Conversations with Care Homes

Conversations with Care Homes

Conversations with care homes a series by My Home Life England 

‘Conversations with Care Homes’ is a series by My Home Life England (MHLE). In Episode 7 we focus on how best to support care home residents living with dementia during COVID-19. The pandemic has posed additional challenges for those living with dementia – for example the disruption of familiar routine, the need to socially distance and wash hands more regularly, and the impact of staff wearing more PPE. We share stories, tips, methods and signposting for how best to support residents living with dementia at this difficult time.

You can see more Videos from My Home Life here >>

A message from My Home life to the care home community:

You are doing an incredible job in challenging circumstances. You continue to make such a positive difference to people’s lives – thank you. We see you, we appreciate everything that you are doing, and we want you to know that My Home Life England is always here for you. Keep up your fantastic work and please do get in touch if you are able, we’d love to hear from you.

Please get in touch! If you have any stories to share, please contact us at mhl@city.ac.uk or call 02070405776 For more information about My Home Life England, please visit our website or find us on Twitter & Facebook – @myhomelifeuk

About My Home Life 

My Home Life was founded in 2006, by National Care Forum in partnership with Help the Aged (now Age UK) and City, University of London.

It is a social movement for quality improvement in care homes that has spread nationally and internationally.

The success of My Home Life lies in our four evidence-informed guiding principles: Developing best practice together, Focusing on relationships, Being appreciative, and Having caring conversations.

“A diagnosis of dementia for a person is also a diagnosis for the whole family.”– Four letters that make communicating with a person with dementia more real.>>

Meaningful conversation is one key to happiness

Talking makes people happy.

When my mother was in the care homes she lived in for the last seven years of her life, I was keen to ensure that she was engaged in meaningful conversation by carers as much as possible, so that when the family could not be there, she felt stimulated and happy.

She had dementia and I observed was that the more advanced her dementia became, the less staff were likely to engage in conversation with her. Often this was because the younger carers had no training in how to start or maintain a meaningful conversation with a person living with more advanced dementia – and of course, their life experiences were so different. It was this observation that largely prompted me to develop Many Happy Returns conversation trigger cards and REAL Communication workshops.

The workshops focus on a range of communication issues, including overt and unspoken language, body language, voice, tone and inflection, the complexities of memory and how it works, compassion and empathic engagement, why listening is so important to us all and how to do it better and the vital importance of a person’s life story and why it matters quite so much to any older person with dementia as well as those caring for them.

Self-care is part of communicating with oneself and more awareness of this and of self can help reduce the well-documented incidences of professional and unpaid carers’ burn-out.

As far as I know, there are no other conversation trigger cards like ours, which include carefully researched images from social culture with contextual background information and conversational prompts. Our REAL Communication workshops are unique. Both are based on research evidence. The following research results contribute to our work.
According to research from Washington University in St. Louis and the University of Arizona, outgoing, gregarious people who fill their lives with deep, meaningful conversations are lucky to have one of the keys to a happier life.


People who spend less time alone and more time talking with others have a greater sense of personal well-being, suggests the study, published in the journal of the Association for Psychological Science.

 

“Having more conversation, no matter how trivial, appears to be associated with a greater sense of happiness among the people in the study,” 

“Having more conversation, no matter how trivial, appears to be associated with a greater sense of happiness among the people in the study,” co-author Simine Vazire, PhD, assistant professor of psychology in Arts & Sciences at Washington University.However, the happiest people were those who often engaged in more meaningful and substantive discussions, as opposed to idle chit-chat and small talk.

Based on the conversation patterns of 79 college-aged men and women was tracked over a four-day period, the study was conducted by Vazire and three colleagues at the University of Arizona.

Using an unobtrusive recording device that participants carried in a pocket or purse, researchers taped 30 seconds of sound every 12.5 minutes, amassing more than 20,000 audio snippets of sound from the daily lives of participants.

Members of the research team listened to the recordings and coded the number of conversations each participant had, and whether each conversation was substantive or small talk. Each participant’s happiness level was scored using standard psychological tools for gauging personality and wellbeing, including self-assessments and reports from friends.

Participants scored as “happiest” in the study spent about 25 per cent less time alone and 70 per cent more time talking to others, as compared with the unhappiest participants. The happiest participants had twice as many substantive conversations and one third as much small talk as the unhappiest participants.

“Overall, these findings suggest that meaningful interactions with others are important for wellbeing,” Vazire concludes.

