Dementia Journal
April 2015



Teepa is an advocate for those living with dementia and has made it her personal mission to help families and professionals better understand how it feels to be living with dementia related challenges and change. Her company, Positive Approach, LLC was founded in 2005 and offers education to family and professional care partners all over the world. Her goal? Making a mind at a time.  

MindfulnessMindfulness:  Using Supportive Communication Techniques
by Teepa Snow, MS, ORT/L, FAOTA 


Not Pushing Present Reality, Focusing on the Past, or Telling Whopper Lies.

Part of mindfulness is being "in the moment," totally aware and focused in that moment, but also being able to integrate what is available in the background-history, subtext, and sensory experience-into that moment

A simple example of this complex phenomenon: when asked what to do when the person says, "I want to/need to go home!" and they are where they live, there is no simple solution. I can't offer a simple answer. It all depends!


Depends on what? On the person doing the asking, on the situation, and on the person who is trying to help, as well as those around, on the place and time, and on what else has happened or has not happened before now and what typically happens after now. In other words, I will need to wrap my mind around the entire situation-all the players and the setting-in order to help investigate the mystery, and be able to better appreciate the meaning of the request, the purpose behind the request, and the need being expressed. Only then can I determine possible responses that might provide that which is being sought.


So, how do I approach this situation in a mindful manner?


First: I take stock of myself.


Am I able to focus on this interaction? Can I stop other activity, other thinking, other responsibilities to focus on this person, this event, and this interaction? Or is something getting in my way?   


If I am feeling overwhelmed or I am trying to do several things at the same time, I will rarely be successful at helping the person who is saying, "I want to/need to go home!"   


If I can't focus for any reason, then I may want to get the distractors - the other concerns-dealt with or handled in some fashion before I try to be helpful. This may involve calling on teammates, stopping or putting a hold on the tasks I was trying to get done, or taking a moment to figure out what is bothering me so I can let it go or fix it, in order to focus on this person in this moment. 


To finish this activity, I breathe slowly and deeply, focusing on the exhale to let other things go. By pausing and getting prepared, I enter the situation with less baggage so I can be free to help as I am needed.


Second: I pause for a moment to experience this person as they are, and I try to put myself in their place, their senses, their space, their emotions, and their time.


Before I move forward or try to help, I look, listen, feel, smell, and try to notice the person, the setting, and what is happening. Allowing myself this moment is typically critical to success. I try hard not to rush into a fixing mode, and instead assess the environment-attempting to see from the other person's point of view using my pre-frontal cortex, my detective skills, my awareness of the big picture, as well as the little details.   


This gives me the context of their request and provides me with clues and ideas about what is driving the person's need without actually approaching them. I might be able to determine factors that are creating a sense of distress or a need to leave or to seek home. If so, then before I approach the person, I can try to eliminate or modify those environmental factors.


When I think I have experienced the world from that person's point of view (only a moment) then I breathe-in and out-to be ready for the next step.


Third: I seek out a connection with the person using my Positive Physical Approach (PPA) skills as an assessment tool.


I place myself at the edge of the person's personal space and seek permission to enter. I offer myself, my hand, my reflection of how they have shown me that they feel. In the offer, I try to make sure they have the option to refuse, but I make the offer so on target that it invites the person to make the connection. As I complete each step of the PPA, I note their abilities, their reactions or responses to me and my offer. This allows me to determine their GEM?

state in that moment. By being open to how the person takes in my offer (processes it, decides what to do, and acts) I can better prepare my toolkit and skills. This way can I effectively work further with them to decipher the unmet need and help them "get home" in whatever way I can.  


It is really quite simple, but oh so complex. I usually just say, "Hey ____ [preferred name], it's Teepa. [Pause.] You want to/need to go home?" In that moment, I acknowledge their message, reflect back that I heard and am listening and available, and want to try to help. Then I listen for what comes next.



Fourth: I pay attention to the level of distress.


If it is low ("I want to go home") and expressive language is still present, I offer one of the following: "Tell me about your home," or "Now you're from _____ [their home town], aren't you?" Or "Do you need to do something there or do you just want to be there?"   

If the distress level is high ("I need to get out of here. I need to go home") then I reflect their emotion, and may say, "You hate being here. You need to be at home!" And then pause. This allows the person to get that you are able to see their point of view, and because you are with them, they can finally relax just a little. There is someone else who gets it and might be able to help in some way.  


Either way, the connection has been made! I will take a deep breath and let it go. Because I have the person's hand in a hand-under-hand grasp, it frequently allows them to breathe with me and lowers their distress as it improves their ability to take in information, and process it.


What happens next will depend on that moment. But you can't get there without getting here first!


Next month, I will take you further on this journey. For now, use opportunities you have to be mindful and in the moment with those who are trying their best to send messages, get messages, and "find home." When we are mindful, we can help find the way home wherever that may take us both.


