The Grove Newsletter Q1, July 2018

SPOTLIGHT: Learning the best practices to provide the best care

Tracey McCormick: Our Certified Positive Approach to Care™Coach

Tracey McCormick, Manager of Community Programs, recently completed her Positive Approach to Care Independent Coach Certification with Teepa Snow. This certification is for those who supervise caregivers so that they can help caregivers change their behaviour towards those living with dementia.

What vs. how

As one of the leading educators on dementia and dementia care in North America, Teepa Snow helps families and professionals better understand how it feels to be living with dementia and related challenges. Her approach involves modifying environments, situations, interactions and expectations to create supportive, positive opportunities for both those with dementia and their caregivers.

While most dementia education models teach the “what,” (mainly facts and information), Snow’s Positive Approach to Care (PAC) teaches the interpersonal skills needed to improve quality of life for everyone involved, essentially the “how” of living in relationship with a changing brain.

What care partners can do
  • Respond to a person’s change in cognition and abilities in a way that is not hurtful or offensive,
  • Understand that, with practice, common “reactions” to the person with dementia can become thoughtful “responses” that improve quality of life for everyone involved,
  • Recognize that the person with dementia is “doing the best they can” and if something isn’t working, it’s the responsibility of the care partner to change their approach toward the person living with dementia as well as to discover what can be done differently to address the challenging situation, and
  • Be aware of environments surrounding a person with dementia and make changes as necessary.
The GEMS Brain Change Model

One of the extremely helpful tools developed by Teepa Snow is the GEMS Brain Change Model. This easy-to-understand model uses different gems to represent different states of the changing brain.

“Just as gemstones need different settings and care to show their best characteristics, so do people…seeing individuals as precious, unique, and capable encourages a care partnership and is the core of this model.”

Each gem is listed with potential behaviours and traits as well as first-person descriptions of how the person with dementia could be viewing their current situation.

  • Sapphire (optimal cognition, healthy brain)
  • Diamond (routines and rituals rule)
  • Emerald (on the go with a purpose, naturally flawed)
  • Amber (caught in a moment in time, caution required)
  • Ruby (others stop seeing what is possible)
  • Pearl (hidden within a shell)

Visit for great resources for both family members and professionals, including online courses, videos, links to research studies, a free ibook and the free DementiAssist app.

Training in Gentle Persuasive Approaches (GPA)

Gentle Persuasive Approaches (GPA) is an evidence-based, innovative, person-centred care approach that re-frames challenging behaviours as self-protective or responsive behaviour occurring as a result of unmet needs.

Training is designed for interdisciplinary care staff from all health care sectors. GPA training encourages the understanding that a person with dementia is a unique human being, capable of interacting with the world. Assessment of the meaning behind behaviour and working alongside the person with dementia are part of GPA.

Participants are guided to fully understand responsive behaviours in order to be able to respond effectively and appropriately in a workplace setting. Training also includes respectful self-protective and gentle redirection technique for use in situations of risk.

Participants learn about the relationship between the disease process and behavioural responses and how to apply emotional, environmental and interpersonal communication strategies that are immediately useful.

Chelsea Daze & Amber Lapierre: Our Behavioural Support Champions

Personal support workers Chelsea Daze and Amber Lapierre have completed training provided by Behavioural Support Ontario (BSO), and now coach and mentor other staff members in behavioural support approaches as our in-house BSO Champions.

What is Behavioural Support Ontario?

Behavioural Support Ontario (BSO) is an initiative aimed at enhancing health care services for older adults at risk for or presenting with responsive behaviours. ARH received funding from the Champlain LHIN for behavioural support training through the BSO initiative. Personal Support Worker Chelsea Daze attended a two-day BSO training course, and now coaches and mentors other staff members in behavioural support approaches.

What are “responsive behaviours”?

“Responsive behaviours” are a result of changes in the brain resulting in cognitive impairment.  These actions, words and gestures of persons with dementia, Parkinson’s disease and/or other major neurocognitive disorders are a response to something important in their personal, social or physical environment. Using this term encourages health care providers to focus on what can be done to make change rather than the behaviour’s impact. BSO recognizes that all behaviour has meaning, and that responsive behaviours are often communication of an unmet need.

Fundamental to BSO is that behaviour is communication. Behaviours are an attempt to express distress, solve problems or communicate unmet needs. They can be minimized through interventions based on understanding the person and adapting the environment or care to satisfy the individual’s needs.

BSO also focuses on collaborative care, where accessible, comprehensive assessment and interventions include shared interdisciplinary plans of care that rely on input and direction from the client and family members, as well as creating and maintaining a culture of safety where older adults and families live and visit and where staff work.