Welcome to week nine. This course just keeps going through and time is flying  by. I hope you're enjoying the content and the articles and the links that are in  this course as well as the response assignments. 

I'm excited to see what your responses are to things and have a chance to  respond to you. Now this week we are going to talk about understanding  dementia. And I just want you to note that research continues to reveal new  things and so I'm going to share some clips of the previous version of this  course because I think there's still some great content to the videos that have  already been created for this. 

But I'm also going to flip in and share some new information that has come  along the way and some new resources that have come out. So jump in to this  week of understanding dementia. So first of all we want to talk about dementia. 

Now dementia is a sort of umbrella term for Alzheimer's and some other  things. Now Alzheimer's relates specifically to memory loss but it is an umbrella  term covered underneath dementia and there are various kinds of dementia that you will hear about. But do want to mention that some people have gotten into  arguments of mom has Alzheimer's, no she has dementia. 

Well both are true because dementia is a phrase that covers many different  diagnoses that have to do with the brain functionality and aging and Alzheimer's  is one of them. So what are we talking about when we say dementia? Well let's  look at some images because it really is changes in the brain and that happens  structurally as well as chemically. So if we actually see the size of the brain and  the amount of mass that there is to it and the functionality that's happening, we  think of it like a muscle, it is actually shrinking in size. 

There are more spaces in between things. As you can see a sort of normal  brain has lots of gray matter to it, lots of the muscle mass to it and one that's  been affected by dementia is actually shrinking and you'll see spaces get  bigger and so the places where you get to keep things like memory and  language are actually shrinking in their capacity to function. But it's also a  chemical change and now you've heard some talk about some of the  neurotransmitters and things like that as Barb has talked but what's happening  in dementia is that the actual chemical transmitters that are transmitting  information and things like mood and tiredness or ability to pay attention, those  are all contained within the little chemical exchanges happening in the brain in  what are called neurons and the synapses are picking up these  neurotransmitters but what's happening with dementia is that the chemicals are  getting sort of mixed up and spread around and some aren't produced quite as 

much or some are producing more, some are catching more than they used  to and so you'll get mood changes and changes in ability to pay attention and  things like that that we're going to talk about because there are actually  chemical changes happening within the brain as well as the structural changes  happening in the brain and so it's not that hard to see that things are definitely  being affected like memory. 

So we might be driving in the car and the person who's experiencing dementia is getting excited about going to the store and has their wallet out and now they  looked out the window and started thinking about something and grabbed  something else in the car to take a drink and all of a sudden now there is this  major amount of angst that they can't find their wallet and they're really stressed  out about this and calling, oh we have to turn around and go back because I  must have left my wallet at home, what are we going to do? And doing a little  digging and helping to remember that it is right there on your lap. So you'll see  things like this happening where memory is just starting to fade and it can pop  up at different times but definitely memory for things like names, words which  we're gonna talk some more about but remembering things, it's not a good idea  to talk about well what'd you have for breakfast today because there's not  probably going to be a great likelihood of that memory still being there. Now you  wanna talk about memory from back in childhood, that's in a different place so  those memories may still be there. 

There may be fuzziness about what actually happened in those memories but  talking more about the short term memory is going to be much more difficult. So  what happens is that we tend to focus on the vision because of those changes  that are happening within the brain. Vision tends to change and I don't mean  that blindness sets in in the physical sense, it's not a change in the actual  functionality of the eyes which can also happen in aging, it's more of a skewing  of the processing and the perception of vision. 

So what tends to happen is that we get to focus on tunnel vision or straight  ahead vision as opposed to the peripheral vision which will be much more  difficult to process and so those things that are in the periphery may be fading or it could be the other way around. Sometimes the peripheral is stronger but  usually it's face on vision. There is sort of this this goal zone of vision that you'll  want to focus on in terms of vision because things that are not right in front may  be completely missed without that. 

