We have determined what some signs for the first stage of dementia might look like and how to communicate with a diamond effectively. A dementia diamond, much like an actual diamond is still clear, they are sharp and can cut with their words and actions, they have many facets, they can shine in the right environment and they are rigid, hard and inflexible. Diamonds want to be in control of their territory and in control of what they believe their role is. They are either joiners or they are loners and it can be hard to tell if a diamond is being real or fake. Old habits and routines are the easiest for a diamond to do and a familiar place will be where they are most comfortable. They want to do what they enjoy and want to be around whom they like and these things may vary. They resist takeover and do not do well with a boss. They may notice other people’s mistakes but are not aware of their own. Some of the activities of daily living that they may begin to struggle with are money management, medication administration, driving, pet care, home maintenance and safety, caring for someone else and cooking. Situations that can cause conflict, push back and agitation include a hospital stay, housing change, change in family, change in support system, a M.D. visit, a new diagnosis, and traveling. These things put a diamond in a new and unfamiliar situation. Remember a diamond does best with continuity and familiarity. You can help a diamond with their activities of daily living by providing visual cues such as highlighted schedules, signs to help them find their way, familiar set-ups for tasks or activities, and always using a personal approach with a smile. Verbal cues you can use would be to knock before entering, be respectful, ask permission before doing things in the room, offer positive comments, ask for help or input, frame things as a “rule” for everyone and try issuing invitations not orders. Be sure to watch how you talk, it’s all about how you say what you say and how you respond to what they say. Some touch cues that you can use are hand shake greetings, return of friendly affection touches, responsive hugs and even hand and foot massages or back rubs. This gets a diamond used to you touching and doing for them which will come in handy later on in the disease when it will be necessary for you to assist them with more of their personal care like bathing and dressing. You should be prepared to apologize repeatedly and be sure to mean it when you do. Be prepared for repeated questions and requests. Listen to the old stories that they tell repeatedly and even write them down. The information contained in these stories will help you in the next stages of dementia when your loved one gets lost in past places and roles. And finally break these bad caregiver habits. Avoid saying, “Don’t you remember?” Do not try to force changes or try to take over completely. Avoid taking responsibility for being the one to say no. Do not argue but do not accept things at face value either. Your loved one may say they have bathed or taken medications when they in fact have not.

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