Our goal is to raise the level of non-medical home care

The GEMS®: Brain Change Model

Teepee Snow and Positive Approach to Care Team

CAREGIVERS RECEIVE 8 HOURS’ DEMENTIA TRAINING

 Brain Change Model

The GEMS® model recognizes the dynamic nature of the human brain and its abilities. Unlike other cognitive models, it acknowledges that everyone’s abilities can change in a moment. Modifying environments, situations, interactions, and expectations will create either supportive positive opportunities or result in distress and a sense of failure. Just as gemstones need different settings and care to show their best characteristics, so do people. Rather than focusing on a person’s loss when there is brain change, seeing individuals as precious, unique, and capable encourages a care partnership and is the core of this model. Providing supportive settings for everyone, including care providers, allows them to use what they have to be their best. The GEMS® advocate that everyone living with brain change when given the opportunity will shine.
                           - Teepa Snow and Positive Approach® to Care Team

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Sapphire ~ True Blue ~ Optimal Cognition, Healthy Brain

  • True to self: personal preferences remain basically the same
  • Can be flexible in thinking and appreciate multiple perspectives
  • Stress/pain/fatigue may trigger Diamond state: back to Sapphire with relief
  • Able to suppress and filter personal reactions: chooses effective responses
  • Selects from options and can make informed decisions
  • Processes well and able to successfully transition
  • Aging doesn’t change ability: processing slows, more effort/time/practice needed

My brain is healthy - true blue. If I am aging normally or distressed, it may be hard for me to find words. I can describe what I am thinking so you understand. I may talk to myself because I am giving myself cues and prompts. I can learn new things and change habits, but it takes time and effort. Honoring my choices and preferences, when possible, is important. I need more time to make decisions. Give me the details and let me think about it before you need an answer. I am able to remember plans and information but supports are helpful. I may like specific prompts such as notes, calendars, and reminder calls. Health changes in vision, hearing, balance, coordination, depression, anxiety, pain, or medication may impact my behavior, but my cognitive abilities remain the same.

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Diamond ~ Clear and Sharp ~ Routines and Rituals Rule

  • Displays many facets: behavior and perspective can shift dramatically
  • Prefers the familiar and may resist change: challenged by transitions
  • More rigid and self-focused; sees wants as needs, when stressed
  • Personal likes/dislikes in relationships/space/belongings etc, become more intense
  • Reacts to changes in environment; benefits from familiar; functional/forgiving
  • Needs repetition and time to absorb new/different information or routines
  • Trusted authority figures can help: reacts better when respect is mutual      

My overall cognition is clear and sharp. When happy and supported, I am capable and shine in my abilities. When distressed, I can be cutting and rigid and may see help as a threat. I have trouble seeing other points of view and may become less aware of boundaries or more possessive about my relationships, personal space, and belongings. I have many facets so people see me differently depending on the situation. This can cause conflict among my family, friends, or care team as it’s hard to tell if I am choosing my behavior or truly have limits in my ability. I can socially engage and have good cover skills. People will vary in their awareness of what is happening to me. I want to keep habits and environments as they have always been, even if they are problematic for me or others. I am often focused on the past, personal values, or finances. I will need help to make changes in my life; it’s hard for me. I can be in a Diamond state for reasons other than dementia. 

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Emerald ~ Green and On the Go With a Purpose ~ Naturally Flawed

CAREGIVERS RECEIVE 8 HOURS’ DEMENTIA TRAINING

 Brain Change Model dementia care

The GEMS® model recognizes the dynamic nature of the human brain and its abilities. Unlike other cognitive models, it acknowledges that everyone’s abilities can change in a moment. Modifying environments, situations, interactions, and expectations will create either supportive positive opportunities or result in distress and a sense of failure. Just as gemstones need different settings and care to show their best characteristics, so do people. Rather than focusing on a person’s loss when there is brain change, seeing individuals as precious, unique, and capable encourages a care partnership and is the core of this model. Providing supportive settings for everyone, including care providers, allows them to use what they have to be their best. The GEMS® advocate that everyone living with brain change when given the opportunity will shine.
                           - Teepa Snow and Positive Approach® to Care Team 

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Aging in Place Brain Change dementia care

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Ruby ~ Deep and Strong in Color ~ Others Stop Seeing What is Possible

  • Makes use of rhythm: can usually sing, hum, pray, sway, rock, clap, and dance
  • When moving can’t stop; when stopped can’t get moving: needs guidance and help
  • Big, strong movements are possible, while skilled abilities are being lost
  • Danger exists due to limited abilities combined with automatic actions or reactions
  • Tends to miss subtle hints, but gets magnified facial expressions and voice rhythms
  • Can mimic actions or motions, but will struggle to understand instructions/gestures
  • Able to pick up and hold objects, and yet not know what to do with them

As the deep red of a ruby masks detail, my obvious losses make my remaining abilities harder to notice. Although my fine motor skills have become very limited, remember that I am able to move and do simple things with my hands. You will need to anticipate, identify, and respond to all of my needs, even though I may not be aware of them. Plan to create a supportive environment, help with the details of care, and structure my day. Just as a crossing guard directs traffic, you will need to guide my movements and transitions. I can rarely stop or start on my own and switching gears is a challenge. Move with me first, then use your body to show me what you want me to do next, going one step at a time. Hand-under-Hand™ assistance helps me to feel safe and secure and to know what to do. Danger is part of my life, due to losses in visual skills, chewing abilities, balance, and coordination. You can reduce the risks to me, but not eliminate them. I can still have moments of joy when you are able to provide what gives me pleasure. 

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Pearl ~ Hidden Within a Shell ~ Beautiful Moments to Behold

CAREGIVERS RECEIVE 8 HOURS’ DEMENTIA TRAINING

 Brain Change Model

The GEMS® model recognizes the dynamic nature of the human brain and its abilities. Unlike other cognitive models, it acknowledges that everyone’s abilities can change in a moment. Modifying environments, situations, interactions, and expectations will create either supportive positive opportunities or result in distress and a sense of failure. Just as gemstones need different settings and care to show their best characteristics, so do people. Rather than focusing on a person’s loss when there is brain change, seeing individuals as precious, unique, and capable encourages a care partnership and is the core of this model. Providing supportive settings for everyone, including care providers, allows them to use what they have to be their best. The GEMS® advocate that everyone living with brain change when given the opportunity will shine.
                           - Teepa Snow and Positive Approach® to Care Team