Social responses will change. You'll notice that responses that you would expect like oh it's nice to see you today might not be there or they might come out  somewhat oddly. Remembering to shake hands or how to do that could  be different.

Just some social responses will be different or you might notice a more reliance  on those little phrases like well so nice out today isn't it or some of those little  chatty phrases that tend to help us get through a social interaction and seeing  those change. Now a couple of the other things are going to come into play with  social responses like our words. Now what happens in our brains is we sort of  have these filing cabinets that keep our words for us and we know where they  are in a category. 

We sort of have to go to that filing cabinet think of that category and then come  out with the word and so what can happen is people start to lose the definite  word that they're looking for and sort of talk around it. We call it circumlocution  or circumduction. Having to vaguely refer to these things because we can't  come up with the exact word that we're looking for. 

For example someone wanted to explain that there was a flat tire out in the  parking lot but all they could think of is it was the circular piece of the vehicular  out the out the box and to come to find they're looking out the window at a car  with a flat tire which is no longer circular and so helping to think through these  these phrases that are trying to get at the meaning can be a little bit tricky but  again what you're noticing is that the words are disappearing. You will also see  changes in impulsivity. You might see some behaviors that you haven't seen in  an adult for a very long time. 

You might see things like suddenly jumping up going I don't like this or  or announcing aren't we going to do this now or eating more cookies than  they really should because now there's just a lack of impulse control and they  just really taste good so they're just going to eat as many as they can get at  the moment not remembering when they might have last eaten or things like that so impulsivity can increase and again this is part of a chemical change in  the brain because those things that control impulses might not be operating  like they used to. You'll also notice a loss of inhibition and so things like  zipping up pants or greeting people in not very much clothing or things like that  tend to lose their importance. The inhibition or the the social constructs  that formulate some of the etiquette that we are typically used to as  interacting with adults might no longer be there simply because of the just the  loss of inhibition and that may not have anything to do with memory of things it's  just simply it doesn't matter to them anymore. 

What they want is what they want. What they need is what they need and and  thinking about the social etiquette for how to address that appropriately is no  longer a part of their conversation. Now something to note is that I've talked  about all of these things but I want you to know that it is a processing difference.

It's not always that these are completely gone. It's not that vision is gone as I  said or that hearing is gone. It's a processing difference in the brain and so  things are changing for this individual as well and they're having to learn how to  do life differently than they used to as well but just take note that just because  now the words aren't coming as quickly doesn't mean they can't hear you or that having to look at things straight on means that they're going blind right. 

This is a processing difference in the brain. It's not necessarily a loss of all the  functionality all at once especially. Some things that are unaffected by this  change in the brain which is a great joy is the fact that experiencing pleasure  gets to stay there. 

The part of our brain called the amygdala at the back of our brain is staying  quite intact and so that's where we experience pleasure and where we perceive  threats. It's sort of our fight-or-flight mode as well. So you'll notice that  experiencing pleasure becomes a big part of what we're after and so the other  thing that you'll notice is that perceiving threats becomes quite strong as well  and sometimes those threats are perceived and not necessarily true threats. 

You will notice things like for example someone has walked into the room  quickly and because of the vision being able to focus in one space that person  who approached very quickly sort of bypassed all the peripheral vision that  would normally alert this person that someone was coming into the room and so now they get very very frightened because suddenly there's someone right in  front of them in their face making demands of them or just simply their presence  is very alarming and so they're perceiving a threat where there isn't really a  threat to their safety but because that's the part of the brain that is still very  much engaged that's the part that is sending the most signals and these other  things that would normally send the brain some signals to alert the person that  oh someone is coming and it's at a reasonable pace that someone who's  familiar all of those types of signals did not make it through in the way that they  were expecting and so now there's just this perceived threat and so you'll see a  lot of behaviors start to come out in terms of I don't like this I don't want to be  here I don't feel safe or things like that because of the perception of threats if we think about our church environment sometimes we have a lot going on I know  Barb has mentioned to you some of my conditions that have helped me to  realize this too in a church environment we have a lot of sounds a lot of people  moving a lot of messages coming at our system and to be able to process all of  that quickly enough to really enjoy it can sometimes be a challenge so knowing  that of this of the condition of this person might have them being perceiving  threats to all of these barrage of sensations coming at them I think we just need 

