What is the Sente-Mente® Project
To whom it is addressed
The Sente-Mente® model is aimed at creating more well-being of all the people who are directly or indirectly involved in this path of Life (people living with the disease, caretakers and social-health professionals, family caregivers, volunteers, family assistants but also municipal administrations, Alzheimer associations, local associations, journalists ...)
A Therapeutic Organizational Model
The innovative aspect of the Sente-Mente® model lies in the identification and enhancement of the vital essence contained in each person.
Sente-Mente® trains people and social health organizations to move from helplessness to self effectiveness, thanks to a method which is capable of creating well-being both for the person living with dementia and for all the people involved in the process of care and assistance. The model allows to boost the social and health organizations involved towards the creation of new actions of assistance and care, and to continuously improve their organizational settings and procedures.
Sente-Mente® also supports the municipal administrations through a Pilot Project that lead them to become a "Sente-mente ®" friendly comunity of the people living with dementia "
From whom it was designed
The Sente-Mente® Project was created in 2014 by Letizia Espanoli, trainer in the social-health field who has been dealing with the therapeutic triad for over 30 years: family caregivers, professional caretakers and people living with the diagnosis of dementia. Throughout Italy, there are more than 80 “Felicitatori”, who are some Sente-Mente® Facilitators trained to support people and organizations in the implementation of workshops and seminars families caregivers or people who live with the disease.
Too often, family caregivers of people living with dementia feel abandoned with a diagnosis that leaves little room for hope. Professional caregivers sometimes experience a sense of helplessness, as they feel unprepared to face daily challenges. It is time to cast aside statements like, “There’s nothing you can do!” “He doesn’t understand anymore!” As a matter of fact, if it is true that memory and cognitive abilities decrease, the ability to perceive feelings and emotions - not only experienced by the person who lives with dementia, but also by those of the caregivers - remains intact until the end for people living dementia. Scientists proved in 2014 that life does not end with the diagnosis. People with dementia have the capacity to love, empathize and feel emotions even if they can’t express themselves in the ways we need. The Sente-Mente® Model restores an outlook of possibility – helping the caregiver view and nurture the vital core within their loved ones. This begins with new ways of thinking. We need to focus on the person living with dementia and the person’s preservation of dignity. The way we talk about a situation already creates an emotional frame : we can categorize a person as a demented elder or we can choose to talk about him/her as a person who lives with dementia. People are not their disease.
2. Positive psychology:
The positive psychology is a branch of psychology that aims to increase the resilience of people. The main idea is that not necessarily everything must be positive, but we cand choose to train ourselves to see the positive aspect out of a difficult situation when we are facing it. According to the studies of the greatest representative of this science, Martin Seligman (Pennsylvania University), we can improve the ability to cope with the changes, also taking advantage out of the most challenging situations. So it is possible, through some specific training, to develop the ability to change the way we look at a situation we experience and our way to deal with it, feeling directly responsible for the response we can choose to give to the event that occur in our lives, enhancing resilience, proactivity and gratititude for the good in our lives. Positive psychology is an important tool to help overcome the sense of acquired helplessness, especially after receiving a diagnosis of dementia that was presented as an aseptic description of the disease , which is usually what comes up with the prospect of an increasingly gloomy future.
The HeartMath University shows how to create a connection with our intuitive heart intelligence. When people develop this form of intelligence, they master their minds, manage their emotions and achieve a greater capacity to create positive changes in their own lives and in that of others. Several researches have shown that using heart intelligence leads to lower blood pressure, improves the nervous system, creates a hormonal balance and facilitates brain functions. More specifically, the research conducted by the HeartMath Institute has shown that the different patterns of cardiac activity (which accompany the different emotional states) have various effects on cognitive and emotional functions, influencing the way we perceive and react to the world. Cardiac coherence is the key concept of HeartMath®: when approaching a person suffering from dementia, it is very important to have a field in a state of coherence, especially considering their sensitivity in perceiving it. To experience feelings of the heart like love, compassion, gratitude,
4. Unconditional laughter:
One of the model’s strategies is unconditional therapeutic laughter. The effect of laughter goes straight from the body to the mind. It reduces blood pressure and cortisol levels and strengthens the immune system. It further benefits the bodymind by improving mood, self-trust and relationships. Unconditional laughter, along with singing, dancing and playing, is a "motor" to increase emotional intelligence. It is a good way to develop a greater capacity for mindful action respect to instictive reaction. It is a bridge that allows mind and heart to dialogue so as to find harmony and beauty. It is therefore a powerful tool for health which is quite useful and simple to train our emotional part. It also promotes teambuilding, sharing, understanding and complicity.
