Dignity in care: Communication
September 8, 2019
It’s about listening to the person, in whichever way that person communicates.
You have to be a good listener, and understand the person. We’ve got Dirty Dancing at the theatre, Cats at the theatre, Grease… We need to communicate about what’s happening in our lives. When Matthew’s got things coming up, we always write it down
into his diary, if he’s going to a concert, if he’s going on holiday, we encourage him to find the correct dates and write it all in.
We make sure that we check it all over that he’s got the right dates, and we encourage him to check that if he’s got anything planned in the week that he finds it in his diary to see what he’s going to be doing. The diaries are kept in the communal area because staff write in and
fill in what Matthew’s done in any day and any trips that he’s been out on. And we also record the menus of the food that they’ve eaten, everything.
And that’s one way that staff can find out what’s been happening, if you haven’t been on shift for a few days you come in, you read up on
the diaries and you see what’s been going on really. Make time to get to know the people you support. Well I do my best to treat everyone as an individual and look at what they want. I’ll be beside myself with glee… Come on, let’s get in. So it’s important to sit and find out about them, and how they
find enjoyment, how they laugh, things that they like to do – – Have I got to hold his hand?
– If you want to. Things that they’ve done in the past that we can sit and talk about.
I was working with past memories of being at the beach. Ailsa’s
registered blind, so we brought shells and sand so they actually feel it. Communication is very important, to be able to sit and talk, getting
to know them, finding out what makes them happy and what makes them sad. We went to the beach every chance we got. Things I’ve discussed with Ailsa over the years. About her family time. I’m trying to think what it is, what is it, what am I going to do. Do I teach? – Well…
– You did teach, didn’t you? – I did teach, but I don’t seem to do anything now. – You’re retired, now.
– I’m retired, yes I’m retired. – Yes, you’re just relaxing now.
– I was a school teacher and I loved it. I treated the children well. I felt a lot of them needed help, they needed comfort, help. Not this sort of thing.
Very important how you treat each other. We must never be little people. – Shall we go downstairs now?
– Just wait one minute till I put yourself into a chair. – We can walk downstairs.
– Well I’ve got your chair here, so it might be a little bit easier for you. – We’re human beings who can walk you know. Yes, but I’ve got a gammy back. – You just sit for two minutes because you have hurt your hip.
– I have hurt my hip, yes. – Are you having your frame Robina or your stick? – Yes, my stick.
– Your stick, let me get your stick. There are so many different types of problems that can arise around
communication. Obviously a lot of our people have got dementia, so if you come up to them and give them a whole list of do you want this this
or this, it’ll be too overwhelming. So sometimes what’s quite nice is just to bring two or three things up and then show it and they can actually visualise it
and they’ll be able to point to what they would like. I’m just going to bring in a couple of things and then you can choose. This is again about getting to know the person and getting to understand
the person. Because basically the more they get to know the person, they will find other ways of communicating
and other ways of reaching out to that person. So sometimes they respond to mirroring, so for example if they are not cooperating with brushing their teeth
for example, you could actually start doing the movement and they may actually pick up on that movement and start doing that themselves. There are so many different ways and obviously there’s no right or wrong
way but it is about getting to know that person and what they respond to basically. – OK Robina, which one of these would you like?
– That one. – John should be here in a minute.
– Yes. My role is to look after people in their own home and to keep them
independent in their own homes for as long as possible. You get to know the particular person, and some people obviously want to
be as independent as possible so if they can do it themselves, they prefer to. And obviously things work very much better when
actually people have a supportive family. Robina is, a lot of it is companionship, I don’t do her personal care. And I tend to provide the activity. So I encourage her to go out
and we sometimes have lunch or a coffee out. Oh that’s really delicious. Oh, look at the rain. Obviously there are handovers and after a while they get fairly routine. John, I think you need some more visit record sheets.
I’ll go to the car and get some more out for you. – I’ve given Robina her medication.
– Right. You need to read the logs and the most important single one is probably
the medication log. To check that they’ve had their medication. From time to time you get new situations and you have really quite
important judgment calls. Particularly when to call in other people’s help. But yes, there is a lot of support and what you’re encouraged
to do, if in doubt, pass the decision up. We very much empower our staff to feed back to us. So if there’s
something that they’re not sure about or they’ve noticed a change in somebody or they’ve noticed that something
on the care plan for example has changed, we really encourage that communication, that two way process. Care workers, there’s a lot of skills are needed. Obviously
they have to be very empathetic, they have to be very organised, – I don’t think we can get in that way.
