"GEMS States," developed by Teepa Snow, helps us see what skills remain and how we can support those skills. It simplifies a very complex process of rating dementia progression and turns it into a structured, more humanistic approach that in turn will enable better care for those living with dementia. "GEMS States" is a system that everyone can use, where all caretakers and family members can identify the stages and discover the best way to approach and communicate with someone living with dementia. "GEMS States" can change throughout the day. As a person is faced with different settings, tasks and people their ability to respond and understand will change as expected or be completely unexpected. Understanding other triggers like tiredness, stress or pain levels and emotional state will all contribute to better caring outcomes. There are 6 stages of "GEMS States." The 1st stage, Sapphire, which is most commonly associated with the normal aging process, healthy brain functions and optimal cognitions. This stage will then progress and develop into the 2nd stage, the Diamond.
The Diamond stage is the first time we see noticeable characteristics that are outside those associated with the normal aging process. The brain may be clear and sharp during this stage and can often be difficult to tell whether or not someone is being difficult or stubborn or if they are in fact having changes in their cognitive abilities. The following are warning signs or traits considered to be in the second stage of the "GEMS States." If they become very rigid and inflexible in how they like things, do things or want things. If they are less aware of boundaries, using vulgar language, racial slurs or being cruel. If they believe they are the center of what is going on and not caring about the needs of others. If they undergo changes or new routines they find it very difficult and tend to focus heavily on money, finances and expenses to help cope. If they primarily only respect those people in positions of authority and always like to speak with the boss or manager. If someone asks the same questions, tells the same stories multiple times or is unable to remember specific words or nouns and commonly has to ask others to finish their train of thought. If they are very good at holding a conversation for a short period of time or having "surface level chit-chat" but cannot maintain conversation for long periods. This will make it difficult for those they are communicating with to be able to recognize any loss of language skills or problem solving skills during such short conversations.
If these characteristics and traits sound familiar to you or remind you of a loved one, they might be in the Diamond "GEMS States" stage. Some recommendations and tips to help your loved one in this stage are to first and foremost, stop arguing with your loved one. You will need to put aside the need to feel like you are right and give up reality orientation and instead just apologize and be a supportive friend to your loved one.
For further information on"GEMS States" and how to communicate and support those living with dementia please visit us at the Trublu Confidence in Dementia Care website linked below to learn more.
Cheryl Doyle
Trublu Confidence in Dementia Care