6 GEMS You Need to Know For A Positive Approach to Dementia Care
Sapphire:A sapphire is a “true blue.” Sapphires may feel “blue” due to changes with the aging process, although there are no significant changes in cognition and no signs of dementia. They are committed to lifelong patterns, enjoying the things the way they’ve always been.A Sapphire is a brain that is aging normally, flexible, organized, and is able to work with all the other GEMS. People in a Sapphire state are the ideal care partners for someone living with dementia, as they possess the adaptability to go with the flow and appropriately interact with the GEMS state of the person in their care.Note: When stressed, even a healthy brain can slip out of the Sapphire state. When that happens, the best thing you can do is to take a deep breath and a break (if possible) to help get yourself back into that calm and collected state.
Diamond:The first stage of actual dementia, or the diamond stage, occurs with the first signs of change or signals of a stressed brain. Diamonds are “clear and sharp,” successful with established habits and routines. Diamonds like to feel competent and valued, and it is important for them to feel comfortable and in control. A diamond can still do things as they always have, but they become more territorial and less aware of boundaries.People in a Diamond state are still clear and sharp, but become increasingly rigid. They tend to have a lot of facets to them, but are noticeably inflexible and are able to still cut you or hurt you. Diamonds don’t do well with change, but are still very much able to shine. They are who they were, but they are different. This can make it difficult for care partners to acknowledge that the person is really living with dementia, as they still know what they’re doing but appear increasingly stubborn.
Emerald:Emeralds are green and “on the go.” Vague, and flawed internally, they may get lost in their past life, places, and roles. They may have problems with communication and comprehension, asking who, what, where, and when often. Emeralds are most comfortable when doing familiar tasks. They like to engage, help others, feel like they have a purpose.Unlike the Diamond, people living in the Emerald state are no longer clear and sharp. This is usually the state at which people begin to struggle and get identified as having something going on. Emeralds are on the go, but might get lost in time or place and their words aren’t always as clear and sharp as they used to be. An Emerald is flawed but unaware, thinking that everything is fine, so they may cast blame on someone else. In this state, care partners are likely to notice mistakes. Instead of pointing out the flaw, care partners will likely have much greater success by going with the flow.
Amber:
Amber likes to live in moments of time, and are focused on sensation – manipulating, gathering and touching things. They are focused on wants and needs, and sometimes are exploratory without safety awareness. Their communication is limited with difficulty understanding and expressing needs, so activities selected need be familiar and sensory stimulating.People living in an Amber state tend to be caught in a moment of time. Many Amber's are all about sensations, and what something feels like. They are therefore more curious than cautious, and lack safety awareness. An Amber is all about seeking things they like, but may strongly respond to things they don’t like. So, this is the state at which care partners often struggle to not turn into a Diamond themselves, as the person’s behavior is so inconsistent with who they used to be.
Ruby:Rubies experience late-stage changes as fine motor skills are very limited. Loses in depth perception, as well as limited visual awareness and major sensory changes result in needed assistance with utensils, brushing, buttoning and moving. Hand-under-hand assistance helps rubies feel safe and secure.In this state of dementia, fine-motor skills in a person’s eyes, fingers, mouth, and feet begin to fade. A Ruby might therefore have trouble figuring things out visually, and struggle with speech production as well as chewing and swallowing at times. While fine-motor skills get lost, a Ruby can still do larger, gross movements, like clapping hands or holding onto things. In this state the person’s strength remains fairly unchanged, so they might firmly hold on to you or miscellaneous items without knowing how to let go. It’s easy for care partners to get stressed and go Diamond in this state, so it is particularly important to take a step back, take a deep breath so you can get oxygen to your brain, and try to let go of what was so you can be a Sapphire once again.
Pearl:Layered and hidden in a shell, pearls are still and quiet, unable to actively move or respond, and have a limited awareness of the world. Pearls enjoy pleasant sounds and familiar voices, grasping onto moments of connection.Understanding each stage of the process allows care partners to gain a deeper insight into what clients are experiencing. After an in-home assessment, we work to create a plan of care to help your loved one live in the comfort of their home.The model allows care partners to build activity lists and communication techniques that aid individuals through each stage.Similar to an oyster shell, which tend to be ugly on the outside but can hold a treasured GEM on the inside, care partners can find a Pearl in this last state of dementia if they just know where and how to look. In this state, the brain has changed so that the person’s reflexes are turned on non-stop, body systems begin to shut down, and gross motor skills are lost. The person becomes trapped, but with the right care the shell relaxes just enough to produce the amazing Pearl that is still there. In this state care partners tend to spend way too much energy on preserving the shell, but miss the GEM that’s still residing inside.
The question for all of us is, can we see the precious and unique?
By seeing the person living with dementia as the valuable GEM they are and offering them the right care and setting, we’re giving them the opportunity to shine.
Caring for a person living with dementia isn’t easy, but with the right skills and tools, the journey can be significantly more rewarding.
Stage Three: Mild Cognitive Decline
Stage five marks the beginning of mid-stage dementia, which continues through stage six.
Also known as Late Dementia, stage seven is the final stage in the progression of Alzheimer’s disease. At this stage, most people will have lost their ability to speak or communicate. They often require assistance with most of their activities, including toileting, eating, dressing, bathing, and other daily activities, around the clock. Because people in stage seven often lose psychomotor capabilities, they may be unable to walk or require significant assistance with ambulation. This stage lasts an average of two and a half years.