“However, our research cannot determine whether meaningful interactions cause happiness, whether happiness causes people to have more meaningful conversations, or whether there is another explanation. We believe it’s likely that both are true – that happiness leads to more meaningful connections with others, which then produce more happiness – but this remains to be tested in future research.”

When we feel valued and appreciated, our sense of self improves and we are more likely to value and appreciate others more and in turn, this encourages them to value and appreciate us more. Nowhere is this ‘virtuous circle’ of value and appreciation more true and more obvious, than in care homes.
To conclude, meaningful conversations need inspiration.

When we inspire a person we are speaking with, we create a welcoming space in which they are encouraged to share, (but not required to). This gives them more freedom in how they respond. If you ask, “How was your weekend?” (an invitation), the person can only respond by answering your question.

Instead, if you share a story from an event you experienced at the weekend that may be relevant to the other person (an inspiration), then they can choose how they respond. It’s up to them. And that means it’s not up to you.

Weaving inspiration into our conversations frees us from the responsibility of knowing what to say next. Inspiration encourages us and the other person to ‘co-create’ a conversation together.

All we need is to be genuine in what we share, and share it in a way that encourages others to share as well.

Four letters that make communication REAL

Four letters that make communication REAL

“A diagnosis of dementia for a person is also a diagnosis for the whole family.” 

Anon

Dementia can be very hard to come to terms with. Hard enough for the person diagnosed of course, but also hard for family carers, who must watch the relentless deterioration of the person they love, usually over many years, with no hope of reversal. They must also adjust their own behaviours accordingly. In many ways, dementia is a slow, ongoing bereavement process, of loss of a loved one before the person’s death and often means massive and often exhausting changes to the carers’ own lives.

Dementia can be scary and disorientating for the person with the diagnosis, often including

  • short-term (working) memory loss
  • gradual loss of awareness of basic things like eating, drinking and personal hygiene confusion as to their whereabouts or who people are — who they may have known for much of their lives
  • loss of life skills like reading, language and vocabulary
  • rapid mood changes, anxiety, depression
  • depleted motor skills and mobility,

And that’s just for starters.

All these aspects of dementia can be frightening, frustrating and mystifying for the person and saddening (and sometimes maddening) for relatives.

And just when things may seem to have settled into a steadier pattern, the person’s condition may decline further and the care goal posts will move yet again.

Despite this long and pessimistic list — and even though dementia cannot be cured or reversed, our own behaviour can make a big positive difference.

A person can live well with dementia for a long time and with changing attitudes in dementia care, the experience does not have to be unremittingly negative

Happily, in recent years, good communication is slowly being recognised as one of the most important and essential ways of helping the person with dementia and their family to deal with the condition.

I developed the REAL Communication Framework in 2003 as a response to my own observations, worries and concerns about my mother’s condition and her care. The four letters of REAL stand for Reminiscence, Empathic engagement, Active Listening and Life Story. These are the four letters create the four pillars of good communication with a person living with dementia.

Mum had vascular dementia and Alzheimer’s disease for about ten years. I had noticed how her friends gradually fell away, how people were nervous to engage her in conversation or worse, ignored her and spoke through me. I had noticed how impatient my father could be with her sometimes, the woman he adored and had lived with happily for over 60 years — and how all of us in the family felt ‘at sea’ with the experience.

Here is the REAL framework, which surrounds the person with connection and meaningful communication – and all from four letters.

Dad wasn’t coping and Mum found herself in a care home. I noticed that the other residents and their families had some similar issues to our own. I saw that Mum was increasingly challenged to express herself. Of course, the carers knew almost nothing about her and had no tools to help them get to know her better.

First off, I made her a life story album ‘This is My Life’ to help them (and me, as it turned out) to get to know her a better and to give her opportunities to be the expert, in remembering and talking about her life.

Unexpectedly, it became the most important item in her life. Nothing fancy, you understand, just a pictorial chronology of her life with some simple autobiographical captions; for example, “Me in the garden dancing”, “Our honeymoon in Bournemouth”, that sort of thing. We looked at and enjoyed the family photos continually over the seven years she lived in a care home.

I was on a voyage of discovery and she was sharing her experiences as a girl and as a younger woman, — memories I knew very little about, a person who seemed so familiar, yet I hardly knew.

In finding out about her youthful years, we bonded more deeply. This growing closeness helped me to understand better what she might want in the here-and-now. Like all of us, her outlook, needs and expectations had their foundations in her earlier life.

