Facilitator Guide – Module 3 Communicating effectively
Australian Government
Australian Aged Care Quality Agency
Demystifying dementia care
Module three:
Communicating effectively
Facilitator guide
Module three: Communicating effectively – Facilitator guide
1
Module three: - Communicating effectively - overview
Facilitator Guide – Module 3 Communicating effectively
Outline
• Explores how the condition of dementia can affect the person’s ability to communicate and
discusses strategies and techniques for staff to communicate effectively.
Timing
Power point slides only
Plus activities
I hour
4 hours
Schedule
Section
Topic
PPTs
Only
Time
#
Learning Activity
Time
DVD/Clip
Time
Total
Time
Intro
Introduction
1-3
5
3.1
Compare different
approaches by care
workers
15
20
1
Understanding
communication
4-9
15
3.2
Drawing exercise
15
40
3.3
Role play –
communicating
needs
10
Strategies for
effective
communication
10-17
3.4
Case Study – John
and Anne
10
3.5
Communication
Skills DVD/Clip 5
20
3.6
Five senses
15
3.7
Scenario
15
3.8
Includes DVD/Clip 6 15
3.9
Case Study – Beryl
15
3.10
Cultural diversity –
our everyday
activities
10
3.11
Includes DVD/Clip
Carers Experience
15
3.12
Carer needs
10
3.13
Module Revision
15
20
3hr
4hrs
2
3
Sum
Total
Time
Communication,
18-26
cultural differences
and working with
families
Key Messages
27-28
30
5
5
60
mins
2hrs
DVD/Clip 5
Incl
[20]
DVD/Clip 6
Incl
[15]
40
DVD/Clip 7
Module three: Communicating effectively – Facilitator guide
Incl
[15]
2
Module three: - Communicating effectively - overview
Facilitator Guide – Module 3 Communicating effectively
Resources required:
Media resources
Location: PPT 3.13
Location: PPT 3.17
Location: PPT 3.23
Time: 20 mins
Time: 15 mins
Time: 15 mins
Activity 3.5
Activity 3.8
Activity 3.11
DVD 5 Communication skills
DVD 6 Relating and communicating
DVD 7 Carers experience
Activity resources
3.1 Compare the different approaches
3.2 Drawing exercise *template provided
3.3. Role play communicating needs (cards) *template provided
3.4 Case Study John and Anne – ** answer guidelines
3.6 Five senses
3.7 Scenario Reality Orientation
3.8 DVD 6
3.9 Case Study Beryl at the Gate – ** answer guidelines
3.10 Group exercise cultural diversity
3.11 DVD 7
3.12 Carer ‘s needs
3.13 Module revision
The relevant activity handouts/resources along with extended activity instructions can be found
at the back of this guide. Please ensure you copy enough of all materials for your group
Module three: Communicating effectively – Facilitator guide
3
Facilitator Guide – Module 3 Communicating effectively
Facilitator welcomes the group and explains session
outcomes and objectives.
Slide
1
Have introductory power point slide showing as group
arrive.
Welcome participants to module 3 - communicating
effectively.
Provide a workbook to each
participant
!
Provide workbooks to each participant
EXPLAIN
•
This module on ‘communicating effectively’ builds on
your understanding of the effect of dementia on the
functioning of the brain.
•
There is an emphasis on practical ways for you to
communicate clearly whilst being involved in providing
everyday care.
•
The impact of cultural and linguistic diversity on
communication is introduced in this module combined
with the importance of using communication skills with
families.
•
The content highlights the importance of establishing
and maintaining a relationship that takes into account
individual differences of a person with dementia and
their family (e.g. cognitive abilities, cultural
background and language skills).
•
It also highlights the need to support and guide family
members and to assist them to understand the
condition of dementia, its impact on the person and
approaches to providing care.
Module three: Communicating effectively – Facilitator guide
4
Facilitator Guide – Module 3 Communicating effectively
SHOW SLIDE and EXPLAIN learning outcomes
Slide
2
•
Today's session aims to build your knowledge in 3
core areas:
3.1 Understanding communication – what is
communication?
