,

[35:04] She can't find her person. She thinks the neighbors are coming in and stealing it.

[35:09] She has trouble making choices.

[35:15] She has troubles getting things started.

[35:17] So she'll get things set out. But she just can't get started. The food's there.

[35:20] But she just doesn't get started. Or she can't stop. So she's cleaning something.

[35:26] And you come back an hour later and she's cleaning the same spot.

[35:29] So you can't stop and move on and take this last one, I'm going to have these last two

[35:36] and I have you take your hand out.

[35:37] So this one is a mirror, you're looking in the mirror, take a look in your mirror, look

[35:41] how great you look, great, everybody looks great.

[35:44] This is your mirror for self-assessment.

[35:46] So think of one thing that you're really good at, right, so I'm going to say I'm a really

[35:51] good listener.

[35:53] Okay, that is an accurate self-assessment.

[35:55] I'm also a really good cook, also accurate, great.

[35:57] but also I know what I'm not good at so I might say like I don't really like

[36:02] driving at night especially when it's raining it's very hard for me to see so I

[36:07] might say I'm gonna raise your other hand I need help so look in the mirror and

[36:12] think of one thing you're not so great at that you might could use some help so

[36:15] this is healthy accurate self-assessment using your frontal lobe I know what I'm

[36:19] good at I know what I'm not good at I'm not gonna do some things I'm not good at so

[36:24] So when the frontal lobe is changing, I have, I'm self-assessing, but it's inaccurate.

[36:31] So my grandmother side-swipe, God bless her, side-swipe the garbage truck twice with the

[36:36] old guys, with the guys on the back, they have to jump off in things.

[36:40] And her self-assessor was, I am a very good driver, it's like, oh my God, no, you would

[36:46] still, it's like, oh no, it was all their fault or I don't remember that happening.

[36:50] like it's like she's just so stubborn she's making this crazy but what she was

[36:55] actually showing us is she could not accurately self-assess anymore and that

[37:00] is so hard for care partners because their impairments are so obvious to us

[37:07] like oh my god no you're not oh no you fell five times you have to use the

[37:12] walker I'm fine I don't I don't need that yeah so that's really really hard but

[37:16] But again, it's not just being stubborn, it's an inaccurate self-assessment.

[37:20] The other one is take your hand here, put on your head here, so you have a point of view.

[37:25] Everybody, we all each have our point of view.

[37:28] And take your other hand, and other people have their point of view.

[37:33] And with our healthy from lobes, we can see other people's points of view.

[37:38] We might not agree, but we can see them, and we can talk it through.

[37:42] And with our healthy, this is how hopefully humanity should be, we can take our healthy

[37:50] frontal lobes, the two of us, and come together to some sort of understanding, hopefully

[37:55] compromise.

[37:56] You at least not get in a fight, but we can see each other's point of view and co-exist

[38:01] in a way.

[38:02] So I'm living with this changed frontal lobe.

[38:06] I see my point of view.

[38:09] I cannot see yours.

[38:11] I cannot see how hard I'm making it for you even though you're crying right in front

[38:16] of me.

[38:17] I can't see the mistakes that you're pointing out.

[38:21] I just think you're being mean.

[38:23] So when my grandmother would come out and ask the same question over again, what times

[38:27] of income?

[38:28] At one point, I remember clearly again, we didn't know anything about dementia.

[38:31] She came out, what time is the income?

[38:34] Well, I'm sorry, we told her 10 o'clock, she goes back, she came out again, before she even

[38:38] asked anything, my mom and I in unison just by chance turned around and said 10 o'clock

[38:44] and there was like dead silence because she hadn't even asked and she said why are

[38:50] you so mean because for her for us it was the what number time you think 50 I don't know

[38:57] who was big and we didn't know what else to do right and it but for her it was what number

[39:02] time. Why? I didn't understand that she was stuck in a loop and but who else was stuck

[39:09] in a loop? He and my mom. Somehow we thought if we keep saying the same thing, she was

[39:14] going to behave differently. Isn't that the definition of insanity? Keep doing the

[39:20] same thing. Expect a different outcome. But we didn't know. So I give myself the grace

[39:26] I've made lots of mistakes, but so now you have some detective skills towards early changes

[39:34] because the memory centers, not just memory, way finding time, learning, remember these

[39:41] executive higher functioning things you might see before you see like serious, you know,

[39:47] not remembering people's names, not the more obvious, obvious symbols.

