Dr Graham Stokes 2

We don't know why dementia starts. It is striking at random. It is a disability. It is a person with a disability. They have rights. The person is still there, it is just that they are disabled. The new always stays strange, so it is good to keep people in their own place. Layers and layers of intellectual devastation. In the beginning it is subtle, changes in concentration. It could be depression, thyroid problems, but needs to be checked out.

Concentration deficits: Capture successes by putting their house number on their door (for Health and Safety, put actual room numbers on the frame of the door). Activities need to be meaningful to the person.

Incidental and intentional learning deficits: Incidental learning is no longer possible. Intentional learning cannot occur. What they know is all that they know now. They become like Teflon, nothing sticks.

Loss of established memories: Forgetting personal history. What they learn last, they forget first.

Disorientation: New place, new room, new toileting place. Don't know where you are, or what time of the day it is.

Language impairment - speech and comprehension: What the person with language impairment suffers from is that they are not able to communicate. People can sing when they cannot speak. Sing directions to them, and they may respond.

Executive dysfunction: inability to make decisions for self. It starts right at the beginning. People make very bad decisions. It is an indicator of problems ahead

Apraxia: loss or impairment of the ability to execute complex coordinated movements without muscular or sensory impairment. Loss of coordination, related to dressing themselves, ido-motor apraxia is unable to make a deliberate movement, like pick up a cup, to drink the tea.

Agnosia: loss or diminution of the ability to recognize familiar objects or stimuli usually as a result of brain damage. Loss of meaning, nothing makes any sense whatsoever. Proso-agnosia, means faces all look the same. Babies have agnosia, until they make sense of the world.

                                                                               - evolving dependency

Dr Graham Stokes part 1

Dr Graham talked about himsef:

He is uncomfortable with people behind him. When he goes out for dinner with his wife, he sits against the wall, and she sits across the table from him.

Move on to if he gets dementia. He is seated in the middle of the room, and he gets up and moves to another seat. Somebody not understanding, leads him back to his seat in the middle of the room, and he gets up and moves again. He is taken back to the seat in the middle of the room, and moves again. By this time the meal is over, he has not eaten, because they have seated him in a place where he has never been comfortable.

It is important to know about people's back story, and the things that make them feel insecure, get the story from family members, or write your own story, the things that make you insecure, and the things that conversely make you secure.

75 in Wanganui part 2

I forgot to tell you about the role playing. which was not very effective, as those who volunteered want the programme in their village or rest home. What was valuable was that none of the used the graphic that I had given them showing the brain when listening to music (entertainers) and when performing music.
The difference is MASSIVE.
One part of the brain lights up when listening to music and all seven parts of the brain light up when performing music.
I can't paste the graphic here, but the following tells you how the brain uses all seven areas when performing music:

Performing music: There are few activities that require more of the brain than performing music. It uses complex feedback systems that take in information, such as pitch and melody, through the auditory cortex, and allow the performer to adjust his, or her, playing (or singing).

1.    The visual cortex is activated by reading — or even imagining — a score;

2.    the parietal lobe is involved in a number of processes, including computation of vocal folds; (voice)

3.    the motor cortex helps control body movements;

4.    the sensory cortex is stimulated with each touch of the voice;

5.    the premotor area remains somewhat mysterious, but somehow helps perform movements in the correct order and time;

6.    the frontal lobe plans and coordinates the overall activity;

7.    and the cerebellum helps create smooth, integrated movements.

–     By Steven Fick and Elizabeth Shilts

75 in Wanganui

I was expecting 60 Diversional Therapists in Wanganui, but there were 75, including four who had driven down from Auckland! They came from Tauranga, and New Plymouth and Wellington. It was most exciting to work with the whole group.

We started with breathing, as that is one of the definite benefits of singing: improved oxygenation. At this point I had someone who tried to take over my workshop. She wanted the people to breathe into their backs, (totally valid for people standing, who have a well developed understanding of the extra breath that is available when expanding the floating ribs) and would not listen to the fact that I was modelling for seated people who could see what they were doing. I had her sing a song, that she suggested, and then was able to control her. She had a very nice voice, and entertained well. Needless to say I am not going to tell you her name :-)

I had duplicated the lyrics to four songs from the first disc, but the CD player that had been supplied was not loud enough for the space, and I was glad that there was a piano available, which I had set up, pulled away from the wall, at an angle, which made the sound bounce off the wall and fill the space.