3.2 Communication strategies – non verbal and verbal
communication, reminiscence, reality orientation and
validation.
!
3.3 Cultural differences and supporting families – we
need to be aware of the cultural context of communication.
•
‘Culture’ applies to a person from another country or a
person born on the ‘other side of the railway tracks’.
Families are good examples of sub-cultures and we
need to communicate effectively to them as well.
Modeling is often the best way to get our message
across, particularly for families who are grieving the
losses or changes in their lifestyles.
EXPLAIN:
Slide
3
At the end of this module you will be able to:
!
•
Define the term communication
•
Demonstrate the use of a range of communication
techniques
•
Provide support to clients using reality orientation,
validation and reminiscence
•
Identify barriers to communication and strategies to
overcome them
•
State the impact of dementia on carers and describe a
range of communication techniques to support
families
•
Provide support and guidance to family members
EXPLAIN:
• Let's start by looking at the basics, and specifically the
difference between effective and poor communication
Module three: Communicating effectively – Facilitator guide
5
Facilitator Guide – Module 3 Communicating effectively
ASK - What is effective and poor communication?
BRIEFLY DISCUSS
EXPLAIN:
Activity 3.1 Compare different
approaches by care workers
[15 mins]
Workbook page 3
•
To help us understand the differences, let's have a
look at a case study.
INTRODUCE ACTIVITY 3.1
•
On page 3 of your workbooks you will find 2 brief
scenarios
•
Take a moment now to read them and answer the
associated questions.
•
By so doing it will provide further insight into the
differences between effective and poor
communication.
Allow 10 minutes for participants to write down their thoughts,
then bring the group back together and ASK:
•
What was good and why? What was poor and why?
•
What was the impact on the person with dementia?
EXPLAIN:
•
Now you have discussed examples of effective and
poor communication and the impact it has on other
people. It is important to remember this when we are
communicating with people with dementia.
SHOW SLIDE AND EXPLAIN:
Slide
4
workbook page 4 if participants
would like to take notes
•
Communication is a two way process.
•
Information is shared by one person, while the other
person must receive the information and communicate
understanding.
•
Both exchange the roles of sender and receiver.
ASK - Who has responsibility for the success of the
process?
• Normally both people share responsibility
•
Both people have a responsibility to ensure the
message sent is understood by other.
•
This process is normally done with little conscious
thought.
Module three: Communicating effectively – Facilitator guide
6
Facilitator Guide – Module 3 Communicating effectively
EXPLAIN:
Slide
5
workbook page 5 if participants
would like to take notes
•
Communication is made up of 3 parts: Body
language 60%, Tone of voice 30%, Spoken words
10%.
•
Communication is not so much about what you say,
but how you say it.
•
This is especially true when caring for a person with
dementia and who is having difficulty communicating.
INTRODUCE ACTIVITY
• Let’s do an exercise to show us how important nonverbal and verbal communication is.
•
This exercise has 2 parts and you will be working in
pairs.
ASK participants to find a partner, and between them to
decide who will be person 1 and who will be person 2
•
All the 1's = Group 1, all the 2's = Group 2
ASK GROUP 1 to leave the room while you instruct group 2,
as they leave let them know they will be the receivers of
some communication from there partner, and that you just
need to set this communication up firstly - it is nothing to
worry about.
Activity 3.2 Drawing exercise.
[15 mins]
handout drawing exercise sheet to
each member of GROUP 2
Facilitator note - If there are uneven numbers ask one
participant to volunteer to be an observer. Tell this person to
note down communication strategies they seen being
demonstrated (ensure other participants do not hear these
instructions).
Group 2 - Senders
EXPLAIN they are the senders in this exercise
GIVE each sender a copy of the abstract drawing.
TELL the senders they must not let their partner see this
drawing and that they are to explain in words to their partner
how to reproduce the drawing.