[39:52] Obvious. Yeah. Yeah. So. And keep in mind, you know, as a caregiver, you're still human.

[40:00] It's okay to get angry sometimes. It's important to express those feelings when talking about the

[40:05] counseling side. You know, take a deep breath, take a break, and know that it's going to be okay.

[40:11] It's okay to get angry. It's okay to get fussy. We're all human. But if we think about it's the brain

[40:17] change, it's two parts of the brain, normally on the left side that's dying, they don't

[40:21] have control over that.

[40:23] We control how we preserve their dignity.

[40:27] We have to, hopefully, the operating brain that's working well.

[40:31] So don't be too hard on yourself.

[40:34] So this is the healthy individual who died in a car accident, and this is the man who had

[40:40] Alzheimer's disease after 10 years.

[40:42] So specifically this occipital lobe, what do you notice about that area of the brain?

[40:48] Shrunk.

[40:48] Shrunking.

[40:49] Shrunking a lot, right?

[40:51] And remember, in the very beginning, we looked at the pet scans of the healthy 80-year-old,

[40:56] and there was a little less red there, too.

[40:58] So we're going to look at what's happening behind normal aging vision change,

[41:03] and then also this, this.

[41:06] So it doesn't go just from here to here.

[41:08] there's a gradual change. There's a lot in the middle. Not everybody will possibly get

[41:14] to this stage, might pass away from something else before then, but we're going to take

[41:18] a look at that. And so we're going to do this together. So what I'm going to ask you to

[41:24] do is stand up and I'll share what's going to stand next to me. So we're going to give

[41:29] an example here. Come stand right next to me. So you guys are all kind of standing next

[41:32] to each other. This is going to take a little bit of logistics for you. So don't do this

[41:37] But if I put my hand up like this, I'm going to hit Cheryl.

[41:40] So I'm kind of alternating.

[41:42] I'm going to be the one.

[41:43] I'm going to step forward so I can do like this and not hit Cheryl.

[41:46] So kind of one person step forward because you want to not hit each other.

[41:49] So Kathleen, take a little step forward.

[41:51] You want to be able to put your arms out but not hit anybody.

[41:54] That's the goal.

[41:55] Don't slap your neighbor.

[41:56] Don't slap your neighbor.

[41:57] Okay.

[41:58] Okay.

[41:59] Great.

[41:59] Some people have really long wingspan.

[42:01] So make sure you have a lot of room.

[42:04] So, first we're going to look at typical age, normal healthy aging.

[42:07] Remember that 80-year-old had less red, high burn in the occipital lobe.

[42:12] So, as we're getting older, where there are some processing changes in the brain.

[42:17] So, not the eyes, let's say our eyes are perfectly healthy.

[42:20] No macular degeneration, none of that, no cataracts, healthy eyes.

[42:26] So, if you're young, I think we have a young person here.

[42:30] If you're young in your 20s and if the 30 or so, when you look straight forward, everybody

[42:37] looks straight forward.

[42:38] Put your hands out to 180 degrees and wiggle your fingers.

[42:42] You can detect motion.

[42:44] I cannot.

[42:45] I am in my 60s.

[42:47] I cannot.

[42:48] That is perfectly normal.

[42:50] When you're young, you have a full range of peripheral awareness.

[42:54] So I'm going to turn sideways so you can see I'm looking straight forward.

[42:57] I have to move my hands to write about here for me to be able to detect motion.

[43:01] So move them in just as far as you need to.

[43:04] It probably is a little bit and it's okay.

[43:07] This is normal change, that little change you saw in that 80 year old.

[43:12] So go like this.

[43:13] It's not just the sides, even though when you take the driver's test, what do they have you

[43:18] test you?

[43:19] Right?

[43:20] Because your peripheral awareness is your safety awareness, right?

[43:24] you detect motion before you even see it properly see it right so you're

[43:28] like oh there's a car there so they want to make sure you see the blinking

[43:31] lights right otherwise you're not safe to drive so but it's 360 so as we get

[43:37] older you might notice you trip more easily anybody yes yes when we were all

[43:45] wearing masks all the time or if you work in healthcare and you wear them you might

[43:49] notice your peripheral awareness is a little less there it's easier to

[43:54] trip when you're wearing a mask, you have to look down more, but that's normal and that's

[43:58] about as far as it would go without any other disease process.

[44:02] So we learned older drivers get a bad rap because their cars are scraped up or they park

[44:06] a little crooked or something, but if you lost a little peripheral awareness, you might have

[44:11] that problem, but we can compensate.

