Reflections on Gentle Persuasive Approaches
Following completion of the eGPA training modules, please review the following
video clips and respond to the associated.
Module 1 – Introduction to Personhood The focus of this module is understanding the person
first and the disease process second. Our examples will focus on personhood. Brenda Hounam
has been involved with the Alzheimer Society for a number of years to inform their policies and
advocate for those living with Alzheimer Disease.
Video 1: Gifts from Alzheimer Disease with Brenda
https://www.youtube.com/watch?v=5KhM2WfvSkY
(2mins)
Video 2: Tough Questions with Brenda
https://www.youtube.com/watch?v=KdHNhBJvKxw
(8mins)
Questions:
1. Outline three (3) things you have learned about Brenda’s personhood.
 Being able to live with her son and family and having a support system is added
benefits of her diagnosis of Alzheimer’s disease.
 Brenda is being able to do things that she hasn’t done before like travelling and she
is happy about that and meeting people and communicating with them.
 Brenda talks about life that how people are ungrateful for what comes the way in life
and how being grateful is most important thing we should enjoy each and every
moment in life.
2. Would you have a similar outlook to Brenda?
 I sure would have different perspective from Brenda. Sure it is all about accepting
the diagnosis and live with it but if was to happen to me it would have crushed me
because according to me my family and close ones will have to constantly check on
me and worry about me all the time and sooner or later I would loose my autonomy
which is something very important to me.
3. If you were her nurse, what do you think would be most important to Brenda?
 Looking at Brenda’s perspective, the most important thing to her is being able to live
with the family and getting all the love from grandchildren every day and been able to
stay with them and this is all possible because of diagnosis. Brenda talks about how
she is worried about the fact that as the time passes, she will not be able to
recognize her family and might hurt their feelings.
Module 2 – Brain & Behaviour Dementia, Depression and Delirium are often called the
“3Ds” or “Geriatric Giants”. They are extremely important for the clinician to identify and
support in the clinical setting.
Video 1: Alzheimers at 46: Living with Young Onset
Dementia https://www.youtube.com/watch?v=ZhCtM9QYyk8
(4mins)
Video 2: Why Dad isn’t Fishing anymore?
https://www.youtube.com/watch?v=DdhPfAnm4xo
(8mins)
Video 3: Screening Using the Confusion Assessment Method
Tool https://www.youtube.com/watch?v=r2yQIiNEnfU (1min)
Questions:
From these three videos:
1. What were some of the differences between dementia, depression and delirium?
 Dementia is a progressive cognitive disorder that affects the brain and is irreversible
while delirium is sudden onset that comes quickly and is often temporary, so it is
reversible with proper treatment and depression is a treatable medical illness.
2. Do you think the person from “Screening Using the Confusion Assessment Method” has
dementia or delirium?
 The person in the video has delirium because she is showing signs of delirium such
as she sees a dog which is not there, she is confused, and she starts talking in
Russian all of a sudden which are all signs of delirium and not depression.
3. What would be an important factor to differentiating between these two syndromes?
 Looking for specific signs helps finding out the syndrome. For example, person with
depression shows signs like loss of interest in any activities or hobbies, eating less
than usual, low energy levels, and difficulty concentrating on the other hand people
with delirium shows signs like changes in personality, seeing or hearing things that
are not there, feeling confused about where they are or what time it is, difficulty
remembering things and being sleepy or slow to respond.
Module 3 – The Interpersonal Environment We know that behavioural expressions can be
exacerbated by internal and external conditions. We are going to explore these conditions
further by looking as specific behaviours and general techniques to support the person.
Interventions will be more effective if they are grounded in Personhood.
Video 1: Shifting Focus: “I want to go Home!” https://www.youtube.com/watch?v=c4kLO7luTGs
(3min)
Video 2: Shifting Focus: “Sundowning” https://www.youtube.com/watch?v=y9RFhxK3pjs
(4min)
Questions:
1. Were the causes listed what you expected? Why? Why not? With both of these videos,
what do you believe was the main message?
 Yes, having an opportunity to work with people with dementia in clinical gave me and
idea of what could be expected or what are the causes. For example, fatigue and
confusion were causes related to person with dementia. Looking at both the videos,
it shows how important it is to fully understand the needs and situation of person with
dementia. The person with dementia is not just a disease to treat but it is a person
with feelings and expressions. It is very important to give them a environment in
which they feel safe and secure and to which they can say home. Often working with
people with dementia is challenging because one does not know how to respond and
so it becomes vital to understand their feeling and respond to what they want to hear
while delivering the information you need to deliver.
Module 4 – Gentle Persuasive Techniques Our goal is to understand when, how and why
to intervene when risk is associated with responsive behaviours. Keeping the person, their
peers and the care team safe is of great importance and care should be coordinated.
Debriefing is an important part of supporting responsive behaviours.
Video 1: Supporting Responsive Behaviours (Overall
Review) https://www.youtube.com/watch?v=do0vw_IDYf0
(38min)
Video 2: Teepa Snow – Challenging Behaviours:
https://www.youtube.com/watch?v=ZpXeefZ2jAM
(6min)
Questions:
1. How would you document the behavioural expression seen in Video 2?
 I would document her behaviour as her banging toy on chair and making sounds.
Even though I understand the reason why she might be doing what she is doing but I
have to document exactly what I can see so that other medical personnel looking at
her file knows if the behaviour is common or new.
2. In Video 2 Teepa Snow explains her way of understanding and interacting with someone:
what would you have done differently?
 I was very impressed with the way Teppa Snow made that a successful effort in
meeting the needs and finishing the task of going to the bathroom. If it was me, I
would have tried and talk to her about what she would like to do and give her
options, so she is distracted from making noise. Giving the options for other activity
say for example, I would say something like “Hey Leona, I need some help in the
ladies room and only you can help me, will you come with me please? I really
appreciate your help. You are very smart and hard working person I know so I come
to you to ask for help.”
3. What would be important information to share with your colleagues about the individual who
was observed in Video 2?
 Sharing Leona’s personal history will be vital for person taking care for her. Because
tepa snow knew what she did before she was here, she used to clean house and so
she was able to make that relatable to Leona and thus complete the task
successfully by distracting her. So, person’s background history becomes important
to know in order to take care or treat the person.