Additional Resources


Another great way to focus on mindfulness when you're in a stressful situation is to step back and BREATHE.  Here's a short video that demonstrates how breathing affects your response.   

Teepa Snow - Making Visits Valuable Part 1 - Breathe
Teepa Snow - Making Visits Valuable - Breathe



It's All In Your Approach

  from the Pines Education Institute' s Dementia Care Academy

Communicate with patient with dementia/Alzheimer's
DVD from Teepa on
communicating with persons living
with dementia/Alzheimer's

Positive Partner:  PAC Coach - Deanna Lueckenotte  

Maintaining personal and professional balance in my busy life requires diligence and upmost mindfulness. My day-to-day operations include running and expanding my two businesses: Leading the Way Seminars, Inc. and Guiding Hands, LLC; working as a Positive Approach Coach for Teepa Snow; providing a resource as a Community Educator with Leeza's? Care Connection; and working toward a real estate license in California. I share this busy time with my teenage child who is a professional actor and my firefighter husband who is gone 2-3 days at a time.   


Some ways that I stay mindful in balancing my personal and professional life include:  

  • prioritizing daily activities and duties,
  • celebrating my successes,
  • utilizing time-saving technology to get things done on the go,
  • delegating chores to family members and business activities to my contract specialists,
  • taking short breaks throughout the day,
  • listening to the valuable advice of my mentors,
  • keeping well organized to be more time efficient,
  • saying "no" or "at a later time" when I already have my plate full,
  • setting boundaries and goals for my workday and sticking to them,
  • scheduling family time to keep me grounded,
  • maintaining a positive outlook,
  • finding humor in every day occurrences, and
  • choosing to surround myself with positive mentors and professionals.
I often consult my mentors to help me maintain and improve personal and professional mindfulness. For example, in my personal life, Megan Zucaro, continues to remind me to play as hard as I work to maintain a healthy balance in life. In my professional life, mentors like Teepa Snow continue to teach me about self-awareness, interaction with others, and the importance of daily breathing exercises. Another mentor in my professional life, Leeza Gibbons, continues to teach me to stay in my lane and to stay hyper focused on my goals with realization that a goal may not be met as quickly as you may want or think it should happen. 

Build your Coaching Skills

The Coach and Care Skills certification program is designed for anyone who supervises caregivers or other team members providing direct care or support to individuals living with dementia. If your goal is to help people change their behavior towards individuals with dementia, this training is for you.

  Learn More

Positive Project:  Canine Companions and Dementia 
by Elizabeth Gallagher, South Carolina 

My husband, Paul, passed away at home on May 11, 2014, from dementia. As anyone who has dealt with this disease knows, it is a difficult journey. 


I was fortunate to have been given a wonderful little mixed breed dog named Tabouli who became a service dog for my husband Paul.

Realizing what an important role Tabouli played in our lives, I had him trained and registered as a therapy dog, which enabled him to be taken to nursing homes and hospitals to comfort others.


Tabouli's work as a mobility and medical alert dog provided security, while his presence brought comfort. Many people living with dementia tend to walk slowly and tentatively. Tabouli was trained to help Paul pick up his pace and walk with confidence. When shopping with Paul and Tabouli, I could give a "Sit/Stay" command if I needed to speak with someone or when I needed to check out. Tabouli wouldn't move until I gave him the "Free" command, so I knew Paul would not wander away. One of the most significant areas of Tabouli's service came at night. If Paul awakened and tried to walk, Tabouli would wake me. Because of this little dog, I didn't have to worry that my husband would get up and fall. Some people living with dementia have imaginary friends that can be frightening. I convinced Paul that no one could bother him with Tabouli by his side and then he would smile and relax.


There are many ways service dogs can help people living with dementia. They can be trained to block a door to prevent wanderin g or to guide a person gently back to their seat. They can provide physical support if a person falls or, through scent training, bring someone home if they've become lost on a walk. Dogs can interrupt agitation and provide immense comfort just by sitting in a lap quietly. If you're interested in how service or therapy dog can help in your home, a professional trainer in your area may be a good place to start. 


Tabouli was at Paul's side when he passed away and by my side at Paul's funeral. He was Paul's little buddy and grieved his passing for over two months. Dogs often outlive the companions they serve. It is important to make sure the dog knows a person has passed away so they don't continue to look for them to return. 


Tabouli has now become my emotional support. I am convinced he was heaven-sent. He continues to be a dog on a mission, taking his job seriously and with confidence.


If you have any questions, please contact me. I would be glad to hear from anyone who might be considering getting a dog for his or her loved one.



 Additional Resources and Programs:


Memory Moments -  Animal Assisted Therapy for Those with Dementia 
Memory Moments - Animal Assisted Therapy for Those with Dementia


Dementia Dog builds services for people with dementia that brings dogs back into their lives or supports them to continue their relationship with dogs.  It aims to prove that dogs can help people with dementia maintain their waking, sleeping and eating routine, remind them to take medication, improve confidence, keep them active and engaged with their local community, as well as providing a constant companion who will reassure when facing new and unfamiliar situations.

