The gems© Approach
Different types of dementia have different expressions, especially in the early stages, but the general progression of these diseases tends to be very similar, especially as time goes on.
We need to know what capacities are strong and which are not – this will change over time and can shift within a day (!) – the progression is not predictable, and people can move in and out of different abilities/capacities from one hour to another
Being able to identify what ‘state’ someone is in can help us connect well – being able to gauge what we can expect, how we should adapt, etc.
Teepa Snow has developed a wonderful system for identifying ‘where people are at’ which we are using on this website. We introduce you to her system, and then expand and illustrate it so you can work with it for yourself. (better still, try and come to a Dementia Reframed workshop or run one for yourself and other carers in your location).
Teepa’s system is called GEMS. It is based on understanding how dementia affects someone’s ability to connect with us, and our ability to connect with them, and how this changes over time.
The GEMS are six precious gems! Five states are represented by a stone and the final stage is represented by a pearl.
'The GEMS® model recognizes the dynamic nature of the human brain and its abilities. Unlike other cognitive models, it acknowledges that everyone’s abilities can change in a moment. Modifying environments, situations, interactions, and expectations will create either supportive positive opportunities or result in distress and a sense of failure. Just as gemstones need different settings and care to show their best characteristics, so do people. Rather than focusing on a person’s loss when there is brain change, seeing individuals as precious, unique, and capable encourages a care partnership and is the core of this model. Providing supportive settings for everyone, including care providers, allows them to use what they have to be their best. The GEMS® advocate that everyone living with brain change when given the opportunity will shine.'