5. From the body to the mind, from the mind to the body:
Once the biomedical model of body-mind separation has been overcome, modern neurosciences and scientific studies of the last few years are moving towards an ever greater integration of these two areas. PNEI (psycho-neuro-endocrino-immunology) views the body and mind as one “bodymind,” in which thoughts determine the state of health or disease. Feeling helpless triggers a bio-chemical cascade of stress hormones. Continuously stimulating this “fight-or-flight” response modifies the “bodymind” physiology, harmfully effecting the cardiovascular, respiratory and immune systems. Recent studies show us the importance of the different techniques that can improve the quality of life (for example, improving the quality of our relationship, the practice of breathing techniques, a mindful contact and touch, focusing on a positive mind). Thoughts and emotions influence each other and we can choose to train ourselves to self-effectiveness and to a resilient attitude.
6. The contact with kindness:
"When you take or pinch someone's hand, the person touched may also feel all your emotions, brutality or sweetness, feelings, and intentions. This is the wealth of touch "(Savatofsky). Another component of the model is contact and touch. Our skin is the pathway to our world and emotions. Through contact and touch, we explore our environment, communicate, and build relationships with the world. Touch goes straight to the heart! Teaching caregivers to get in “con-tact” with themselves and with people they care for with kindness and “tact.” This is the first step to restore wellness and health in both caregivers and care receivers. Contact triggers the “bodymind” system with a cascade of happiness hormones such as oxytocin and endorphins. The release of these chemicals also works to hinder the harmful and cumulative effects of cortisol – the stress hormone. In this sense “Contact and Touch” are therapeutic and must therefore be considered to all effects a right of the person and performed with competence. Training caregivers to communicate with people living with dementia through a warmly eye contact relationship, bring kindness as a practice at all levels in an organization, develop an organizational culture of welcoming. Hands have always been used for healing, but in order to create a therapeutic healing. It is necessary to create a gentle care with-tact.
7. Special Behaviors:
Too many times we have said that people suffering from Dementia do not understand anything, that they are a problem, they are affected by behavioral disorders, they are agitated, aggressive ... But people living with dementia "feel". What if the behavioral disorders were a language? The desperate scream of people asking to be understood and not sedate? That's why new knowledge, new ideas, new visions are needed ...This the reason why behavior disorders are no longer to be seen as a symptom to be treated, but as a language and re-actions to be interpreted and listened to. The key idea of this pillar can be summarized in this statement: "Every behavior is a form of language, therefore a message!". Often the person who live with dementia, cannot express themselves verbally and explain the pain they experience. In this situation special behavior become an expression of pain and a way to communicate some discomfort. We should always keep in mind that emotions are not a disease, but they are the expression of an emotional intelligence that can turn out to be a bridge for a better understanding between caregivers and people living with dementia; and create new possibilities despite of the disease. “Welcoming, embracing and transforming their own emotions and other’s emotions” has to become the new paradigm for caregivers, and will erase the "therapeutic distances".
Why Sente-Mente® Day?
Up to five million Americans today suffer from dementia
a number that is expected to triple by 2050, as people live longer and the elderly population increases. Sente-Mente® is a revolutionary therapeutic organizational project aimed at the therapeutic triad: social healthcare professionals, families, people living with dementia.
Join us for this special day
Send an e-mail to firstname.lastname@example.org to confirm.
Dr. Letizia Espanoli, health and social consultant and trainer for public and private organizations, have some thirty years' experience in the domain of human fragility and Dementia and is the creator of the Sente-mente® model. She was inspired by Harry Urban's life writing her last book #lifedoesntendwithdiagnosis.
Harry Urban, has been living successfully with dementia for more than a decade (13 years). He has been working to establish mentoring programs for people diagnosed with dementia. Harry’s awareness of the strain on caregivers and his passion to help others is inspirational and motivating. He lives in Pennsylvania and is part of the scientific committee of the Sente-Mente® model.