– Oh right. I think they have to think a little bit outside the box. I think
when you’re a carer you have to understand that people are not robots and whatever says on the care plan, that might be, that gives you
a general outline but you have to be a little bit flexible and you have to listen to the person basically. It’s
not a checklist of I’ve done this, this and this. I think you have to be very flexible. Use technology to help people communicate We use DVD and iPads that we have now with each of the people who live here to record their support plans. So each person coproduces their
support plan with the key workers, the families, myself. We get together, talk it all through, we’ve got various headings
that we use. Make sure that they’re happy with what’s in there. For example when we’ve updated a support plan with Moira, Moira and I
have sat and discussed progress she’s made, things that she’s really happy with, further progress she’d like to make. So we’ve changed all
that on the laptop, that’s been printed off. And then we sit in her room so she’s got some privacy and we just
video that and then that can be transferred onto DVD so Moira’s got that to access whenever she wants to. And it’s a really good way of just being able to sit and say well,
yeah this time last year you were doing that, but look at what you’re doing now. And also a lot of the progress that she wants to make is actually her ideas now. It’s actually her coming up with ideas and saying ‘I’d like
to be able to do this now’. So that’s really good, it’s a really good way of being able to work, and the ownership of the support
plan is actually Moira’s, we’re just supporting her to carry it out. So then I’ll take this and put it on the DVD, and then you’ll
have it to watch back whenever you want, ok? Each of the people who live here have got their own iPads now, and
we’ve found them to be really good for doing lots of different things on. – Smile!
– (laughs) There it is. – See, he’s watching what we’re doing isn’t he?
– He is. Val’s always wanted to use a computer, but she’s not able to
recognise letters or numbers, so obviously for an iPad, if she knows what she wants to press, if there’s a particular
game that she likes, she can just press on it, she doesn’t have to wait for somebody else to support her to access anything she just knows
how to get onto it straightaway and it’s another form of communication for her. We’ve also used them for Skyping. So, just press on there, press ‘answer with video’. – OK. There’s Peter, he can hear you and there’s Roy.
– Hello Roy. – Hello Moira, you alright?
– Yes. We use Skype at Laverneo for each of the ladies to contact people
that they don’t get an opportunity to speak to regularly. So for example Moira was Skyping some friends that she’s made in another
service that Scope has, which is down in Halifax. – Training on a Wednesday to become a mentor.
– Yes. We also use Skype for the ladies to have contact with
some of our senior management in Scope, so they can all speak to my manager for example. And they’re talking
about their lives, what they like to do. Which is really good, it’s making new connections, so it’s great. And over the other side from where I am, is where the other two staff go. In Leicester we have a very diverse community and it’s important when
we’re placing our staff with the people that we provide services for that we match them as best as possible. So we recruit from that
community, so we’re enabled to incorporate language requirements and cultural needs. We ensure that we listen to people, and their carers and families. And we need to take on board cultural needs and differences, we would listen to and speak with individuals, we’re sensitive and
understanding of religious needs and preferences. It’s definitely beneficial for the people that we care for. They
get a better service, because their confidence in us increases, their anxiety is far less. They feel that their care is
more personalised, is taking into consideration their cultural needs, and enabling them to communicate
effectively with the people who are caring for them. Care workers’ language skills are important for
communication and understanding people’s needs. At Age UK, at interview, we always ensure that the applicants
have good verbal and written communication skills. It’s absolutely vital for the people that we care for that
they are fully conversant and that they can read the care plan and understand clearly what the person requires. I’m Alka, I’m from Age UK, I’m a respite worker, that’s what I’ve
been doing for the past ten years. Anna, I’ve been going there the past three,
four months. She’s a lovely lady. She just needs someone there to reassure her, a bit of company
for her when her daughter Eva goes out to just have a little break, now and again. So we go and step in and just be with her.
Normally when I arrive at the house at about quarter past six, and then have a little chat
with Anna and Eva, how’s her week been. And then Eva goes out for a little while, whatever she needs
to do. She has a break, and then me and Anna sometimes watch TV together. Care workers should be supported to develop good non-verbal skills. I think with Anna communication is very important, so you have
to give her a rub on the hand to make sure that you’re there.
And she does do eye contact. And now and
again you do get a little smile from her, so then you know that she’s happy with you. To me dignity
means understanding the person’s needs. In my work we have to treat people with dignity, everything
what we do. We have to be a good listener and understand the person.