SUBMISSION FORM FOR PRESENTATION PROPOSALS

The deadline for submissions is DECEMBER 10, 2018

 

Thank you for your interest in submitting a proposal to present at the 2019 Re-Imagining Dementia conference. Session/workshop proposals should reflect the theme of the conference - fostering attitudes and practices that Engage, Empower and Enable the lives of individuals with dementia. Proposals are being accepted for 90-minute concurrent sessions or 3-hour workshops.

   

PRESENTATION & SPEAKER CRITERIA

1.    Higher consideration for acceptance is given to presentations that include individuals and care partners living with dementia.

2.    Sessions/workshops must be presented in an interactive, engaging format. PowerPoints are permitted but should comprise no more than 50% of the presentation.

3.    Because of the importance of interaction with the audience, please ensure that your proposal includes at least 15 minutes or longer for Q & A engagement.

4.    Session/workshop speakers should provide practical and useful techniques, information, and/or tools that engage, empower and enable individuals living with dementia.

5.    Session/workshop speakers must register for the conference and provide their own laptops if electronics are needed for the session/workshop. Projectors, screens and mics are provided.

SUBMISSION CRITERIA  

If you are an individual with dementia who would

like to submit a proposal to present at the conference, please contact Karen Love at karenlove4@verizon.net for assistance with the submission process.

 

 

Each presentation proposal must have a unique username and password.  If you are submitting more than one proposal, you need to create a unique username and password for each proposal.
Username: Password:
 
You may continue to work on your proposal at a later date prior to the submission deadline.  Enter you username and password below IF YOU ARE RETURNING TO YOUR SUBMISSION.
Username: Password: Load Data


All fields in the submission form must be completed to be accepted.  The first speaker listed in your submission will be considered the primary contact for your session.  Please note that a resume or curriculum vitae must be submitted for each speaker before the submission is considered complete.

 

QUESTIONS?

Questions about the submission process? Please contact Misty Frank at misty@optplanning.com. Questions related to your proposal? Please contact Karen Love at karenlove@daanow.org.

 

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You may print a copy of your proposal at any time by

clicking PRINT at the end of the submission form.

SESSION/WORKSHOP CATEGORIES - Submissions are encouraged for all residential, community and other care settings – home, home care, adult day, assisted living and memory care, nursing home, acute care, rehab, hospice.

Select one category for your proposal -

Select one category CATEGORIES CATEGORY DESCRIPTION
Changing the Status Quo

Dementia is beset by widespread, societal misperceptions and stigma which harmfully affect the lives of people and care partners living with dementia.  Outdated perceptions and practices, such as pathologizing behaviors, assuming they cannot manage or learn new things, and thinking everyone is the same, remain the status quo. 
How are you changing the status quo of perceptions and practices of living with dementia in your family, community, organization, business, state/national association?

Engaging Local Communities in Dementia Inclusivity

Many community efforts are underway at local and state levels aimed at increasing understanding and knowledge about living with dementia.  Some efforts bring people together in social settings such as Memory Cafes.  Other efforts follow a template with technical assistance such as Dementia Friendly America and Dementia Friends.  These efforts are helping dispel misperceptions and stigma about living with dementia. 
How are you successfully engaging your community?
Enhancing Life with Dementia through Technologies

Innovative technologies are increasingly enhancing the lives of individuals and care partners living with dementia.  Please specify if your technology is in the marketplace or in development.
How is your innovative technology enhancing lives?
Nurturing Creative Expressions through the Arts

The Arts, such as painting, drawing, watercoloring, pottery, woodworking, photography, and writing, can be great creative outlets and bring purpose and meaning for individuals living with dementia. 
If you are living with dementia, how are you using Arts to enhance your life?  If you are supporting an individual(s) living with dementia, how are you using Arts to enhance their lives? 

Optimizing the Well-Being of Individuals Living with Dementia

Person- and relationship-centered practices support holistic well-being through attention to all dimensions of human needs – physical, social, emotional and spiritual. 
How are you helping enable individuals living with dementia to retain their self-worth and value, be as independent as possible, live proactively, and maintain their important social connections?
Promoting Ways to Support Care Partners' Well-Being

Care partners* are an essential and vital part of supporting an individual(s) living with dementia.  Care partnering can be physically, emotionally and/or socially challenging that can create taxing and draining situations. 
As a care partner, how are you supporting your well-being? 

*Care partners include family members, friends, and direct support service providers.

 

TYPE OF PRESENTATION


SESSION/WORKSHOP TITLE (limited to 15 words)


Words remaining:

SESSION/WORKSHOP DESCRIPTION (limited to 150 words)
The description of your session/workshop will be utilized to evaluate the overall value, impact, applicability and interest of your session. If your proposal is accepted, the description will also be used to describe your presentation on the website and in the program brochure.


Words remaining:

SESSION/WORKSHOP ELEMENTS

SPEAKER – List the name of the speaker.

OBJECTIVES – List measurable objectives starting with action words such as Apply, Analyze, Create, Compare, Define, Discuss, Evaluate, Interpret, and Plan.  Avoid using non-measurable words such as Learn or Understand. Each session/workshop must include 3 or more objectives.