We would watch DVDs together which I knew would make her laugh. In the earlier days we might watch episodes of one of her favourite comedy TV programmes like Dad’s Army. Later, she couldn’t follow the plot lines and even Arthur Lowe’s pompous disdain no longer seemed so funny. Then we moved on to The Marx Brothers.

Nothing like a bit of slapstick for some instant shared hilarity. Her favourites were A Night at the Opera and Duck Soup…

On warm days, we might sit in the care home garden in the sunshine and talk about the birds and bees and flowers and trees and remember her tending the garden at home (mostly endless weeding) and chuckle about Dad in what was his favourite haunt, wearing nearly threadbare gardening clothes.

And while she still could, we talked. About growing up and then bringing up four children, about the hard labour of housework, about life during wartime and dad’s ‘courting’. I admired her endless capable creativity in the house and her delicious cooking. Through sharing her reminiscences and with some empathic, concentrated listening from me, over time, she seemed to be more settled in the confusing, wobbly world she found herself in — and the long list of negatives seemed just a tiny bit shorter.

When these four letters R-E-A-L are in place, anyone can have an easier and more meaningful relationship with a person with dementia and help make it an experience that can be borne more lightly by all.

You can learn more about the REAL Communication Framework and how it helps to transform the lives of people living with dementia and their caregivers here>

How does good communication help the person with dementia? (Part Three)

Part Three: Paralanguage

“They won’t remember what you said, but they will remember how you made them feel” 

Carl W. Buechner

When any of us communicate with a person living with dementia, we will both be using non-verbal ways to communicate beyond the words.

These unconscious methods of exchange: body language and paralanguage, may be overt or subtle, but they are always part of the mix. They help to reinforce what the other person — or we are saying and help us to understand one another better.

Can we cross into the world of the person living with dementia, with all its confines and limitations, rather than expecting them to fit into ours?

Our own reactions may inadvertently add to the person’s lack of mental capacity. I have witnessed many conversations between a person with dementia, a caregiver and another, where the caregiver answers on behalf of the person, or completes their sentences for them — all meant kindly, with no intent to harm, but disabling to the person they care for, nonetheless.


For a person with dementia, feelings are often uppermost. In situations in which they feel fearful, anxious, bored, confused, frustrated, in pain or angry, the feelings of isolation and/or helplessness that the person experiences may find different outlets. The words they then use may not relate to the actual conversation, but instead, include those that reflect familiar, well-rehearsed social norms, or those that transmit their fear, dissatisfaction or frustration at the challenges they are facing.


A person might even swear, despite their normal good manners. They may use paralanguage to communicate their feelings, bypassing words altogether, meaning that petulance, physical force, annoyance or anxiety spill over; or conversely, they may retreat into detachment and passivity.

“The single biggest problem in communication is the illusion that it has taken place.” 

George Bernard Shaw

 Caregivers often develop highly nuanced paralanguage skills with those they care for, in order to stay more in tune with them.

When a caregiver enters into the person’s perceptual world with attentive observation, curiosity and empathy, the effect of and feelings about what is happening matter more than the words spoken. Let’s call this “super-awareness”. This deeper engagement makes it easier to identify, understand, respond to and reduce behavioural expression that has been created by negative, uncomfortable feelings.

Those who listen keenly, observe astutely, mirror accurately and understand thoughtfully, can assist in enabling the paralanguage of a person living with dementia, empowering the person to communicate and participate more effectively and make their lives more meaningful as a result.

We need to understand how challenging it can be for a person living with dementia to understand and relate; and how disempowering it is for the person to be judged from a purely cognitive viewpoint.


The heart of good caregiving means being super-aware and being able to “read the person” accurately. To do this well, we need to be present, listen not only with our ears but also with our eyes and nose. Above all perhaps, we need to listen with an openness to hear beyond the words the person is saying. It is only then that we become thoughtful enablers for them, to nourish and enrich their lives.

How to communicate well with someone living with dementia (Part Two)

Photo by Nick Fewings on Unsplash

 

Part Two: Words aren’t everything

The Language of Dementia

Unfortunately, speech and language deterioration is almost inevitable for a person living with dementia. The reasons are multifarious — among others, the person’s natural language and vocabulary are increasingly challenged by reduced mental capacity. Reduced brain-processing power means that they may struggle to understand what is being said to them. Loss of short-term memory makes it harder for them to orientate themselves in a narrative, or in conversation. They may be unable to respond at we would consider to be a ‘normal’ speed. They might return to using another language learnt in their childhood.