to be aware of that and be able to gently guide a person into some spaces and  sometimes and probably give a little warning when that that loud music is going  to start or think about how we approach the spaces but we'll get more into  strategies later do you want to tell you though that that idea of experiencing  pleasure stays with us and there have been some studies about how the brain is affected by pleasure particularly music which I think we would think a lot about  when we think about our church environments and our worship practices and so there are actually centers in the brain that come alive and you actually can in  fact get a sort of tingling sensation you sort of say you get goosebumps or you  get that chill down your spine sometimes because there was such a gorgeous  sunset or it's your favorite song and hearing those notes every time just gives  this sort of rush to your system well that is actually a scientifically proven  fact that our brains activate in certain ways especially with music and in  people experiencing Alzheimer's and that form of dementia we've noticed that  there are elements of the brain that really truly come back alive in some ways  when there is music being played particularly music that strikes that chord for  them that is connected with the music that they prefer and so I would love for  you to read this article and some of the links within this article about  how memories of music cannot be lost to Alzheimer's and dementia it's  absolutely a beautiful thing and I think it gives us a lot of hope when we think  about our worship practices and Barb and I will talk about that some more later  but I do want to tell you that dementia does happen on a predictable schedule it  is a period of about eight to ten years in which the disease typically develops  now there are set there are things such as early onset dementia and that will  play with the timeline a little bit but it does happen over a predictable set of time  you will notice changes in memory and then you might notice some changes in  vision you will notice some changes in those inhibitions and impulsivity but there is actually a predictable flow to when these things will come and when they will  go so while you will see individuals and it affects every person differently  because we all have our own neurological makeup we have our own personality differences we have our own things that trigger our happiness and trigger our  perception of threats and so you will notice lots of individual individualization to  this however it does happen in a predictable flow and it takes about eight to ten  years to progress throughout someone's journey with dementia so just want to  tell you about that want to share with you a few resources that are out there we  are not experts on dementia but we have had some experiences with it with  people within our congregations and within our families and we'll share with you  some things about that but there are those who are studying it that who are  focusing on this and who have learned a great deal about it and we have  learned a great deal from them one of them is Teepa Snow and her website is  called positive approach to care she's written many many books and she talks a  great deal about that predictable flow in that eight to ten year journey with 

dementia sort of describing people as different gems that they go through these  stages of amber and diamond and these various levels of clarity and how we  can look for the giftings in people still at every stage within this journey through  dementia and she her slogan is always until there's a cure there's care and I  think that's a very true statement and so we have a lot of great resources that  we have utilized that come from Teepa Snow we also very much have drawn  from the work of John Swinton and some of the books that he has written and  I'm going to ask Barb to read a quote from him at the beginning of our next  segment but I just want to let you know that he has written some great books  and quotes from him come out in our work all of the time he has written a book  called becoming friends of time that I would highly encourage you to look at as  well as one completely focused on dementia and he talks about something we  might call the three mile an hour God and thinking about how quickly we often  rush through life when God is really calling us to slow down to the pace at which Jesus walked this earth and some of the things about simply taking the time to  be is quite a gift and so I think that we really appreciate his point of view when  we think about dementia and how it affects our worship practices and our  engagement with one another when we think about the ministry of being and the time that we spend with one another and how important it is to simply slow down and acknowledge that we all do have a place to belong even and especially  when we're walking through something like dementia so we'll talk some more  about these resources and some strategies you can try when we get together  next time so enjoy some of the reading material that I've mentioned here and we will see you at the next session 



Last modified: Monday, May 4, 2026, 8:58 AM