Module three: Communicating effectively – Facilitator guide
7
Facilitator Guide – Module 3 Communicating effectively
EXPLAIN to GROUP 2:
•
You have 2 tasks to complete
PART 1 - back to back - no descriptor words
EXPLAIN:
•
In the first part you are to sit back to back your their
partner and when explaining, you cannot use words
that describe shapes such as circle or triangle.
•
After completing this part, you are not to show your
partner the drawing but should go onto part 2 of the
activity.
Part 2 - with gestures and words
!
EXPLAIN:
•
In this part, you can sit facing each other or side by
side, you can use any words you like and can use
gestures etc, anything except showing the drawing to
your partner.
•
When your partner has completed the drawing the
second time, you can show them the original drawing.
COMMENCE THE ACTIVITY by inviting Group 1 to come
inside and pair up with their partner from Group 2. Five
minutes back to back and then signal time to go face to face
for five minutes.
When you were back to
back:
After both rounds bring the group back together
• What made it hard for
the receiver when back
to back?
• What made it hard for
the sender?
BUILD CHART and ASK them to spend 5 minutes
discussing the charted questions with their partner in
readiness for a discussion
When you were face to
face:
•
What was it like for the
receiver
•
What was it like for the
sender?
Module three: Communicating effectively – Facilitator guide
8
Facilitator Guide – Module 3 Communicating effectively
Feelings
Difficulties
(barriers)
Helpful
(enablers)
PREPARE A CHART/WHITEBOARD into 3 columns and
ASK participants to share back the results of their paired
discussion
Discuss with group the results of paired discussion.
•
?
If participants mention a feeling e.g. frustrated, write it
up. If they mention a difficulty (could not see them) or
something that was helpful (when I could see their
face), write it up.
ASK:
• How does the activity relate to the experience of
communicating with a person who has dementia.
EXPLAIN
• Many of these barriers can interfere with
communicating effectively with a person who has
dementia?
•
When you take away some basic elements of
communication it is hard to get your message across.
Even more so when communicating to a person with
dementia.
REINFORCE that communication is complex and there are
many factors involved, both verbal and non-verbal elements.
EXPLAIN:
!
•
This activity highlights the impact of removing or
adding barriers to communication e.g. not seeing
someone’s face.
•
The impact on a person with dementia is not only the
possibility of these factors occurring naturally but
additional barriers or difficulties due to the illness
causing the dementia.
EXPLAIN:
• Now we will look at the impact that dementia can have
on communication and how you can communicate
effectively.
Module three: Communicating effectively – Facilitator guide
9
Facilitator Guide – Module 3 Communicating effectively
EXPLAIN:
Slide
6
•
There is a space on page 6 of your workbook to take
notes as I explain some of the things that make it hard
to communicate with people with dementia
SHOW SLIDE and READ IT OUT
Workbook page 6
?
Slide
7
ASK - How may the person with dementia be feeling
when they try to communicate?
BRIEFLY DISCUSS
CHECK AND TOP UP by SHOWING SLIDE and reading it
out
Module three: Communicating effectively – Facilitator guide
10
Facilitator Guide – Module 3 Communicating effectively
SHOW SLIDE AND EXPLAIN:
Slide
8
•
The difficulties in communicating with a person with
dementia are like barriers.
•
It is up to us to knock the walls down so we can
communicate and relate effectively.
INTRODUCE ROLE PLAY Activity 3.3
EXPLAIN:
Activity 3.3 Role play
[10 mins]
•
We are going to do an activity to help us experience
what it may be like to be dependent just on non-verbal
communication to get a message across.
DIVIDE the group into small groups of 3-6 people
EXPLAIN:
•
Each group will be given a card with instructions about
a message you need to communicate.
