Teepa's GEMS® Brain Change Model

Summary

This script discusses the progression of cognitive diseases, advocating for a shift in perspective from focusing on losses to recognizing the remaining abilities of individuals. It introduces a metaphorical 'gem' scale to describe six cognitive levels, each represented by a unique gemstone, to help caregivers provide appropriate support and care. The speaker emphasizes the importance of understanding each stage's characteristics to enhance the quality of life for those affected, encouraging a compassionate and positive approach to dementia care.

Takeaways

• 🔍 The script emphasizes the importance of focusing on the abilities and strengths of individuals with cognitive impairments, rather than solely on their losses and limitations.
• 💡 It suggests reframing the way we perceive and discuss the progression of cognitive diseases by shifting from a negative to a positive perspective, highlighting what individuals still possess.
• ⚖️ The speaker critiques existing scales that measure cognitive decline, arguing they are too focused on the negative aspects and overlook the remaining capabilities of the person.
• 💎 The concept of 'gems' is introduced as a metaphor for the different stages of cognitive impairment, with each gem representing a unique set of abilities and characteristics.
• 🔵 'Sapphire' is used to represent the care provider's role, emphasizing the need for flexibility, understanding, and support to help the individual 'shine'.
• 💠 'Diamond' signifies a stage where individuals are clear and sharp but inflexible, requiring a careful approach to care that respects their routines and habits.
• 💚 'Emerald' represents a transitional phase where changes are noticeable, and individuals may struggle with clarity and direction, necessitating patience and understanding from care providers.
• 🟠 'Amber' symbolizes a stage where individuals are caught in a moment of time, with a focus on immediate sensations and a lack of safety awareness, requiring vigilant care.
• 🔴 'Ruby' indicates a stage of significant change where fine motor skills are lost, and individuals rely on gross motor movements, requiring care that accommodates their strength and rhythm.
• 🌊 'Pearl' is the final gem, symbolizing the end stage where individuals are deeply affected by the disease but still possess an inner value and beauty that can be revealed with the right care.

Q & A

What is the main message the speaker is trying to convey about progression of diseases like dementia?

The speaker emphasizes that the focus should not solely be on the losses that occur with disease progression, but also on the remaining abilities and opportunities for individuals to shine. They advocate for a shift in perspective from viewing people as numbers or stages to appreciating their uniqueness and preciousness.

Why does the speaker criticize the existing scales used to measure cognitive decline?

The speaker finds existing scales depressing because they overly emphasize future losses and negative aspects of the disease, rather than the current abilities and strengths of the individual.

What alternative approach does the speaker suggest to understand individuals with cognitive decline?

The speaker suggests viewing individuals as 'gems' with unique characteristics and qualities, much like different types of precious stones, each having its own value and beauty.

What are the six 'gems' the speaker uses to represent different cognitive states?

The six 'gems' are Sapphires, Diamonds, Emeralds, Ambers, Rubies, and Pearls, each representing a different cognitive state with unique characteristics and challenges.

How does the speaker describe the Sapphire state?

Sapphires represent a flexible and organized brain that is not experiencing the changes associated with dementia. They are the care providers who need to be adaptable and supportive to help other 'gems' shine.

What challenges are associated with the Diamond state according to the speaker?

In the Diamond state, individuals are clear and sharp but rigid, resistant to change, and may unintentionally hurt others due to their inflexibility. They are good with habits and routines but struggle with new situations.

What does the Emerald state signify and what are its challenges?

The Emerald state signifies a change where individuals are no longer clear and sharp. They may be confused about time and place, make mistakes, and struggle with tasks, often being unaware of their flaws.

How does the Amber state differ from the others, and what are its key features?

Amber represents being caught in a moment of time, focusing on immediate sensations without caution or safety awareness. Individuals in this state may act impulsively and inconsistently, often exhausting care providers.

What are the characteristics of the Ruby state as described in the script?

In the Ruby state, individuals have lost fine motor skills but retain gross motor strength. They may have difficulty with visual tasks, chewing, swallowing, and speech, yet they still have a connection to rhythm and music.

Why did the speaker choose the Pearl as the final gem to represent the end state of cognitive decline?

The Pearl represents the end state where, despite the outward signs of the disease being 'ugly' like an oyster shell, there is still an amazing gem inside. It signifies that even at the end of the disease, the person's essence remains valuable and precious.

What is the speaker's ultimate goal in using the gem analogy?

The speaker's goal is to encourage care providers and society to see the value and uniqueness in individuals with cognitive decline, to provide the right care and support so they can continue to 'shine' despite their challenges.