But words aren’t everything

We can communicate better with a person living with dementia by using overt and subtle, non-verbal language that conveys meaning beyond the words — especially if it mirrors theirs. Mirroring non-verbal cues helps to give clarity to our engagement, making it easier for us to understand one another.

Over the years, I’ve heard a number of stories of people living with dementia who have become newly attached, or antagonistic to another person because the person reminds them of a family member or friend they once liked or someone they disliked. It is often something in the tone of the person’s voice that has created this attraction or repulsion.

And it is not just what we say, but how we say it — our tone of voice.

Tone of voice matters, because it helps us to express the feelings behind the words we use, and may reflect among other things, our social culture, where we come from, our age, social status, education and command of language, our sense of ourselves, our attitudes, our state of health and our current mood. The timbre of our voice may help or hinder our connection with someone, even if we may be hardly, if ever, conscious of it.

Over the years, I’ve heard a number of stories of people living with dementia who have become newly attached, or antagonistic to another person because the person reminds them of a family member or friend they once liked or someone they disliked. It is often something in the tone of the person’s voice that has created this attraction or repulsion.

What are the ingredients that make up tone of voice?

These include natural vocal musicality, pitch, depth and intensity, the clarity and sound of our words, the accentuation we use, the speed at which we speak and more generally, the personality and outlook we convey by these means.

Even the simplest of questions, such as “How are you today, John?” may be imbued with a range of meanings depending on the tone of voice used, from genuine authenticity to patronisation, from positivity or cheeriness, to sadness or negativity. How many underlying meanings are you able to convey, just by changing your tone of voice and accentuation in the sample question?

Being more aware of how we sound can help improve our relationships with everyone

How to communicate well with someone living with dementia (Part One)

Photo by Harli Marten on Unsplash

 

Part One: Beyond the words

“Nonverbal communication forms a social language that is in many ways richer and more fundamental than our words.” 

 

Leonard Mlodinow

Body and paralanguage always speak louder than the words we use.

When we are alert to these, communication can be more effective, helping us to better understand the main — and also the underlying messages being conveyed.

When talking with a person living with dementia, they are particularly important to understand, for a few reasons. Firstly, the person’s reliance on non-verbal communication may accelerate as their natural language skills become increasingly compromised by the condition. Secondly, their sense of self alters subtly over time. Thirdly, the speed at which the person is able to process and absorb information is reduced. Finally, emotional feelings may rise to the surface (sometimes quite unexpectedly) in situations that challenge them in some way. All these facors contribute to how the person is able to hear, listen and respond.

Approximately 60% of our interactions use non-verbal communication.

These include proxemics (the space between us), kinesics (our body and head movements), hand gestures and posture. Facial expression and eye contact are key, of course. Perhaps crucially, a person’s tone of voice, intonation, pitch and speed of speaking, hesitation noises, gestures and facial expressions, make a significant difference to how we perceive both them and their message. We rely more heavily on this paralanguage to make sense of the world and our experiences than we might realise, or like to admit.

For any person, a diagnosis of dementia can feel like the beginning of the end.

Hardly surprising perhaps, given the prevailing, dismal medical model with which dementia is often viewed: as a journey of emptiness and inexorable physical and mental decline.

This depersonalised stereotyping over-simplifies the experience, presenting a one-dimensional view of personhood, overly dominated by cognition and short-term memory loss. Of course, as the disease progresses, the person’s thoughts and words inevitably become more tangled and confused.

However, a broader (and more humane) definition recognises that a person is far more than their thoughts alone and that together with their many long-term memories and experiences, the essence of the person remains, despite changes to the brain.

To keep well-connected to a person living with the condition, we need to become increasingly attentive to their non-verbal clues — as well as our own. We need to try to be more aware of what we are both communicating, beyond the words.

Chatterbox groups

chatterbox groups

Chatterbox Groups

Being listened to matters. People living in care homes need meaningful conversation every much as do we who live independently – it’s part of our wellbeing.
 
In a care setting, if a person’s dementia is advanced, staff may struggle to engage with them. Few carers have any training in meaningful conversation – added to which, their ages, life experiences and possibly social cultures may be very different. 
 
According to a study by Washington University in St. Louis and the University of Arizona, outgoing, gregarious people who have deep, meaningful conversations also have happier lives. People who spend less time alone and more time talking with others have a greater sense of personal well-being, suggests the study, published in the journal of the Association for Psychological Science. Co-author Simine Vazire PhD, assistant Professor of Psychology in Arts & Sciences at Washington University says, “having more conversation appears to be associated with a greater sense of happiness among the people in the study.” The happiest were those who engaged often in more meaningful and substantive discussions, as opposed to idle chit-chat and small talk. 
 
