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“They call me DQ.”

Sue Paul has been an occupational therapist for over twenty years.  Early in her career, she realized there is a segment of the population that is largely neglected by our healthcare system.  Alzheimer’s disease seemed a hopeless diagnosis to any physical or occupational therapist proficient in rehabilitating clients through the use of conventional, traditional therapeutic approaches.  No one was even aware of the possibility of a “back door.”

So Sue pursued additional education, and in 2001, became a board certified geriatric specialist through the American Occupational Therapy Association.  Since then, she has collected and categorized behaviors and skills unique to each stage of dementia, and has initiated new interventions to benefit both the patient and the caregiver.

Sue is both a teacher and a student of the evolving body of knowledge pertaining to the causes, symptoms, and treatments of Alzheimer’s disease and other dementias. Her experience and insight into this crippling condition, along with her ability to talk about it in a clear, passionate way, has established Sue as a sought after speaker, expert guest and advocate.

  • Congressional and Community Ambassador, Alzheimer’s Association of Greater Maryland
  • TV guest on programs such as the Hope Network’s live television talk show, “Go Healthy for Good”
  • Guest speaker at the Alzheimer’s Association Dementia Care Consortium and in Community Conversations, a focus group targeting ways to improve early diagnosis and intervention of Alzheimer’s patients in Maryland.
  • Radio guest on  “Alzheimer’s Speaks,” where she offered tips and advice to listeners who are caring for someone with Alzheimer’s disease.
  • Writer and author of weekly posts on her blog The Dementia Queen (https://www.thedementiaqueen.com), and publications on MariaShriver.com and the Huffington Post.

Sue leads the day-to-day operations of Baker Rehab Group and Baker Driving Rehab, both in Frederick, MD.  Please feel free to contact her anytime at sue.paul@bakerrehabgroup.com or dq@thedementiaqueen.com.








  1. Hi Sue,
    Can I have your thoughts of the value of psychosocial approaches , when supporting and working with a person living with Dementia, relating to their retention of emotional memory.
    I think more can be understood and put into useful and effective psychosocial approaches with the person as a unique individual, if we can have a positive approach and understanding of emotional memory.
    Thank you for reading and if you can respond that would be most welcomed.

    • Hi Graham,
      This is a great question, but one I might not be qualified to answer. My “thoughts on the value of psychosocial approaches, when supporting and working with a person living with Dementia, relating to their retention of emotional memory” would be that I see tremendous value in them.

      Speaking specifically to the retention of emotional memory, I would note that implicit memory circuitry (emotional responses to subconscious thoughts) is very complex. Positive intentions don’t always lead to positive results in terms of eliciting emotional memory- there are things like fear conditioning, post-traumatic stress, and confusing social contexts that might not result in a good experience for a person with impaired circuitry… kind of like poking the bear.

      The amygdala and hippocampus, key players in the emotional memory circuit, are neighbors in the brain and are very susceptible to damage from Alzheimer’s disease. This is partly what is so upsetting to family members caring for a loved one with dementia who seems to morph into a completely different person, “He was never like this. He always enjoyed the outdoors. Now he won’t even open a window.” And the more the family tries to convince him he really loves the outdoors, the more stress and anxiety this can produce, because he doesn’t remember that quality about himself and it simply isn’t true anymore. Emotion and memory circuitry just isn’t always reliable.

      Sorry, I’m off topic…

      There are many psychosocial approaches that have been useful in helping people living with dementia cope with the stress of memory impairment and loss of introspective skills- reality orientation, cognitive-behavioral therapy, reminiscence therapy- I think these approaches honor “personhood” and facilitate the person having contact with their own identity. This subject gets very deep and complex (Erikson, Jung, Freud- these guys are way smarter than me and this is really outside my area of expertise) but I agree that at least a rudimentary understanding of psychosocial approaches is a very valuable tool for caregivers.

      The bottom line is this…

      I think people, the demented and the non-demented, like to be recognized…to be really seen, and appreciated, understood, and valued. Eliciting those feelings of recognition and value are not dependent on memory- those feel-good neurons are accessible well into the disease process. And I don’t think being able to provide quality psychosocial interventions requires a PhD in psychology. Reality orientation or reminiscence has its place in decreasing stress from confusion, and cognitive-behavioral therapy is useful for managing behaviors and fear. But at the end of the day, I think we really just need to slow down, make eye contact, find a way in, compensate for the deficits, and give safe touches and firm affirmations… and honor their sense of personhood.

      Amen 🙂

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