Trends in aging: Alzheimer's and dementia - Part 7: diamond stage

By Wendy McHaney
Dec. 27, 2013 at 6:27 a.m.

The first stage of actual dementia, or the diamond stage, occurs when cognitive changes are no longer normal.

We use the diamond as the gem to represent this stage because diamonds are still clear, but they are very rigid. A diamond can still do things as they always have, but they are going to struggle with new information.

Some basic characteristics of this stage are as follows:

• Diamonds can be rigid, hard and totally inflexible, but they also shine and can be perfectly fine.

They can do what they have always done, and they often get upset when things change.•  They have many facets, so it is possible that different people see different sides of a diamond.

•  Diamonds have trouble learning new information, but they can remember old stories.

At this stage, effective communication techniques are key. The following are tips for successful communication with a loved one in the diamond stage:

The phrase "I'm sorry" is the most important words you can use. It does not necessarily mean you did something wrong, but it is an opportunity for you to acknowledge that you have upset them and that they are still in control. •  Diamonds enjoy talking about the past because those are the memories they still have. Encourage talking about the past, as these stories will help as the disease progresses.

•  Never use the phrase "don't you remember?" The fact of the matter is they don't remember and pointing this out to them is not helpful.

•  Accept that there is a change taking place. Don't pretend that nothing is going on.

•  Ask permission. Diamonds want to still feel like they are the ones in control, so ask before you start a task.

Don't be the person who tells them "no" or what they should be doing. Instead, put the blame on someone else. For example, tell them they should take a shower today because the doctor said they need to have a shower every day.

Don't take away their hope and present changes as temporary. For example, use the phrase "just for right now." Although the change may be permanent, they do not need to know that.

Finally, planning activities and establishing a routine are important in the diamond stage. Activities should be organized into four categories: productive, leisure, self-care and wellness and restorative.

Examples of productive activities can include basic household chores like setting the table or doing laundry as well as volunteering.

Watching television, playing games and going to church are good leisure activities. Light exercise and salon appointments promote wellness and restorative activities can include regular naps and going for a walk.

My next column will discuss early to mid-stage dementia.

Sources: SH Franchising Senior Gems training materials

Wendy McHaney is a certified senior adviser and the owner and director of operations of Senior Helpers. For more information about Senior Helpers, visit



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