Transcript Presenting Academic Work - Ulster University Faculty of

Interpersonal skills and
collaborative team working,
in supporting persons
with dementia and their family.
Pat Deeny
Structure of Session
 Key facts about communication and
people with dementia.
 Communication needs of people with
dementia.
 CONCERNS regarding communication.
 FAMILY needs in relation to
communication.
 Activity and reflection.
Key facts.
 Alzheimer's disease and Vascular dementia
diminish ability to communicate.
 People can feel isolated from the social world.
 Apathy and social withdrawal develop.
 Family burden is increased due to language
deficits, communication issues and problem
behaviours.
 Quality of life for all is strongly influenced by
communication and social relationships.
(Haberstroth et al, 2011)
Communication needs.








feel a real sense of identity and dignity.
lead on the conversation for once!
have non-verbals, eye contact attended to.
feel a sense of belonging, have a laugh, fun; to
participate in social activities, dance, sing, poetry.
be consulted and not always be ‘tested’.
experience touch as before, hugs and kisses.
appreciate the natural environment and the arts.
sit in silence, pray and be spiritual.
CONCERNS
 C: Comprehensive Care Plan that takes full
account of personal biography (memory box\life
history); everyone must read this plan and\or be
familiar with the memory box.
 O: Observe first. Wait!!! Only start the
conversation if you think the person really needs
prompting.
 N: Non-verbal and eye contact. Most
communication is non-verbal. Use it.
CONCERNS
 C: Choice and participation. Facilitate choice in
relation to little but important things i.e. clothes,
food… encourage social participation, dance,
music, good craic.
 E: Expressive touch. Shaking hands, normal
greeting, touch back of hand, fore-arm and
shoulders, kiss on cheek and hug when
appropriate (refer to life history, culture, gender
and preferences).
CONCERNS
 R: Rapport. Very individual, wait for rapport to
develop. Speak slow and clear but NOT too slow.
avoid complex sentences.
be aware of ‘personal space’.
reflect the person’s non verbals, eye contact,
smile, laugh, sing...
don’t have too many items at once, wait for reply,
Know slang words or colloquial descriptions.
CONCERNS
 N: Natural environment. Use the natural
environment in communication,
plants/flowers\insects/animals/ provide a sensory
experience.
 S: Spiritual. Sitting in silence, appreciating the
person’s identity, an awareness of the person’s
background, being able to talk about the person’s
life, the arts, listening to music, reading, poetry,
talking books, religion, saying prayers or reading
Bible, reading Koran, using prayer mat.
S: Spiritual (reminiscence)
Relationships
The natural
environment
SPIRITUALITY:
is ultimate meaning mediated
through
Religion
The arts
MacKinley and Tevitt, 2010, p 396
FAMILY needs.
 F: Feelings of loss: Carer feelings of loss, a
feeling that he\she has ‘already gone’, the long
good bye.
 A: Adapting to guilt and isolation: prevent
distress, fatigue and exhaustion, promote tolerance
don’t expect acceptance.
 M: Meeting as a group: Group meeting with
Alzheimer's Society very helpful. Needed to
beginning planning care rota. Recognise that there
will be ‘conflicts’ within families. Begin discussion
on, resuscitation and enteral feeding.
FAMILY needs.
 I: Information on communication issues:
families need assistance and advice regarding
communication. Information about ‘illusions’ and
how to react.
 L: Listening not talking: Family need to see
themselves as; equal partners in decision-making
and have their concerns listened to. No ‘power
plays within Multidisciplinary Team’.
Don’t be patronising!!! More listening than talking.
FAMILY needs.
 Y: Yīnyáng. It is all about balance, about creating
space to find meaning, being holistic and spiritual.
Recognising that the person with dementia will
have ‘good days ‘ and ‘bad’ days’. Continue
engagement with the natural environment, the
seasons, human relationships. Use the arts and
religion to foster this.
Preliminary conclusions
 Need for improved understanding of interpersonal
communication issues in dementia.
 Greater awareness of the CONCERNS.
 Improved awareness of FAMILY needs.
 Everyone needs to ‘reflect’ on communication.
“the little things matter”
“be more holistic”
“think spiritual and you will be”
The mask!
 Did you know the word ‘person’ comes
from the Latin persona which means
“mask”?
The mask activity
 Groups of four.
 First person wears a mask throughout. This
person has dementia (late or early stages).
 He/she begins tells a ‘mixed up’ story in the
present tense (5 mins). Can be about
anything..a birthday party..a special day. Maybe
his\her own birthday, we don’t know. Use
colloquial words. Laugh, cry, sing, what ever
emotion is appropriate. Everything must make
total sense to the person with the mask. Have
an illusion if you wish. Talk about life, your life!
The mask activity
 The second and third person take the role of the
family (daughter/ son). Both listen to the person
with the mask. It is Ok to be unsure, a little
anxious, puzzled.
 The fourth person takes the role of the health
professional , quietly listening\observing
everyone, taking notes, may prompt on ideas i.e.
eye contact, expressive touch.
 After 5 minutes everyone stops and gives
feedback. What did you learn?
Useful Reading
 Haberstroh J, Neumeyer K, Krause K, Franzmann J, Pantel J, (2011)
TANDEM: Communication training for informal caregivers of people
with dementia.: Aging & Mental Health 15 (3) pp. 405-13.
 Hammar LM, Emami A, Engström G, Götell E, (2011) Communicating
through caregiver singing during morning care situations in dementia
care. Scandinavian Journal Of Caring Sciences 25 (1) pp. 160-8
 Mackinlay E and Trevitt C,(2010) Living in aged care: using spiritual
reminiscence to enhance meaning in life for those with dementia.
International Journal Of Mental Health Nursing 19 (6), pp. 394-401
 Siemens I, and Hazelton L, (2011) Communicating with families of
dementia patients: practical guide to relieving caregiver stress.
Canadian Family Physician. 57 (7) pp. 801-2