Dementia Journal
December 2015

Positive Approach wishes you the very best this holiday season.  May you all have many moments of joy! 



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.  

Celebrations and Holidays 
by Teepa Snow, MS, OTR/L, FAOTA
As the end of the year approaches, many of us have rituals and celebrations as part of our lives. At these events, dementia can become a very interesting, and sometimes surprising, guest.

Although we tend to think about holidays and their celebrations as joyful, it is important to remember that there are several aspects that cause stress: feeling the pressure of time as you try to continue your daily routines while planning for something new, growing fear that you aren't prepared for your role in an event, and even memories of past gatherings or people that cause anxiety. As we dive in to the holiday season, it is a good idea to have a plan to help you find your balance.
With dementia, the key to a successful and joyful celebration is to:
  1. Get the team together before hand, and think through and develop Plan A, Plan B, and Plan C
  2. Hope for the best, but plan for the worst case scenario (avoid being blindsided)
  3. Go with the flow, and find moments for joy among the changing abilities
  4. Think shorter, simpler, and what is best for the GEM you see in front of you
  5. Consider what each person wants and needs from the celebration and see what is probable, possible, and unlikely
I offer two charts to help consider your options:
  1. Tips for the Holidays offers suggestions for the person living with dementia, the care partner, and any visitor.
  2. Celebrations by GEMSTM State offers thoughts about the world and experience through the eyes and brain of the person who is living with dementia. I offer suggestions on how to modify the celebration or event for improved participation and enjoyment with decreased stress and distress potential.
One final note, try to keep in mind that you matter, too! Take care of yourself and find ways to fill your cup and see, hear, and feel those special moments that happen. They may not appear to you until the celebration or event is behind you, so take a little time to reflect, either alone or with a friend depending on your needs.

May you find what your spirit and heart needs most in the celebrations of the moment.

contributed by Amanda Bulgarelli

Are you interested in Becoming Dementia Aware??

Have you always wanted to attend a PAC certification event but haven't been able to for one reason or another?

Have you always wanted to learn from Teepa herself?

Well, great news! Our first PAC Online Course series has been released! You can now take your own, individual journey towards Becoming Dementia Competent in our 4-part series from the comfort of your own home.  

We start with Becoming Dementia: Aware which is presented in nine 20 minute sections for a total of 3 hours. Don't worry, you won't have to sit down and do it all at once. The course is designed for you to do this when you have the time, and you can go back and watch something you may have forgotten. In true PAC fashion, the lessons are interactive and will give you practical skills that will help you keep and develop your relationship with a person living with dementia. Depending on your needs and comfort level, you can choose to take this course on your own or have the help and guidance of a certified PAC mentor. With short videos, songs, quizzes, helpful slides, and lots of great Teepa Snow content and skill, everyone can learn and grow through this first course. Whether you are just beginning your journey, or are a long way down the road, this affordable course offers you great PAC information at your own pace and in your own location.

Not only is the course convenient, but it is inexpensive as well! For $100 you will get to see Teepa in action, learn about dementia and its progression, Teepa's Living GEMS™, and so much more. As a holiday gift to you, we will give you 25% off for signing up before January 7th, 2016. Simply type in the coupon code DECEMBER25!
Check out the promo video from Teepa and sign up today for your Becoming Dementia Aware online course!

Looking Ahead:   When you finish Becoming Dementia Aware you will be able to learn more with our other courses: Becoming Dementia: Knowledgeable, Becoming Dementia: Skilled, and Becoming Dementia: Competent. Each course will build on the previous level and go more in-depth giving you the skills and knowledge to handle real-world challenges that care partners know all too well.