[44:13] I know I need to really look.

[44:15] I can't, like a young person, just flick my eyes.

[44:17] I need to, I mean, you're supposed to turn and look, but I should really turn and look

[44:21] the older I get to make sure that I'm safe and I find myself looking down a

[44:25] little more as I go downstairs than when I was young and I would just fly

[44:29] down the stairs run without regard to falling down so so that I'm gonna have

[44:35] you take your hands and make two L's L's like this because that everybody here is

[44:40] in their 70s and put them up to your face like this like you're looking through

[44:45] to the port hole of a ship. Hello. This simulates the visual awareness field for someone

[44:51] who's 70. Do you have an awareness of your neighbors? Make to the right and left? A little

[44:56] bit, right? If you take it off, is it better? Yeah.

[45:00] But you're pretty functional. Good. Great. You're still functional. You're allowed to drive. You can see the red, red dots. Great. But make sure you turn and look. But now we're going to take this changing normal brain, healthy brain, but getting older. And we're going to overlay dementia on it. So we're going to go from here. You were about here, right here. And you're going to come into about 45 degrees. So you have like an L. This cone that you've made in front of you is the visual awareness field for someone living in

[45:29] with early dementia, like we saw in that PET scan, make two C's, two C's, and make

[45:36] like you're going snorkeling, put it right on your eyes. So snorkel mask. Now

[45:41] what happened to your neighbors? You disappear, you disappear, so you can't even

[45:46] see them, right? How about, if you take it off and then put it back on, what

[45:52] else do you notice? It's darker, it feels a little darker. You feel like a real

[45:59] tunnel, right? You get a real tunnel vision. So go ahead and take your hands down. This

[46:04] stuff in front, go like this, curiosity. This is our curiosity vision. This is where all

[46:09] the good stuff is. Where's the chocolate? Where's my helper? It's in the front, right? So

[46:15] as my brain is shrinking and dying, it's actually, I cannot process all this, but I can keep my

[46:23] focus on here. So it's nothing, it's not like glasses will fix this. It's a change in the

[46:28] brain. I'm focused here. I'm so focused here. And we do it too. And we're super focused.

[46:33] You can't see the stuff on the side because you're so hyper focused in the front. It's

[46:37] like it's like that. So this is early stage. So again, early driving. Possibly. Possibly.

[46:44] There are plenty of people living with early stage Alzheimer's out there driving and having

[46:49] some challenges like my grandmother did. That's why she hit those garbage trucks. Okay. So

[46:55] So now put your hand shoulder with the part, make a little tube.

[47:00] So this is mid stage, mid stage, make two o's like you're going to have binoculars, put

[47:07] those binoculars on.

[47:08] So now what happened to your neighbors?

[47:12] Completely gone, completely gone.

[47:14] Now just imagine you have some food on your shirt and I say, hey you got some food on your

[47:18] shirt, try and find it.

[47:25] I'm trying to find your neighbor.

[47:28] What do you notice you have to do?

[47:31] Turn.

[47:31] What are you turning?

[47:33] You have to turn your whole body and when you find them, it's a little bit of a surprise.

[47:41] Like, oh, because you're like scanning, scanning, oh, he's right there.

[47:45] How can I miss him?

[47:46] He's tall.

[47:46] Right?

[47:47] But I can see him now, even though I'm looking at Lenora, but with this, I don't see him until,

[47:56] oh, when did you get here?

[47:58] Where'd you come from?

[48:00] Exactly.

[48:01] Because I'm just missing the outside edges.

[48:04] That's a different part of the brain.

[48:05] That's another part of the brain.

[48:07] Okay, so now, one, we're getting to the later stage, one, oh, and close the other eye.

[48:14] So you can have your hand over it or close it. So this is called monocular vision, monocular.

[48:22] So go ahead and look down. I'm not going to walk but imagine if you're going to try and walk.

[48:29] And keep when I close and put the monocle on and reach up like you're going to touch the lights.

[48:35] What do you notice about that when you try and do it? Can you tell how far away anything is? You lose all depth perception.

[48:44] So my brain has shrunk to the point that I can't take in data in from two eyes, I'm not

[48:51] blind in one eye, my eyes actually working okay, but I can't process vision from two

[48:55] eyes.

[48:56] So I start to have trouble, I'm going to just focus on one, and so I start to have trouble

[49:00] with that perception.