•
Your task is to try and communicate the message
(without using words) so that it is understood by
others. (so you can only mime/act.. no talking at all)
•
The rest of the group is going to try and guess what
your message is
Handout cards - one per group
HANDOUT CARDS - one per group
EXPLAIN:
Workbook page 7
•
There is a space on page 7 of your workbooks to plan
your role play
Allow 5 minutes for groups to plan then COMMENCE
ACTIVITY by selecting a group to go first
Work through each group in turn, until all groups have role
played and the guessing has been completed.
Thank the group for their input
Module three: Communicating effectively – Facilitator guide
11
Facilitator Guide – Module 3 Communicating effectively
SHOW SLIDE AND EXPLAIN:
Slide
9
•
A person with dementia has a progressive
deterioration in communication and comprehension
skills.
•
Although not everyone progresses at the same rate
(everyone is individual), everyone will deteriorate over
time.
•
This slide depicts the progression of change of
dementia.
DISCUSS the gradual loss of ability to write and speak and
understand writing and spoken words.
EXPLAIN:
workbook page 9
•
People with dementia will need increasing assistance
to communicate.
•
A person finds it more and more difficult to express
themselves clearly to you and others, and to
understand what you or others say.
EXPLAIN:
•
Lets now have a look at some strategies for
communicating with dementia effectively.
•
These include verbal, non verbal and rephrasing.
•
There are spaces on page 9 of your workbooks to
take notes
SHOW SLIDE AND EXPLAIN
Slide
10
•
The Five 'S's'
•
Use of familiar words
•
Reflecting
•
Repeating, Rephrasing.
Module three: Communicating effectively – Facilitator guide
12
Facilitator Guide – Module 3 Communicating effectively
SHOW SLIDE AND EXPLAIN
Slide
11
•
Non verbal communication can be very useful to gain
attention and to prompt and guide
Gain attention:
•
Make sure you can be seen and heard. Lighting, keep
your face in the light and avoid glare
•
Minimise distractions e.g. noise - TV, radio, other
people talking loudly etc. Remember people with
dementia may have difficulty screening out
interference from other sources
workbook page 9
Active listening:
•
Use your ears, eyes, mind and ‘gut’ feeling.
Warm, pleasant calm:
•
This approach will lower anxiety.
•
A calm environment will help maximize a person’s
abilities and reduce ill-being.
Tone of voice:
• Keep pitch low and pace of speech slow.
!
•
This sounds calmer than high pitched rapid speech
Face to face:
•
Ensure you are at the same level and have eye
contact.
•
Use facial expressions and gestures to back up
words
•
Never argue and watch the position of your body.
Module three: Communicating effectively – Facilitator guide
13
Facilitator Guide – Module 3 Communicating effectively
SHOW SLIDE AND EXPLAIN:
Slide
12
Activity - 3.4 Case study
[10 mins]
Workbook page 10
•
Active Listening – using all your senses to help
understand what the person is expressing.
•
Empathy is an important tool – i.e. the ability to step
into the person’s with dementia shoes and see the
world from their perspective.
Reinforce that these strategies are important ways of
connecting with people with dementia – not just for
communicating information about tasks.
INTRODUCE ACTIVITY - 3.4 Case study
EXPLAIN:
•
Let's do a quick activity to highlight the importance of
the communication skills required to first engage or
make contact with a person with dementia.
•
Turn to page 10 in your workbook, here you will find a
case study, read it and answer the questions as best
you can.
•
You have 10 minutes
After 10 minutes ASK participants to share their ideas
SHOW SLIDE AND EXPLAIN:
Slide
13
!
•
There are some simple and effective communication
strategies that you can use to assist communicating
with people with dementia. These include:
•
Accepting attitude – use a calm, friendly and nonthreatening approach and try not to be judgemental.
•
Speaking clearly – short and simple, one idea at a
time. Speaking loudly does not mean a person
understands.
•
Body language – your body speaks louder than
words
•
The right environment – calmness by minimising
distractions e.g. lowers noise, busyness and respect
privacy.
•
The right level and words – eye level with familiar
words.
