What in the world was happening? The lifetime of behaviors and expectations seemed to have disappeared. In January my mother and I made plans to rent a summer home at the place where memories are made. I had two small children and Grammy Pammie was excitedly plotting out how she was going to make everything special. She was planning special outings and trips with the kids that did not include me and my husband.
When we met at the beach house a very different person was presenting herself as my mother. For the past 6 months I had very brief conversations on the phone and a few quick visits with my mom. Chit chat conversations and pleasantries were easy and masked cognitive decline. But when she showed up to the vacation house with only a couple outfits and one beach towel. I knew something was up.
Twelve years later I learned about Positive Approaches to Care. The "GEMS States," developed by Teepa Snow, helps us see what skills remain during cognitive decline and how we can support those skills. It simplifies a very complex process of rating dementia progression and turns it into a structured, more humanistic approach that in turn will enable better care for those living with dementia. "GEMS States" is a system that everyone can use, where all caretakers and family members can identify the stages and discover the best way to approach and communicate with someone living with dementia.
My family discovered the Diamond stage on that family vacation. Grammy Pammy was uncharacteristically self-centered and unable to break from a routine that was deeply rooted with the person she was taking social cues from. It was confusing to see my mother not following her own inner compass and to do what she loved most which was to engage her grand kids. I was angry and upset but had I known the “ diamond state” I could have responded better for our family.
Clear with Multi Facets
These are the first time we see noticeable characteristics that are outside those associated with the normal aging process. The brain may be clear and sharp during this stage and can often be difficult to tell whether or not someone is being difficult or stubborn or if they are in fact having changes in their cognitive abilities.
The following are warning signs or traits considered to be in the second stage of the "GEMS States."
Become very rigid and inflexible in how they like things, do things or want things
Less aware of boundaries, using vulgar language, racial slurs or being cruel.
Become very self centered and not caring about the needs of others.
Changes or new routines tend to be very difficult and they tend to focus heavily on money, finances and expenses to help cope. ( relying on things that have a firm process to follow)
Only respect those people in positions of authority and always like to speak with the boss or manager.
Asks the same questions, tells the same stories multiple times or is unable to remember specific words or nouns and commonly has to ask others to finish their train of thought.
Very good at holding a conversation for a short period of time or having "surface level chit-chat" but cannot maintain conversation for long periods. This makes it difficult for those they are communicating with to be able to recognize any loss of language skills or problem solving skills during such short conversations.
If these characteristics and traits sound familiar to you or remind you of a loved one, they might be in the Diamond "GEMS States" stage.
For our family that vacation was a very troubling and very unpleasant. I spent a lot of energy arguing and trying to be the right one in the situation. I was exhausted and confused. It was the beginning of our long journey with dementia. It was the time when we realized that our family need to get help and guidance on what to do.
Some recommendations and tips to help your loved one in this stage are to first and foremost,
Stop arguing with your loved one.
Set aside the need to feel like you are right
Give up reality orientation ( meet them where they are)
Be supportive and kind
For further information on "GEMS States" and how to communicate and support those living with dementia please visit us at Monarch Care Partners.com