A Heart Full of GEMS 
by Rev. Linn Possell, Author, PAC Mentor

Hope is what helps us see the possibilities in difficult situations. It is different than a wish because hope is based in reality. The reality for people living with dementia and their loved ones is that we can find ways to stay connected and engaged with one another throughout this process. A Heart Full of GEMS is a children's book that teaches how to find hope for children, adults, and the person living with dementia. The story begins with Abel learning how to find his balance. Finding our balance is an important step for those who love someone with dementia because we will find that along the way it is necessary for us to be flexible and adjust to the changes that happen. A Heart Full of GEMS tells us how Abel learns to maintain and enhance his relationship with his grandmother by figuring out what GEM she is showing, what she can still do, and how he can join her in these activities. These skills are based on the GEMS™ ability model created by Teepa Snow and the PAC team. The GEMS™ ability model is important because it focuses on what a person living with dementia can still do rather than what they have lost. A wise peacock teaches Abel, we are all
reminded that it is up to us to change and look for what is still possible in order for people to live well with dementia. Relationships are what enhance and hold life together; when we notice what the person living with dementia can do, and match our abilities to their abilities, we will find that we are able to celebrate one another. Download an excerpt from the book

About Linn

When my mother was diagnosed with early onset Frontal Temporal Dementia, I knew that she would need an advocate and accepted that responsibility. With this in mind I went to work to prepare myself: I am a teacher and so I educated myself about dementia. I am a coach and so I started gathering a support team. I am a pastor and so I looked to my faith. These three things all helped me be an advocate for, and remain closely connected to, my mother. The first piece of my education was carefully and empathetically observing my mother, noticing her needs and abilities, and adapting to those accordingly. I was fortunate that my formal education in dementia came from Teepa Snow and Positive Approach™ to Care. My support team included friends, family, and professionals who could guide me along the way. My faith reminded me that while dementia may change my mother's abilities, it could not change the beauty of her spirit. Dementia could have changed our connection if I expected my mother to be the same as she had been before her diagnosis or if I were to focus on her losses. However, because I knew that it was my responsibility to change as her dementia progressed, the possibilities for connection and relationship were endless. I wrote A Heart Full of GEMS in order for families to see the possibilities when we live with dementia. It is my hope that this book helps you to have the kind of experience I had with my mother, and find the joys that I have found working with people living with dementia.


"I think it's incredibly brave to be working with flowers and leaves and petals. But I have to: I can't edit the materials I work with. My remit is to work with nature as a whole."
- Andy Goldsworthy, Artist

As we move through the hustle and bustle of the holidays, we near the close of another year.  It is important to take some time to reflect on the events of the past and set your intentions for the year to come.  We offer you the opportunity to experience the work of British artist, Andy Goldsworthy

The video below is an excerpt from Rivers and Tides, a documentary on Mr. Goldsworthy's work and his uncanny ability to move through time, work with what is and create moments of beauty that are ever changing.  As you view the film, think about the parallels between the artist connection with nature and your own journey with dementia.  What resonates for you?  As we  move forward, let's all take some time to stop and observe - take in the beauty of the light in the moment, breathe - and then, when we arrive in a new place, we will begin the work again.
An excerpt from
An excerpt from "Rivers and Tides."

Living Well...Dementia World News
Positive Approach Announces Opening of the First PAC Dementia Resource Center
by Lee Mohler

Teepa and the Positive Approach™ team are proud to announce the opening of the first Positive Approach™ Dementia Resource Center, in partnership with Mountain Home Care. Mountain Home Care is a western North Carolina based family owned business committed to providing in-home nursing/care services to area seniors. Looking to provide education as well as direct care, Mountain Home Care expanded their Arden, N.C. home office to serve as their training and resource center. Owners Lana and Jim Wilde, along with their sons Jeremy and Jason, make up the leadership team. Lana's passion for helping people and advocating for clients was the driving force that led her to create Mountain Home Care.   Striving to help seniors maintain their independence and remain safe, Lana works collaboratively with others to find appropriate solutions for families. This led to her desire to expand their scope of service to include training, educational resources, and products based on Teepa Snow's Positive Approach™ to Care philosophy.

Prior to the opening of the Resource Center, two key members of the Mountain  Home Care team successfully completed a PAC Certification in their respective areas of expertise. Lesley Bratro, Agency Director and Nurse
Mary Donnelly,  PAC Trainer and Lana Wilde, CEO
and Founder of Mountain Home Care
Supervisor, serves as the center's Certified PAC Consultant, providing consultations for individuals and families to help resolve difficult situations related to dementia. Jean McGuire, Nurse Supervisor, serves as the center's Certified PAC Trainer, providing informative and engaging workshops to staff and the external community. They have initiated a structured training program to educate all employees in Teepa's Positive Approach™ philosophy and care partnering techniques.