I had the group set up the chairs against a solid wall as that is the most supportive place for singing. During the session, I asked half of them to experiment with singing in a space, and they noticed the difference straight away, they had to work much harder, and the sound disappeared into the space.

During question time I did not have the current prices available, but when the pastor of the Wanganui Central Baptist Church came in, I was able to get online. The church has a completely unhackable password, but I managed to get all 20 characters in, in the right order.

Many people said that they were going back to their site and going to sign up for the programme. I do hope that they take the graphic showing the brain when listening to music, and when singing, to their manager when they ask for funding.

FYI the do-it-yourself price is $9 a week with chance to cancel at any time, or $7 a week if locked in for 12 months.

To have access to the training for the diversional therapist and the manager it costs $15 a week to cancel at any time or $11 a week if locked in for 12 months.

Going to Wanganui to present to 60 Diversional Therapists

Diversional Therapist Elizabeth Juden (who I have known since we were children, and lived across the road from each other) was at the conference in Hamilton last year.

She has invited me to speak to the lower North Island Diversional Therapists at the end of this month, in Wanganui. I will be travelling there by bus, rather than driving, and it is far cheaper by bus. I get congitation time :-)

I have two sessions with them. The first will be a chance to sing, and use the products. This is to get them to reflect on how good singing makes them feel. (I know this because singing releases endorphins, and those are happy hormones, furthermore in increase oxygenation, as people breathe with the musical phrase, and therefore breathe more deeply). Having experienced it for themselves is important, as they know that the same thing will happen to their residents, as they use the programme.
The second session will be helping them to work out how to engage with their manager. Having had experience with Diversional Therapists and their place in the 'pecking order' of a retirement site, this is important: for them to be able to start a conversation about why they need our singing programme in their facility.

For starters, all the work is done for them. The songs are chosen, the lyrics are provided, in size 20 font. They get a singalong disc to learn the songs, and an accompaniment disc to use when the songs are learnt. They get ongoing training to apply the benefits of the singing programme, with Monday Monthly webinars on different topics. This is relevant, as DHB funding comes to each facility, and it is increased, when the facility can show that the staff are undertaking training.


This is what one of the users of the programme says:

 “Singing for Seniors has done all of the hard work” says Bronie. "You get an email every-time a new resource is made available. Every month there is a new health theme for us to focus on, like depression, or the health benefits. We know our residents, but Singing for Seniors give us the confidence to work with them in the best way possible. We even have a lady on oxygen 24/7 who joins in. We wouldn’t have known that this is good for her if it wasn’t for the Singing for Seniors programme.

Training is 30 minutes long, once a month and they gives me new ideas I introduce each month. Because can’t leave the village training is easy to join, and I spend more time with our residents. I don’t have a computer at work so I call in by phone and if I can’t dial that month because we’ve short staffed I watch the training at home and if I have any questions I just email Dr Julie. "

 Singing can alleviate the effects of a Stroke

(Natural News) The damaged brains of stroke patients can be "rewired" by
singing, restoring the ability to speak to patients who have lost it, according to a
study conducted by researchers from Harvard Medical School and presented at
the annual meeting of the American Association for the Advancement of Science
in San Diego.

The findings came out of an ongoing trial in which stroke patients who have
lost the ability to speak are treated with music therapy and taught to put words
into simple melodies that they tap out with their hands. According to Schlaug,
patients who had previously been unable to form any words at all became able to
say "I am thirsty" after just one session.

Music has been used as a form of therapy for stroke patients since the discovery
that damage to the brain's speech centers did not affect the ability to sing.
"People sometimes ask where in the brain music is processed and the answer
is everywhere above the neck," said Aniruddh Patel from the Neurosciences
Institute in San Diego.

"Music engages huge swathes of the brain - it's not just lighting up a spot in the
auditory cortex."

Speech and movement are mostly controlled from the left side of the brain,
making them vulnerable in the case of damage to that side.

"But there's a sort of corresponding hole on the right side," Schlaug said.
"For some reason, it's not as endowed with these connections, so the left side is
used much more in speech. If you damage the left side, the right side has trouble
[filling that role]."

Putting words into song, however, appears to stimulate the formation of speech
connections on the brain's right side.
"Music might be an alternative medium to engage parts of the brain that are
otherwise not engaged," lead researcher Gottfired Schlaug said.

Sources for this story include: news.bbc.co.uk/2/hi/science/nature/

8526699.stm.