Module three: Communicating effectively – Facilitator guide
14
Facilitator Guide – Module 3 Communicating effectively
EXPLAIN:
Activity 3.5 - DVD
20 Mins
•
I am going to play a DVD, as you watch your task is to
list all the verbal and non-verbal forms of
communication you notice that are used by the care
workers
•
There is a space on page 11 of your workbook to take
notes
workbook page 11
Show DVD - clip 5
After the DVD, run an open group discussion around the
verbal and non-verbal communication skills they noted.
Thank the group for their input
EXPLAIN:
•
!
workbook page 12 has the content
you are covering replicated for
participants to follow
Now let's look at some techniques to encourage
effective communication.
EXPLAIN:
•
Let's now have a look at some additional
communication strategies
The ‘real’ world
•
Communication becomes more difficult as the
condition of dementia progresses. The person may at
times lose the ability to live in the ‘present’ as we
know it.
•
They may live in the past, or go ‘in’ and ‘out’ of reality.
They may experience delusions (a fixed firm belief
held by the person even though it is not true) and/or
hallucinations (seeing, hearing or feeling something
that is not really there) but which are very real to the
person.
!
Key to communication
•
Acknowledge the feelings of the person no matter
whether they are ‘in’ or ‘out’ of reality. It is important to
acknowledge that their feelings are real and they are
responding to their perceived world.
Module three: Communicating effectively – Facilitator guide
15
Facilitator Guide – Module 3 Communicating effectively
EXPLAIN:
Slide
14
•
There are some communication techniques that will
assist you in communicating with residents with
dementia.
SHOW SLIDE AND BROADLY EXPLAIN THE 3
TECHNIQUES
!
Slide
15
workbook page 13
Combination of techniques
• The success of reminiscence, 24 hour reality
orientation or validation will depend upon the
individual and the situation. A combination of all three
techniques may work at times.
•
As a general rule if these communication techniques
or combination of them increase the person’s sense of
contentment or well being e.g. happiness, you are on
the right track.
ASK participants to turn to page 13 in their workbooks and
with their team at the table answer the first 3 question boxes
Allow 5 minutes then bring the group back together and
show SLIDE as a way for them to check their answers
CHECK AND TOP UP
• Definition: the process of ‘recalling the past’
• It is powerful because it is often where people with
dementia feel most comfortable.
•
Activity 3.6 Five Senses
[15mins]
workbook page 13
Reminiscence uses past events to calm or distract a
person with dementia. They may be happy or sad
events. Try and use events that calm a person.
Why is it effective?
• A person with dementia loses their short term memory
but retains their long term memory until the last stage
of dementia. Therefore, although they may not be able
to remember what they had for breakfast they may
remember their home life as a child and how that felt.
It also feels good to be able to remember something
rather than feel like you are failing or forgetting all the
time.
INTRODUCE Activity 3.6
EXPLAIN:
• This next activity will help to make you aware of the
range of our senses that can be used for reminiscing.
•
With the group at your table complete the activity at
the bottom of page 13
Allow 10 minutes , after which, bring the group back and
BRIEFLY DISCUSS
Module three: Communicating effectively – Facilitator guide
16
Facilitator Guide – Module 3 Communicating effectively
ASK - Does anyone know what Reality Orientation is? Can
you give examples?
Slide
16
SHOW SLIDE AND EXPLAIN:
!
Activity 3.7 Scenario
[15 mins]
•
Definition: the process of ‘putting in touch with now’
reminding of day, time, relationships and occasions
•
This technique has been practised in many different
ways over the years. When caring for a person with
dementia it is best used as a passive 24 hour
approach (rather than as a confronting approach,
which is not recommended). Reality Orientation
should not be used if it is causing an argument or not
calming the person with dementia.
HOW IT WORKS:
• This technique gently brings the person back from
their world into our reality i.e. the here and now. You
can do this by orientating the person throughout the
day and night to:
• Who they are e.g. gain their attention by calling them
the name they prefer.