Dr. Gayatri Devi MD is a neurologist who is a Clinical Associate Professor at New York University School of Medicine and an Attending Physician at Lenox Hill Hospital. Dr. Devi is the Director of the New York Memory and Healthy Aging Services. She is board certified in the specialties of Neurology, Psychiatry, Pain Medicine, Behavioral Neurology and Dementia. She is the author of “What your doctor may not tell you about Alzheimer’s Disease” (Time Warner Books; November 2004) and A Calm Brain: Unlocking Your Natural Relaxation System (Penguin Dutton Books, 2012).
I join hereunder a clearer explanation about what the Sente-Mente ® model is, but first let me explain why I have written to you an e-mail.
I hope you will read my letter to the end, watch the video that I sent you and, knowing what it is about, give me an answer or registering and be present to the event we are organizing in the USA.
In about 30 years that I spent in nursing homes, meeting people living with Dementia and their relatives, I often faced the despair and the sadness of the latter ones, talking about their loss and about the fact that their mom or dad, or their wife/husband did not recognize them anymore because of Dementia.
The video that I recorded and sent you, and that I would like you to watch, testifies just the opposite.
The man talking beside me in the video , Harry Urban a man from Pennsylvania who is living with dementia, is the best witness of how these people actually know who you are, despite they don't remember your name.
Yes, it's true, they did lose their cognitive capabilities, they may not remember names, but what I'm sure of, not only because I worked so much with these people but also because my dad too is living with Dementia, is that they don't lose, till their last breath, the capability to feel emotions and to feel other's emotions too.
I founded this model after having studied and experienced so much, and I know for sure that, in their heart, deep inside in people living with dementia there is still a hidden vital core. It's up to us to build bridges to reach them in their world. We have plenty of different ways to do this, no one of which passes through our cognitive part.
Having being raised in cultures in which cognitive understanding comes first, either you and me were being said that our relatives living with Dementia are, and are becoming more and more, hollow shells. Every relative of a people being diagnosed by Alzheimer's is being said from the doctors words of impossibility and mourning, as if their beloved ones were already dead.
Sente-Mente® model, instead, speaks words of possibilities, and trains every day not only healthcare specialists, but also relatives, ferrying them from a state of despair to a state of possibilities.
We are planning to organize in 2018 a Sente-Mente® day in the USA, just like the one we have been organizing for four years from 2014 on in Italy.
We would be pleased and honored if you would like to participate. The event will take place on April, 18th, in New-York.
Waiting from a kind reply from you, and wishing you all the best
A warm regard.
“New glimpses and new ideas for taking care of people living with Dementia and of their families”
On April, 18th, 2018, Directly from Italy, the Sente-Mente® model lands in New York!
And it lands thanks to an extraordinary event, an event which can make the difference for the creation of a new, young and revolutionary social healthcare and organizational system!
A model bringing the scent of new possibilities and new horizons in a scenario usually characterized by the drama of the Alzheimer's disease brought us by the media.
This model, named Sente-mente®, was created in 2014 by an intuition of Letizia Espanoli, health and social consultant and trainer for public and private bodies, having some thirty years' experience in the domain of human fragility and Dementia.
Dr. Letizia Espanoli's intuition arose from an emotion, which can grip your stomach and that it is impossible to deny and hide for a long time: indignation. Indignation, like a spark of opportunity, gave birth to the creation of this model!
Indignation for that negligence foreshadowing violence; for a bio medical and social and health stagnating and ignorant model which, supporting only primary cares and pharmaceutical therapies, lost its focus on people and on the vital core residing deep inside all of us. An indignation pulsating of urgency and change.
Life doesn't end after having received the diagnosis of Dementia! Nevertheless, the sentences spoken to most of the families in that case are: “There's nothing more to be done”; “You will become the mother of your own mother”; “Soon your wife will not recognize you anymore”.
The time has come to stop thinking about Dementia in a conventional manner! It's time to lead the social and healthcare system to the change dictated by the new researches of Neuroscientist’s in this domain.