[49:01] So you might see me like, if there's a mat here, stepping over it like it's a hole, because

[49:06] I can't tell, is it a hole or not?

[49:08] and my balance is probably not very good, my fold fall down.

[49:12] I start to have trouble with something on the table.

[49:16] I might miss it when I first grab for it,

[49:18] and that's a sign of depth perception.

[49:19] So again, with your detective hat,

[49:22] you can kind of see the changes that are happening.

[49:25] So not saying things like, oh, when did you get here?

[49:29] Or getting startled very easily when you come from the side.

[49:32] It's a sign that their visual awareness

[49:35] is becoming more and more now.

[49:37] Go ahead and sit down.

[49:38] Great job, everybody.

[49:40] Great job.

[49:41] So that was the vision.

[49:42] Vision.

[49:43] We're going to look to, because vision is, hey, we want to see what's coming.

[49:48] We human, our human brains are not comfortable if we don't see what's coming.

[49:53] If we hear a loud sound to the side, what's the first thing you're going to do?

[49:56] Look, right?

[49:57] See, if something touches you, go ahead and bend the ocean, something touches you, like,

[50:01] ah, you're going to scream, but you're going to look.

[50:03] Because once we can look and see, it's like, oh, oh, it's you.

[50:06] Oh, it's just a piece of seaweed, then we can calm down.

[50:10] But it's a startling thing, right?

[50:13] So we're going to look at hearing now because we as caregivers, care partners, we love

[50:18] to do something.

[50:20] We love to talk.

[50:22] We give instructions all day long, possibly a lot of corrections too, but we love to talk.

[50:28] And you signed up to come here and to listen to us talk for like two hours straight.

[50:32] So, we're counting on you, understanding our language, and you're counting on us, understanding what you say as well.

[50:41] But, here is, like I said, almost like if your bread was a toaster, if the chewing piece of toast comes up,

[50:48] your left touch the left side of your brain, your left temporal lobe, and your right temporal lobe.

[50:54] So, we're going to look really quickly at the functions that are changing here.

[50:57] For some reason, touch the left.

[50:59] The left temporal lobe is affected

[51:01] with all dimensions earlier and more severely.

[51:04] And your left side is your higher language centers.

[51:08] So first thing that's over there is your vocabulary,

[51:11] maybe multiple languages.

[51:13] Your ability to generate, take that vocabulary

[51:15] and spit out full sentences, generate speech.

[51:18] The ability to hear other people's speech

[51:21] and process it using your vocabulary

[51:23] to understand the content.

[51:25] these three things work together as this left side is changing I might lose

[51:33] vocabulary so we have language touch your left side again and say language on

[51:38] the left one more time tap your head tap when I bang it into your head

[51:42] language on the left now you're gonna say rhythm on the right rhythm on the right

[51:47] one more time laying on the left rhythm on the right now with your left hand

[51:52] and throw it away and say, lose on the left and with your right hand, put it in like this.

[51:59] Say, retain on the left and retain on the right.

[52:06] So this side, the higher language is kind of going out the window and everybody's different

[52:11] but it becomes harder and harder.

[52:13] But on the right side, this is the gift side.

[52:16] There's a lot left.

[52:17] It's not affected as severely and can last be functional through very late in disease.

[52:26] Rhythm, music, poetry, prayer, social chit-chat, social chit-chat, hi, how are you?

[52:33] How are you?

[52:34] I'm good in you.

[52:35] I'm fine.

[52:35] How's your family?

[52:37] She's doing great.

[52:38] This is very shallow conversation.

[52:40] It's like a little song.

[52:41] I can do this late into the disease.

[52:45] Because someone can come and visit and say, oh, your mom seems fine, I just had a social

[52:49] tip, because that is a skill that I still have.

[52:52] Music, I might not be able to speak a full sentence, but I can sing all the song words

[52:58] to the early songs, different part of the brain.

[53:01] You don't have to remember the words to the songs, your favorite song from high school, it

[53:05] comes on old school, the radio, comes on the radio, the first two notes, boom, all the words

[53:11] come out of your head, no problem.

[53:12] So it's a different part of the brain and it's a way, take this two hands again, that we can get connected, even late in the disease, late through music.

[53:23] Poetry and prayer are kind of music, they're rhythmic, they're memorized.

[53:29] And so someone who maybe has a Christian background, you might be able to start the Lord's Prayer, just like the first few notes of a song, and they can say the whole thing.

[53:37] And that is a way to get connected there and rhythmic movements.

