The Oxford Concise English dictionary defines communication as ‘the act of imparting, especially news.’
Communication is a two way process.
In psychological terms, broadly speaking, communication is the transmission of something from one location to another. The ‘thing’ that is transmitted may be a message, a signal, a meaning, etc. In order to have communication both the transmitter and receiver must share a common code, so that the meaning or information contained in the message may be interpreted without error (Reber S and Reber E, the Penguin Dictionary of Psychology).
Those supporting people that live in care homes must be able to communicate both effectively and appropriately with those people. Additionally, this level of communication should also extend to our colleagues, the family and friends of the people we care for and, in fact, anybody else we come into contact with.
Communication can be verbal or non verbal. It is estimated that as much as 70% of human communication is carried out through non-verbal channels (Asher M, Body Language).
Why then do we appear to take so little notice of something that plays such a prominent part in our lives? Often, body language speaks louder than words and therefore dictates how people react to you and how you perceive them. This is especially so when we are supporting people who have dementia.
Make only one assumption when supporting people who are believed to have dementia:
That the person understands everything being said and all that is happening to him or her
Listen carefully to what the person is trying to tell you. Look at their body language. Allow the person time to get their message across. It can take a good 30 seconds or more for somebody with a cognitive impairment to respond to you. Always respond to a person who is saying something – it is never acceptable to walk away without responding.
Always explain to the person what you are going to do before actually doing it. Always involve the person in the decision making process. Speak clearly, using terminology that is appropriate to that person – this may include local slang words. Ensure you have compiled a thorough Life Story Book or Collage with the person. By doing this, the whole care team will have a good understanding of the communication systems used by the person.
I would like to refer readers to Dr Jennie Powell’sCare to Communicate – Helping the Older Person with Dementia. This is a practical guide for care workers and can be obtained from Hawker Publications, 020 7720 2108. Included with this guide is the
Cardiff Lifestyle Improvement Profile for People in Extended Residential Care (CLIPPER) system and the directions for its use. It is a valuable tool which can be used to improve communication skills and competencies.
Positive interactions with people living in our houses includes respecting and valuing the individual, no matter the level of dementia, and a big part of achieving this is through communication. Some ways of doing this are:
vEnsuring there is a large orientation board in the house which is kept up-to-date. This should include the day, date, weather conditions, and names and photographs of carers on duty.
vMaintaining a clear and accurate activities board – this can include pictorial references to support the written word.
vEnsuring facilities in the house are well signposted – for example, pictures of traditional toilets and baths on communal toilet and bathroom doors. The written word should also be clearly visible.
vThrough knowing the person’s communication systems and language – remembering that many people with dementia will revert to their natural language as the disease progresses, and if English is a second language, they may well lose the ability to speak it, read it or comprehend it.
vLet people see a clock and have access to a daily newspaper.
vEnsure the environment is conducive to meeting the everyday needs of the people living there. Personalised doors; street or road names instead of corridors; use a valued reference such as housemates or something similar instead of residents or dementia patients; refer to houses instead of EMI units.
These are just some ways in which we can help people – I’m sure there are many others appropriate to each unique individual.
Of course, we need to be able to communicate with others too.
For example, whenever anybody telephones the house, the person answering should say clearly the name of the company, the name of the house and also their name. It is totally unacceptable, unprofessional and against company policy to simply say ‘Hello.’
Remember – this may be a relative or enquirer, and they too deserve to be treated with the same level of respect and dignity as everyone else.
I think we all agree that enhanced communication skills results in an enhanced quality of life for all of us.