GEMS model helps interaction, treatment of dementia patients

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It is heartbreaking when a parent doesn't recognize you.

But with Alzheimer’s and dementia, memories fade and sometimes personalities change.

Melinda Dillehay describes the transition as a role reversal. She is now the parent, her mother is the child.

"I try not to ask why," Dillehay said.

Her mother, Martha Weddle, 83, knows she gets confused.

"I can't remember sometimes, you know," Weddle said.

Weddle doesn't remember when her doctor told her she had dementia. But she knows something is wrong.

"It's where you forget...can't keep it all in here," she says, placing both hands on her head.

With Martha and her disease stage, the same conversation may repeat time and again, day after day.

Dillehay, 57, is single and misses lost intimacy with her mom.

"It's just hard. I kind of isolate myself, it's just hard, not having any body to ventilate with," she said.

The family gets support from the staff at Brownsburg Meadows, which is trained in the Teepa Snow GEMS model. It's a way to classify and better relate with people as their brain ages. In Snow's model, seniors are classified as a gem that signifies their progression in the disease process.

"For Martha, she is who we would consider to be a Stage 4 and now what we call an 'Emerald.' When we call her an Emerald, what we are trying to do is give our staff a visual cue as to how to take care of her," said Rehab Consultant Stephanie Head.

In the GEMS model, Emeralds are on the go mentally and physically and perceive they are independent. They have limited awareness of changes in ability. It is recommended Emeralds have 24-hour care.

"Her thoughts are kind of on the go. One of the things that is difficult in communication with an Emerald is that she can answer your question initially, but ability to stay on the topic or finish that process is very difficult," Head said.

To help staff understand Weddle's classification, plastic Emerald gems are displayed on her memory box outside her room, on the bulletin board, in the hallway, and on her walker.

To better communicate and minimize fear in residents, staff and family are encouraged to appeal to the senior's visual, verbal and touch senses. Seniors often have limited vision, so when greeting them, make sure you position yourself so they get a good look at you. Introduce yourself on each encounter. Finally, reach out to handshake, hug or touch. The routine helps the aging brain process the interaction.

"We have to understand because their realities are changing and they are not always understand what is going on. Help them see us and then they understand us and then if they allow us to then we can put our hands on them to help them with their care and not do it to them," Head said.

The approach has worked for Martha and her family.

"She's actually become more relaxed since she got here. We had some real behavioral issues before we came out here and those basically have gone away," Dillehay said.

Those who care for seniors urge caregivers to understand this disease is a progression.

"It's not going away. It's only going to get worse," Head said.

To cope, focus on what your loved one can do, instead of what they can't.

"I love that she is still so mobile," Dillehay said.

Because of that, Dillehay easily takes her mother home for Sunday visits with the grandchildren. The abilities mindset makes the evolution easier to endure.

If you would like to learn more about the GEMS staging and the gem that may be represent your loved one, click here.  

Memory Care Specialists from American Senior Communities will be available to meet with you this weekend at our WTHR Health and Fitness Expo from 10 a.m. to 5 p.m. Saturday and Sunday at the Indiana State Fairgrounds.

Get free tickets here