This finding is also true of people living with dementia. When we value people’s histories, co-incidentally, we help give them a kind of meaningful future. If we fail to listen to their rich life experiences, we fail to value them. Stories of learning how to make do, mend and keep your chin up in challenging times are as relevant now as they ever were. It can be oddly comforting for us to hear the experiences of a person who has ‘come through’ with a longer perspective on life.
 
Since 2015, it’s been a privilege to facilitate regular conversation groups with residents at a London care home, based on the principles of REAL Communication (Reminiscence, Empathic engagement, Active listening and Life story) and the Chatterbox cards. The sessions last for about an hour each and take place twice a month. Four or five residents with advanced dementia attend the first group and about ten people with cognitive impairment but whose communication skills are still relatively intact come along to the second one. 

A four-month trial proved so successful that they have continued ever since. The stories people have shared have helped us to map their life stories in a way that a more formal assessment simply cannot. Our thoughts, experiences and memories rarely follow a chronological path. In capturing them as they are sprinkled throughout the sessions, we have been able to build a more complete – and interesting picture of each person. This has then been translated into more focussed care.

Chatterbox Groups

Since 2015, it’s been a privilege to facilitate regular conversation groups with residents at a London care home, based on the principles of REAL Communication (Reminiscence, Empathic engagement, Active listening and Life story) and the Chatterbox cards. The sessions last for about an hour each and take place twice a month. Four or five residents with advanced dementia attend the first group and about ten people with cognitive impairment but whose communication skills are still relatively intact come along to the second one. 


A four-month trial proved so successful that they have continued ever since. The stories people have shared have helped us to map their life stories in a way that a more formal assessment simply cannot. Our thoughts, experiences and memories rarely follow a chronological path. In capturing them as they are sprinkled throughout the sessions, we have been able to build a more complete – and interesting picture of each person. This has then been translated into more focussed care.

Communication Masterclass

Communication Masterclass

SCIE and REAL Communication Masterclass

 SCIE (Social Care Institute for Excellence) is running a Communication Masterclass, a customised  Real Communication Workshop program.

This is an open course for dementia care practitioners that focuses on how to communicate more effectively with a person living with dementia.

The interactive workshop includes exercises, games, discussion and reflection in an open studio environment. The workshop techniques are designed to make it easier for professional carers to positively contribute to the quality of life of those they care for. 

This is also CPD-accredited course will give you a range of easy-to-use and effective dementia communication strategies and techniques.

Content includes:

  • Techniques to establish trust and safety to support the person and their family.
  • How the brain’s different memory systems function
  • REAL communication framework and techniques: reminiscence, empathic engagement, active listening, life story.
  • REAL approaches to working with family carers and friends to deliver a better quality of life for all.
  • REAL communication techniques for mapping a person’s life story
  • Adjusting REAL communication techniques to a person’s needs as their dementia advances
  • Understanding how feelings are at the root of communication challenges
  • Strategies for self-care.

Learning outcomes

Participants will learn:

  • the deeper principles of communication that make care more meaningful
  • how to provide more relevant support to an individual living with dementia at home or in a care setting
  • how to connect more effectively with families and/or the person’s advocates
  • how to deliver better care through improved understanding and communication

The REAL framework is based on evidence gathered over a decade working with people living with dementia and their carers. Research showed that reminiscence, empathic engagement, active listening and life story are key to the wellbeing of any older person living with dementia.

When accompanied by the Senses Framework (My Home Life example here), everyone’s lives improve.

You can also learn more about SCIE’s Dementia training courses for health and care in collaboration with REAL Communication Works here

Chatterbox Cards and the Memory Café

Chatterbox Cards and Memory Café volunteering

My visit to the Alzheimer's Society Memory Café

There’s an Alzheimer’s Society Memory Café at a Housing Trust in north London. Everyone who attends is living with dementia, to varying degrees and I’ve been lucky to spend time there with the regulars to facilitate conversation using Many Happy Returns 40s and 50s Chatterbox cards.

My first visit included one family carer and four housing trust staff members. There were about 18 of us in the room, sitting around small tables with oilskin cloths, on each of which was a small glass vase with a single bright yellow fabric chrysanthemum. The colour of hope, I thought wistfully.

