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“An excellent presentation…It was great to hear about your true collaborative working highlighting the importance of understanding culture and systems. Some excellent outcomes for the individuals concerned and plenty of professional learning and reflections.”
Every two months we work together as an allied health professionals community to develop, for you, a national AHP Dementia Webinar where we share the work and practice of allied health professionals in Scotland. Our vision for the webinars is “through working in partnership, we can all improve outcomes for people that really matter”.
Colleagues joined the webinar in June 2023 to hear how colleagues from Speech and Language Therapy in Lothian have been using The Five Good Communication Standards to foster best practice for people in care homes living with dementia. Our guest presenters were:
Daisy Blair, Speech and Language Therapist, NHS Lothian
Rebecca Kellett, Speech and Language Therapist, NHS Lothian
WATCH AGAIN. The webinar link is here
During the webinar, participants asked lots of great questions and today we are posting the replies from our webinar hosts. Please leave any further comments on this blog post for Daisy and Rebecca to continue the conversation with you at the end of this blog or email us at AHPDementia@alzscot.org. You can also contact the community SLT team in Lothian for further information at: rebecca.kellett@nhslothian.scot.nhs.uk
Question: As a newly qualified Radiographer I was wondering what your advice would be regarding how I could improve my verbal and non-verbal communication skills with dementia patients to improve their experience within the x-ray department, considering the short amount of time available to interact with these patients in a busy hospital environment? Thank you!
Answer: Check for information on persons communication in advance; consider having visual materials to support instructions (e.g. Photographs, written instructions as well as verbal); allow extra time if possible for processing; ensuring the primary communication partner is allowed into the appointment to support communication; a portable listening device to use if people are not allowed to wear hearing aids during scan; check dementia friendly guidance for layout, lighting and noise in x-ray room e.g. consider soft music; a photograph of the team or professional who will be carrying out scan in advance of appointment eg on appointment letter; a photograph of the room in advance; checking signage on routes through to your department.
Question: I work in a hospital/ ward based environment. How easy do you feel it would be to apply these standards within this environment especially getting nursing staff to co-work with AHPs?
Answer: A hospital ward is the optimal setting to apply this framework. You could have the standards as a standing item on multi-disciplinary team meeting minutes and share the responsibilities out amongst the team to promote collaborative working. Ensure all roles are included in discussions e.g. nursing assistants
Question: How do I communicate with a person who is non-verbal and had a stroke and no facial expressions?
Answer: All behaviour communicates something. What other non verbal communication have they maintained? There will still be subtle ways that this person is able to communicate. How can you tell when the person is uncomfortable for example? What do they do e.g. can they point or move their body? Do they make certain sounds or eye gaze? Is there a speech and language assessment of their communication? What is their understanding like? Perhaps you could use pictures or written information to ascertain their thoughts and feelings. Once you have a clearer picture of their remaining communication skills, you could also consider trying Adaptive Interaction to connect with them: https://www.bing.com/videos/riverview/relatedvideo?&q=maggie+ellis+adaptive+interaction&&mid=82D3DB93A79DFEA923C082D3DB93A79DFEA923C0&&FORM=VRDGAR
Question: Can I ask Daisy a question about how she assessed people’s communication difficulties. She said she used clinical judgement – was this informal or formal assessment?
Answer: Assessing communication of people with dementia is difficult to do using formal assessment tools because it can cause distress. An informal approach through observation, discussion, interaction is usually more appropriate. Being flexible is key as it will take more than one interaction, ideally in different environments, with different communication partners to gather the information you need to inform your assessment.
Question: Are we able to access the standards?
Answer: The full document can be found here:https://www.rcslt.org/wp-content/uploads/media/Project/RCSLT/good-comm-standards.pdf
Easy read document can be found here: 5-good-comms-standards-easy-read.pdf (rcslt.org)
Question: How did you use the speech and language therapy students within the project?
Answer: Speech and language therapy students helped me to audit all the care plans against communication criteria during my initial scoping period when I was establishing the level of communication need that exists. Some students also helped during their non-clinical placement to model life story book creation in one of the care homes. I worked with Queen Margaret University to facilitate the placement in the care home.
Question: Where is the blog available?
Answer: We post blog weekly on a Thursday at https://letstalkaboutdementia.wordpress.com/ and you can sign up to receive the blogs by email each week. We then share the blog on twitter on the Saturday at @AHPDementia. However if you are not on social media we post of the webinars at www.alzscot.org/ahpwebinars or you can email us at AHPDementia@alzscot.org for more information.
Question: Re Standard 4 how does a person with dementia answer this statement – I have lots of chances etc?
Answer: The person can’t necessarily answer this themselves, so it is up to those around the person to provide those opportunities given their knowledge and experience of the individual and their life. The 5 Standards are really a self-assessment tool for carers but phrased in the first person to be person centred.
Question: Very interesting webinar, thank you! Are there any recommended communication models or frameworks that can be taught to carers to enhance their understanding and application of effective communication techniques for those with dementia?
Answer: You could use the 5 good communication standards document to self audit your service and identify gaps in knowledge and skill (see link for document above). There are some ideas included in the document for ways you could support your carers to improve their skills.
Brilliant presentation. Will hopefully change many people’s viewpoints/ attitude on communication within care homes. I worked in Learning disability teams for many years and a lot of the topics covered today were utilised in my practice in LD pts. The commonality being a cognitive impairment and communication difficulties. The standards that you discussed are echoed in the National Care Standards. Thank you for taking the time to make this presentation.
We invite you all at the end of each webinar “Something you will take away from today’s webinar and use in your practice, or life, going forward”. Here is a selection of some of your replies. We wish you every success in following up your ideas and inspirations that you shared with us.
A better understanding of the challenges for care home staff and the outcome for residents. The benefits of having a wealth of personal information.
This webinar encouraged me to think outside the box and possible be more creative with regards to options /ideas of communication. I liked the statement that “sharing experience is a form of communication” from personal experience I think this is an easy start to many conversations.
I am new to the field of Speech and Language Therapy, so the knowledge gained in this webinar will be beneficial to my professional development.
Thought provoking for life as a 24/7 carer of partner with dementia
Use of communication techniques for people with word finding difficulties. Explaining the importance of completing a life story plan with people living with dementia.
An increased awareness of how little communication is conveyed through words alone! Will be much more aware of body language and voice tone now!
Visit the 5 standards, think about how i communicate and document information.
The idea about leaving behind appropriate tools to facilitate positive improvement/change. As AHP practitioners we dip into many different care homes but I’m taken with Daisy’s approach to really understanding the dynamics of each of her individual three CHs in the study and shaping intervention around those individual characteristics.
Share the information with colleagues in Wales & consider similar opportunities for care home projects. I also look forward to reading the blog.
Using students to pursue a project within care homes in the future and considering communication opportunities with patients in the future.
Our next webinar is on Wednesday the 30th August from 3.30pm-4.30pm where we are sharing an evidence based occupation intervention called Connecting People, Connecting Support on line and Journey through Dementia. Email us at AHPDementia@alzscot.org and or follow @AHPDementia to find out more.
Stay connected!
We tweet daily @AHPDementia
We blog weeklywww.alzscot.org/talking_dementia
We use #AHPConnectingPeople & #AHPScot as our hash tags
We support our AHP students to share their learning on AHPDementia Instagram
We share AHP evidence based self-management resources at www.alzscot.org/ahpresources
We have an email for youto send questions AHPDementia@alzscot.org
We developed an interactive website with 32 resources for you www.connectingpeopleconnectingsupport.online
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