[53:44] So if I'm working with Cheryl, so Cheryl is later into the disease and I'm going to

[53:50] ask Cheryl to take a step, but she's not going to take a step so I go, okay, let's go.

[53:54] Come on, let's go.

[53:55] She's not going to want to get started, but if I start making some rhythmic movements

[54:00] and maybe when the saints go marching in yeah, when the saints go marching and she has rhythm and I can

[54:16] use that to get her started. Remember she has trouble getting started and but that's preserved.

[54:21] This is a really gift. The last one, permitting words, I'm going to call them a gift even though some

[54:28] people, we call them a curse. So for bit in words, what kind of words are we talking about?

[54:33] You want us to say it? Well, this is on television. I don't know. Children might see.

[54:39] So the children might see, okay, curse words, right? That's bomb, curse words, sex talk,

[54:48] body parts, racial slurs, right? Yeah, things like that. Things you're like, oh my god,

[54:54] You know, you're a saint-aid grandmother who never used those language.

[55:00] I'm going to have everybody take a deep breath because it's awesome stress and faces.

[55:05] We all know these words.

[55:07] They're just words.

[55:09] They're very special words for very special occasions.

[55:13] And so when you were little and you heard grown-ups using those words, think about the first

[55:18] time you swore in front of a grown-up, you might not even know what the word meant, what

[55:23] happened.

[55:23] Yeah. Big, big, old school, right? You got, you got yelled at, you got punished. Don't

[55:30] ever say that again. You might have a corporal punishment mouthwash with soap, local,

[55:33] wet, chili pepper water, right? Chili pepper water. And you learn some things about

[55:39] these words. One, you learn, not to say, so you learn, touch your forehead, impulse control,

[55:47] right? You can think those words, but not say them, right? So you start to develop impulse

[55:52] control. You know if you say them around grown-ups, you're going to get in big trouble. You also

[55:56] learn that they're very powerful words. And you watch adults use them with specific purpose.

[56:03] And that purpose is either to hurt and harm or to self-protection scare away. So they have a

[56:11] purpose. And it's been shown that cursing can relieve pain. If you're spending a lot of pain,

[56:17] It's not a bad person, but it does help.

[56:21] I once had some surgery on my foot.

[56:23] I think it's something removed.

[56:24] The doctor very kindly said, swear all you want, but don't move.

[56:28] So I'm like, okay, that's great instructions.

[56:31] She wanted to give me an outlet, because it was going to hurt.

[56:35] The last one is the sensory motor.

[56:38] This one touched.

[56:39] So human beings, we are hardwired when something feels good, we keep doing it.

[56:44] But if it does feel bad, kind of poke your arm, don't hurt yourself.

[56:48] We pull away.

[56:49] Stove's hot.

[56:49] You don't even have to think.

[56:51] It's automatic.

[56:52] So when touch feels good, we are happy to stay connected.

[56:56] So take your two palms and put them together and kind of give yourself a little hand.

[57:01] Palm to palm pressure.

[57:02] We love it.

[57:04] It's comforting, right?

[57:06] When we're anxious, what's this called?

[57:09] Bringing your hands?

[57:11] It's comforting.

[57:11] We're yourself soothing.

[57:13] Self soothing.

[57:13] So this is something that we know about us as human beings and we can, we can connect

[57:18] this way, palm to palm.

[57:20] And the top touch the top of your head, this is your sensory motor area.

[57:24] We have a lot of real estate dedicated to this.

[57:27] It starts to also go on the fritz.

[57:30] So take your two hands and these three fingers, these are your skill fingers.

[57:36] So your skill fingers do things like button a button, thread a needle, take your glasses

[57:42] is on and off, if you wear earrings, if you wear earrings, this is fine motor skills.

[57:48] These two strength fingers, so pliers, door knobs, peanut butter jack, it's all this,

[57:58] all dimensions.

[58:00] You start to lose skill, but you keep strength, so I'm able to grab onto things, sometimes

[58:09] I can't let them go.

[58:10] Things that require fine motor, like these darn buttons, I just why did they?

[58:16] Right?

[58:17] I button it all wrong, if I'm able to button it at all.

[58:20] I start to have a lot of trouble.

[58:22] So people who are living with dementia, they really are doing the best way they can.

[58:26] And remember who has a healthy brain?

[58:28] And there are things that we can do to adjust our approach to be able to get connected

[58:33] and then to move forward together.

Caring Together: Ep - 1 Living With A Changing Brain

Agenda

Transcript