Everyone was wearing a badge and as always, we all introduced ourselves. I noted unusual names – most of those present were local, but a few had arrived here from the Commonwealth or as refugees from war. I knew that meant we would likely hear some intriguing stories.

The room was quiet and expectant. My first prompt was to seed thoughts of childhood – toys and games and freedom – adult authority. Tentatively to begin with, the group started sharing memories of favourite toys from childhood. Descriptions of dolls and dolls’ houses, of dolls’ prams and dressing up family pets to wheel around in them, of cap pistols and Painting by Numbers, these soon became stories of constantly being sent outside regardless of the season, (even when unwell) of running around unsupervised, of climbing trees, of innocent ‘gang’ games, and in winter, of mucking about in the (helpfully warm) local tube stations.

One man who said his family could afford no toys at all, described his pet Collie, 'Sailor'. "Rather an odd name for a dog I suppose!"

As often the case, despite their relative poverty, they described lives of happy, unfettered freedom hardly known by children today. One man who said his family could afford no toys at all, described his pet Collie, ‘Sailor’. “Rather an odd name for a dog I suppose!” he laughed, “he never ever went on a boat. I trained him and he was at my side all the time. He would do that thing that Collies do, crouching down to listen. He was really clever.” There was a lady who had grown up in Greece. Her language has reached that stage where her words sound quite feasible but are nonetheless, challenging to understand – or even hear, spoke with poignancy and pleasure about playing with her sisters in the sunshine on her local island beach.

Then we spread the Many Happy Returns Chatterbox cards arbitrarily around the tables. Every group – by now animated and chatting away happily, carried on. As always, prompted by the subjects, pictures and information on the cards, the volume in the room rose swiftly and dramatically as these fascinating older people revealed their histories to one another.

Their memories now spread across the landscape of their lives, their relationships, jobs, children and grandchildren.
As always, the volunteers expressed astonishment at the instant connection prompted by the cards, at the enjoyment and pleasure they observed, and at the sheer amount of conversation and animation. As always, the participants commented on the cards and how well they prompted meaningful memories.

People didn't really want to stop sharing and lingered on beyond the finish time to continue chatting

As always, like all good parties, people didn’t really want to stop sharing and lingered on beyond the finish time to continue chatting.

And as I have often found, as I trudged back to the bus stop, I felt a real sense of satisfaction that the chatterbox cards had once again delivered. Prompting so much fun and excited communication for everyone that day at the Memory Café. I also felt a deep sense of privilege and wonderment to be able to bear witness to their hidden treasure troves of life experience and history.

You can find out more about the the Many Happy-Returns Chatterbox Cards here >

REAL Communication workshops for carers

REAL Communication workshops for carers

REAL Communication workshops for carers help develop communication skills through interactive, experiential and blended learning programs.

Facilitating REAL Communication workshops for carers is always a privilege. Being interactive, what happens is always a Quid Pro Quo: a real exchange of learning and experience.

Good communication is absolutely central to good care. Nowhere is this more true than in the care of people living with dementia, for whom there is no cure and almost no palliatives. For family carers and care workers, good communication is vital: they all live with stress, anxiety, loss and grief on a daily basis while the person is still alive.

The REAL Communication* framework and mantra developed to address these issues:

  • We cannot care for a person if we don’t care about them;
  • We cannot care about them if we don’t know who they are

Care is always a triumvirate between the person being cared for, professional health and social care staff and relatives and friends. As all evidence shows, when these relationships work well together, good care always results. Conversely, if these relationships fail, poor care is inevitable.

Older people who are vulnerable and frail need sensitive relationship-centred care and robust advocacy, especially if they have dementia. They have rich life experiences that can have a deep affect on how they view their relationships with everyone around them – and life in general.

When we have empathy for the person, listen to them well, understand how their memory systems function; when we show kindness and recognise, appreciate, honour and celebrate their life experiences, they are encouraged and empowered to live life more fully, regardless of their condition.

 

*The REAL Communication Framework 

REAL is an acronym for: Reminiscence, Empathic engagement, Active listening and Life story.

All REAL Communication workshops include the REAL framework. This means that any carers attending our workshops will further develop and improve their communication skills and abilities.

The resulting learning outcomes will further encourage the provision of improved  communication. This enhances relationship-centred care and delivers improved quality of care received by the person living with dementia.

Our  unique approach sits at the heart of the Norfolk & Suffolk Dementia Alliance blended learning programme, recognised by the Performance Learning Institute gold award in 2014.

Image: Will van Wingerden

Find out more about REAL Communication Workshops here >