We look forward to working with Mountain Home Care and appreciate their commitment to improving the lives of people living with dementia.  Learn more...

Organizations interested in becoming a Positive Approach™ Dementia Resource Center should contact Lee Mohler.

Bobby Vee - "Work with what you got!"

You may remember him from the 60's as the pop/rock singer that stood in with his band, The Shadows, when Buddy Holly, The Big Bopper and Ritchie Valens were killed in a plane crash en route to a concert in Moorhead, Minn. For so many, Bobby Vee's music is a huge contribution to the soundtrack of our lives.
In 2011, Bobby was diagnosed with Alzheimer's.  He and his wife, Karen were building their retirement home in Arizona.  Their children rushed to be by their side and offer support. Bobby turned his focus on the two things he loved the most - his family and music.  It was just the "feel-good" he needed.  In 2014, he released "The Adobe Sessions," a labor of love constructed by Bobby and his family. Below is a preview of the album and some additional resources that will provide you with some more information on the family's journey to live well with dementia.
Bobby Vee - The Adobe Sessions 
Bobby Vee - "The Adobe Sessions"
Bobby Vee's Website

care ADvantage - Spring 204 - article written by Jeff Vee (son)

(Alzheimer's Foundation of America's free publication)

Positive Approach extends our condolences to the entire Velline Family on the loss of their  mother, Bobby's wife, August 2015. 

Positive Approach™ to Care in the United Kingdom
by Amanda Bulgarelli

On our journey to change the culture of dementia, PAC ventured into new lands in 2015. This past summer, Teepa Snow and two of her PAC Team members, Amanda Bulgarelli and Linn Possell, traveled to London for the very first UK PAC Trainer certification course. The trip was a huge success, leading to over 15 newly certified PAC Trainers all over the UK and Europe. While all of our PAC Trainers are helping others to gain awareness and knowledge, we wanted to share one truly hope-filled and exciting story from across the pond with you to brighten your holidays.
The newly trained team at the NorseCare residential home in Norfolk, UK.  Kate Grange (far right) is using her new PAC Trainer Certification to spread Teepa's message with these amazing Care Partners and beyond.

Kate Grange (far right) works as the Dementia Care Lead for NorseCare in Norfolk, UK. Norsecare is Norfolk's largest care home provider managing residential Homes and Housing with Care schemes across the county. As part of her role with NorseCare, and as a newly Certified PAC Trainer, she has already trained over 60 dementia care leads within the last six months. Given Kate's new knowledge, skill, and effective use of the PAC Training techniques, the dementia care leads were introduced to Teepa Snow's GEMS™ along with some of the other PAC Skills. All of the leads found great value in the GEMS™ and were inspired to implement this new way of speaking and assessing the progression of dementia within many care homes right away. When visiting these homes now, many staff can be overheard talking about residents as the different GEMS™ levels and can identify the different characteristics within each individual resident and focus now on the retained abilities rather than the cognitive losses.  
In addition to a heightened awareness of PAC and the GEMS™, many of the leads have had small group training with Kate. This has provided them with the PAC Skills of Positive Physical Approach™ and Hand-under-Hand™ techniques that they have taken and used in each of their respective homes. One of Kate's favorite success stories related to one of the trainees using Hand-under-Hand™. One of the female residents who, before Kate's training, would become distressed with washing and dressing as she was not at all involved in this very intimate work. After her training with PAC Skills, the lead is now utilizing Hand-under-Hand™ in this exchange and has been able to empower the woman so that she is now able to wash and dress with less assistance and reduced anxiety. The relationships and skills of the leads with their residents are growing daily with Kate's impressive efforts to change the culture of dementia care.
Next year, Kate has been asked to look at rolling out the PAC Skills of Positive Physical Approach™ and Hand-under-Hand™ to even more of the homes.
Great work Kate, you are truly doing amazing work for Teepa Snow and the PAC Team to help us spread our message of a better way to care!

Living Well After Diagnosis 
contributed by Robin Andrews
Published by the Alzheimer's Society UK, this new resource guide is for anyone who has recently been told they have dementia.  A useful guide for individuals living with dementia, and or friends and families who want to understand more about treatments, support, and services to live well now and making plans for meaningful life in the future. Download the resource guide



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.