Alliance of Therapy Dogs is a national organization with its corporate office located in Cheyenne, WY. ATD was incorporated in the year 1990. Currently we have 12,000+ handler/dog teams in the United States, Canada, Puerto Rico, and U.S. Territories. 
The Pets for the Elderly Foundation (PFE) is a 501 (c)(3) public charity whose mission is to provide companionship to senior individuals through pet ownership, while saving the lives of companion animals in shelters; animals which might otherwise be destroyed due to lack of appropriate homes, and space limitations.


MEDITATION: Mindfulness


"Mindfulness is the aware, balanced acceptance of the present experience.  It isn't more complicated than that. It is opening to or receiving the present moment, pleasant or unpleasant, just as it is, without either clinging to it or rejecting it." 
-- Sylvia Boorstein from  It's Easier Than You Think
In her book, The Mindful Caregiver: Finding Ease in the Caregiving Journey, Nancy Kriseman writes of mindfulness:


"Many caregivers share that they often feel alone, isolated, and unappreciated. Mindfulness can offer renewed hope for finding support and value for your role as a caregiver. Mindfulness requires that you pay attention to how you feel in the present moment and that you do so in a non-judgmental way. It requires that you slow down and connect to your heart so that you can more fully experience yourself and the life around you. Mindfulness embraces the qualities of compassion, kindness, and patience. It is an approach that everyone can use. It can help slow you down some so you can make the best possible decisions for your care recipient. It also helps bring more balance and ease while navigating the caregiving journey. Being a mindful caregiver requires paying attention to how caregiving impacts you ."  


Read more about The Mindful Caregiver: Finding Ease in the Caregiving Journey (Rowman & Littlefield Publishers.)
Mindfulness is a tool that is always available to each of us, if we remember to breathe.


Living Well...Dementia World News
Voices Remember: An Intimate Musical Cabaret honoring
B. Smith and Dan Gasby


A show-stopping musical cabaret that brings together the voices of Broadway stars and top voiceover actors who, through song and spoken word, lend their voices to the millions of those who have lost their voices to Alzheimer's Disease.


The Event 



Purchase Tickets 


If you are unable to attend,  
please consider making a donation.


LED Talks Now Available Online

If you weren't able to attend the 7th annual AHCA/NCAL Quality Symposium, you still have a chance to view Provider magazine's inaugural LED Talks-a series of nine 18-minute talks modeled after the ever-popular TED Talks, including a "fantastic" offering by our very own Teepa Snow.


The LED - Lead, Engage, Discover - Talks are aimed at discussing topics and ideas that are provocative, inspirational, and sometimes disruptive, with the goal of helping people break out of "group think."


Teepa Snow 
Care For The Person With
Dementia: A Civil Rights Issue


Additional Resources:  

LED Talks


Thank you to AHCA/NCAL for another dynamic Quality Symposium and to Provider Magazine for inviting Teepa to participate.



Teepa Applauds Xavier University for their focus on Interdisciplinary Team Building 
This past February,  Teepa participated in her 7th program with a group of participants at Xavier University.  Each year she conducts a session on understanding dementia and working as a team to solve complicated cases.  Multiple disciplines and degree levels represented include  BSN, MSN, OTR-MS, PT-PhD, Psych-PhD, Health Admin-MS, SW-BS and Pastoral Care. The faculty committee that organizes the event is composed of OTs, Nursing, Phd Psych, MD - Health ADMIN and Social Workers.  Community partners are also present.  These practitioners participate by monitoring or "coaching" the sessions where students work in collaboration with others to develop teams that become skilled in problem solving a variety of situations that may arise while providing care.

Please visit the Xavier Teaming site for more information on the program and related publications.

Xavier Participants, 2015 - Photo credit: Edmond Hooker


News from the Dementia Action Alliance

A Nation Joined Together
Will Make A Difference
The Dementia Action Alliance Leadership Team is pleased to share this Call for Action adopted  by the participants of the First World Health Organization (WHO) Ministerial Conference on Global Action Against Dementia.    We are particularly pleased to see that their overarching principles and call for actions for people living with dementia, their caregivers, families and community align so well with the mission and efforts of the Dementia Action Alliance, including, but not limited to:
  • "Promoting a better understanding of dementia, raising public awareness and engagement, including the respect for their human rights, reducing stigma and discrimination, and fostering greater participation, social inclusion and integration of people living with dementia"
  • "Facilitating the coordinated delivery of health and social care for people living with dementia, including capacity building of the workforce, supporting mutual care taking across generations on an individual, family and society level, and strengthening support and services for their caregivers and families"


If you know someone working or living with dementia who might benefit from the teachings of Teepa Snow, please forward this to them now. 

Be knowledgeable. Be prepared. Be positive.


If this journal was helpful to you, we would appreciate your feedback.  Please share your comments and further interest with us.