My dementia knowledge revolves around the end of life process. I know it is a symptom of various diseases rather than a disease itself. I know that as we get old our mind naturally has bits of dementia— memory loss being a major “old age” symptom.
I know that dementia doesn’t play by the rules of approaching death. The guidelines relating to food, sleep and sociability don’t fit with dementia. I know that I am seeing and interacting with more situations that involve dementia than I have in my many years of healthcare. I know that almost everyone I know has someone living with various stages of dementia. I know as we age we fear it and I know that most of the why’s and what-to-do’s aren’t really understood yet.
I am friends with Mary Anne Oglesby-Sutherly. She is the author “Remember for Me,” a dementia doula and has developed a course to train others to be dementia doulas. In one of my conversations with her she mentioned The Gems of Dementia. I had not heard that term before so I asked Mary Anne for help, and did a bit of research myself.
The term and concept of The Gems of Dementia was created by Teepa Snow. They are now used by many in categorizing “levels” of dementia.
This is such important information and so simple to understand that I am sharing highlights in this blog. It doesn’t really fit into end of life education until it does. I think these gems can be helpful.
The premise is all the jewels we love are different. They are shaped differently, colored, and, most of all, hold a beauty that we need to nourish and care for. So it is with people with dementia.
The Gems of Dementia assign a gem to a stage of dementia. It isn’t so much about the qualities we associate with a particular gem as it is using a name to identify dementia’s possible progression. I’m going to qualify this statement and say not everyone plays by the rules. Not everyone with dementia will follow the gems outline BUT many will. It is like the signs of approaching death. Some people do everything, some do none, but most people do at least some of the things that lead us to see death is approaching.
These gems are guidelines, not concrete. Each gem represents symptoms. I want to use “stages”. That’s not quite right, but does give us an idea of how dementia progresses.
Here are the Gems in order of symptom progression. I have just put a couple of the guidelines to give you an idea of what each represents.
Sapphires, Diamonds, Emerald, Ambers, Rubies, Pearls
Sapphires: normal aging, no changes in cognition, just seems to take longer to adjust to new things
Diamonds: prefers the familiar, may have difficulty with change
Emeralds: may have challenges with communication and comprehension
Ambers: focused on sensations such as touch and smell, may be impatient
Rubies: losing motor skills, limited visual awareness
Pearls: end of life approaching; problems swallowing, hard to get connected.
Obviously the above just scratches the surface of dementia and how it unfolds. Go to Teepa’s website for more detailed information. https://teepasnow.com.
My hope is that I have planted a seed of thought. If dementia is in your life or the life of someone you care about, this information may be helpful. FYI: End of life work begins when the loved one is adorned with pearls.
Something More… about Do You Know About The Gems of Dementia?
If your special person is nearing end of life, my booklet How Do I Know You? Dementia At End of Life will help you navigate the dying process.
Here is what Diana C. had to say about the booket: My husband has Stage 3 Alzheimer’s with severe aphasia. So his speech is not understandable. Your book has opened a door for me and given me much hope.