Doctor Espanoli writes:
“The typical language of education in the social and healthcare world, that same process allowing people to acquire new knowledge but based only on “understanding” can't represent, alone, the basis of our growth. It is urgent to integrate it into the language of “change”, a language that doesn't make you learn, but let you live experiences. Because only experience can, in a while, change your way to “feel” things. It helps you to by-pass the cognitive resistance, because, sometimes, consciousness seems really to represent a limit to possibilities”.
The Sente-Mente® model is the method creating opportunities while all the social and healthcare world around us speaks about impossibility.
Welcoming the Sente-Mente® model means to change our point of view and to bring Dementia and their expressions out of the craving of doing, which is life-consuming. It means taking care of the existence. It generates Resilience.
A dehumanization of the interventions, a healthcare job focused only on bodies which are more and more compromised by the disease brought us more and more to take distances from the disease; the assistance cares based only on the body needs have brought to an increasingly emotional distance from the healthcare job.
In the Sente-Mente® model, people living with Dementia are not considered as empty jars on which we can stick the label of the diagnosis! They are much more! They are people having lost most of their cognitive capacities, but still able to feel and perceive emotions, up to the last instant of their lives.
People living with Dementia feel the emotions of all the people going along with them in their life path. Their hearts and a remote part of their mind will recognize their caregivers up to their last breath!
This is the vital core hidden in every one of us! This is the beauty of the rainbow of human fragility!
Transforming the healthcare world to make it more human means not only to pay more attention to the necessities and needs of the people we take care of, but also to cultivate the marvelous beauty of all the human beings, beginning from the caregivers themselves, who offer their cares.
«Our trip begins from where we are now! Every one of us has his/her life experience, which is unique. We leave to explore new possibilities and beauties within and outside ourselves”- Dr. Espanoli says.
These are the values that Sente-mente® aims to defend; and here are the words of the model manifesto:
“We believe in the everlasting presence of the vital and original "core" hosted in every man and woman, and we therefore engage ourselves to reveal it by our curiosity, to keep it by our kindness and to honor it by our strength. We believe in beauty and in the possibilities of human fragility, and we therefore engage ourselves to embrace, appreciate and transform it…”.
The Sente-Mente® model, being based on -and supported by- several Neuroscience researches recently issued, teaches that a life full of love and opportunities is still possible, even after having received a diagnosis of Dementia. We only need to refer to a simple but powerful instrument: relationship!
A relationship made of kindness, contact, respect of human dignity and of people independence is still possible, and represents the focus of the model itself; right this one, by its 7 pillars and 52 tiles, can ferry people, families and health care operator out of a of the condition of helplessness and lead them towards a new sense of self-effectiveness!
Leading families and operators out of the darkness and drama characterizing the Alzheimer's disease is possible! It is possible to stop adding new dramas on dramas, and allow on the contrary these people to regain their “voice”, their dignity and their place in the world. Testimonial of this model is Harry Urban, a man who has been living with dementia for 13 years, living in the Pennsylvania state. Notwithstanding his disease, he never gave up and never put apart his spirit and the vital core pulsating in himself. From years, he is yelling, through his Facebook profile, his motto: Life doesn't end with diagnosis!
Doctor Letizia Espanoli was inspired by Harry Urban's life writing her last book #lifedoesntendwithdiagnosis.
Together with Wendy Suzuky, famous Professor of Neural Science and Psychology in the Center for Neural Science at New York University, Harry Urban is part of the scientific committee of the Sente-Mente® model, and are promoting the first Sente-mente® event in the US: The SENTE-MENTE® Day USA.
The SENTE-MENTE® Day USA will be an exciting morning of study that will take place on April, 18th, 2018 in New-York.
Doctor Letizia Espanoli, Harry Urban and Wendy Suzuky will alternate to explain the seven pillars on which the Sente-Mente® model is based, and to color your vision of the Dementia by new possibilities and to share with all of you the best international practices about the taking care of fragile people, the support to their families and of the well-being of health care and relationship professionals.
“Feelings without memories in Alzheimer Disease”, Guzmán-Vélez E, et all Cogn Behav Neurol. 2014
“Transcending the Tragedy Discourse of Dementia: An Ethical Imperative for Promoting Selfhood, Meaningful Relationships, and Well-Being”, Reed P, et all AMA J Ethics. 2017.
“Living well with dementia”, Morgan J, Lancet Neural. 2017