PRESENTATION CONTENT – Describe content of information speaker will cover.

TEACHING METHOD – Identify type of method (e.g., discussion, panel, interactive audience participation, group exercises, questions & answers, use of the arts, role playing, etc.).

TIME ALLOCATION – List the amount of time allocated for each speaker.

OUTCOME – Identify what outcome(s) attendees will gain from speaker (e.g., knowledge, skills, application, other-please describe).
 

Speaker Objective(s) Presentation Content Teaching Method Time Outcome

SPEAKER BIOGRAPHICAL INFORMATION [This information needs to be completed for each person who will be a presenter in the session/workshop.]

First Name:
Last Name:
Title:
Organization / Affiliation:
Address: Office
Address 2:
City:
State:
Zip:
Country (if other than USA)
Phone:
Country Code (if international):
Cell Number:
Email Address:

SPEAKER ACCOMMODATIONS

Please indicate below any special accommodation(s) needed by speakers (e.g., special seating for vision limitations, navigation/escort to presentation, sound/noise sensitivity).

SPEAKER EDUCATION

Please include basic preparation through highest degree earned.

Institution #1:
(Name, City and State)		 Degree:
Major Area of Study: Year Awarded:
Institution #2:
(Name, City and State)		 Degree:
Major Area of Study: Year Awarded:
Institution #3:
(Name, City and State)		 Degree:
Major Area of Study: Year Awarded:


SPEAKER’S EXPERTISE/EXPERIENCE  (limit to 50 words)

Please provide a brief summary of your qualifying expertise and/or experience for the subject matter you are presenting.


Words remaining:

CLICK HERE TO UPLOAD YOUR RESUME OR CV

CLICK HERE TO ENTER INFORMATION FOR SECOND SPEAKER

First Name:
Last Name:
Title:
Organization / Affiliation:
Address: Office
Address 2:
City:
State:
Zip:
Country (if other than USA)
Phone:
Country Code (if international):
Cell Number:
Email Address:

SPEAKER ACCOMMODATIONS

Please indicate below any special accommodation(s) needed by speakers (e.g., special seating for vision limitations, navigation/escort to presentation, sound/noise sensitivity).

SPEAKER EDUCATION

Please include basic preparation through highest degree earned.

Institution #1:
(Name, City and State)		 Degree:
Major Area of Study: Year Awarded:
Institution #2:
(Name, City and State)		 Degree:
Major Area of Study: Year Awarded:
Institution #3:
(Name, City and State)		 Degree:
Major Area of Study: Year Awarded:


SPEAKER’S EXPERTISE/EXPERIENCE  (limit to 50 words)

Please provide a brief summary of your qualifying expertise and/or experience for the subject matter you are presenting.


Words remaining:

CLICK HERE TO UPLOAD YOUR RESUME OR CV

CLICK HERE TO ENTER INFORMATION FOR ADDITIONAL SPEAKER(S)

First Name Last Name Title Organization Email Address

SPEAKER’S EXPERTISE/EXPERIENCE  (limit to 50 words)

Please provide a brief summary of your qualifying expertise and/or experience for the subject matter you are presenting.


Words remaining:

CLICK HERE TO UPLOAD YOUR RESUME OR CV

First Name Last Name Title Organization Email Address

SPEAKER’S EXPERTISE/EXPERIENCE  (limit to 50 words)

Please provide a brief summary of your qualifying expertise and/or experience for the subject matter you are presenting.


Words remaining:

CLICK HERE TO UPLOAD YOUR RESUME OR CV

First Name Last Name Title Organization Email Address

SPEAKER’S EXPERTISE/EXPERIENCE  (limit to 50 words)

Please provide a brief summary of your qualifying expertise and/or experience for the subject matter you are presenting.


Words remaining:

CLICK HERE TO UPLOAD YOUR RESUME OR CV

First Name Last Name Title Organization Email Address

SPEAKER’S EXPERTISE/EXPERIENCE  (limit to 50 words)

Please provide a brief summary of your qualifying expertise and/or experience for the subject matter you are presenting.


Words remaining:

CLICK HERE TO UPLOAD YOUR RESUME OR CV

First Name Last Name Title Organization Email Address

SPEAKER’S EXPERTISE/EXPERIENCE  (limit to 50 words)

Please provide a brief summary of your qualifying expertise and/or experience for the subject matter you are presenting.


Words remaining:

CLICK HERE TO UPLOAD YOUR RESUME OR CV

AUDIO/VISUAL EQUIPMENT

All rooms will have an LCD projector, screen and microphones.  Speakers are responsible for providing their own laptop computer.


Click here to PRINT your proposal information.
 

By submitting, you acknowledge all speakers are responsible for their own travel, hotel arrangements/fees and costs, conference registration and that no speaker fees or honorariums are provided.  You also agree to provide electronic copies of session/workshop handout materials by JUNE 6, 2019.

Click here to SAVE your proposal information to continue working on later.

Click here to SUBMIT your proposal submission for review.  NOTE: you cannot return to the proposal after submission.