• Who you are e.g. by introducing yourself and say for
whom you work
• Where they are e.g. ‘you are in your bedroom’
• The time e.g. ‘such a lovely Sunday morning’
• The date e.g. ‘it is a lovely Saturday afternoon sunset
on 3rd March’.
WHY IS IT EFFECTIVE:
• Sometimes people with dementia become
disorientated in time, place and situation. This can
make them very frightened or anxious. Sometimes
their routine may be unintentionally changed (e.g. a
relief staff person) and this can make them have a
sense of ill-being. You can reassure them they are
safe and you are with them.
INTRODUCE ACTIVITY 3.7 - Scenario
workbook page 14
EXPLAIN:
• Let's practice the use of reality orientation via a case
scenario.
• In your workbooks on page 14 you will find a scenario
and some questions to answer
• Spend the next 10 minutes answering them as best
you can
Allow 10 minutes, then bring the group back and DISCUSS
their ideas
Thank the group for their input
Module three: Communicating effectively – Facilitator guide
17
Facilitator Guide – Module 3 Communicating effectively
ASK - Does anyone know what Validation is? Can you give
examples?
Slide
17
SHOW SLIDE AND EXPLAIN:
!
workbook page 15 for
participants to take notes as you
explain validation
•
Definition: accepting and acknowledging the feelings
of the person with dementia
•
It is the process of communicating with the person
with dementia in whatever time or location is real to
them, even if it doesn’t correspond to the here on
now.
How does it work:
• Acknowledges and empathises with the person’s
feelings and reality. You do not correct the person or
argue about the truth, because it is real to them. This
technique helps us ‘enter into their world’ and
orientate ourselves to their reality and helps us to put
ourselves in touch with their feelings (empathy).
Why is it effective:
• It enables the person with dementia to feel accepted
and to encourage expressions of their feelings.
How - Accept, Acknowledge, Express and Divert:
•
•
•
•
Accept – by your non-verbal (facial) cues and tone of
voice
Acknowledge – by empathetic statements how they
are feeling and reassure them that they are safe and
that you are there with them
Express – ask them questions that allow them to
express how they are feeling
Divert – to another activity or topic or location.
INTRODUCE ACTIVITY 3.8 - DVD clip 6
Activity 3.8 DVD/clip 6
[15 mins]
EXPLAIN:
•
I am now going to show a DVD that outlines the
effective communication skills we have discovered so
far
•
As you watch jot down any questions you may have
on page 16 of your workbook
Workbook page 16
After the DVD ASK - What questions do you have?
Module three: Communicating effectively – Facilitator guide
18
Facilitator Guide – Module 3 Communicating effectively
Activity 3.9 Case Study
[15 mins]
Workbook page 17
INTRODUCE ACTIVITY 3.9 Case Study
•
It's time to put our validation skills into practise via an
activity
•
On page 17 of your workbook is a case scenario.
•
Read the scenario and answer the questions as best
you can
•
You will have 10 minutes
Allow 10 minutes, after which BRIEFLY DISCUSS responses
EXPLAIN:
Slide
18
•
We are now moving into the final topic of our
workshop, and this section is all about
Communication, cultural differences and working with
families
SHOW SLIDE and READ IT OUT
Workbook page 18
REFER participants to page 18 of their workbooks where they
can take notes
ASK:
•
What additional strategies might we use when
communicating with a person who has dementia and
who is from another cultural background?
BRIEFLY DISCUSS
?
ASK:
• What might we have to consider?
BRIEFLY DISCUSS
Refer to notes for current statistics in Australia.
Module three: Communicating effectively – Facilitator guide
19
Facilitator Guide – Module 3 Communicating effectively
SHOW SLIDE AND EXPLAIN:
• At the bottom of page 18 is a space for you to take
notes as I explain a little more about the similarities
and differences between people from diverse cultural
and linguistic backgrounds.
Slide
19
workbook page 18 for participants to
take notes
ACTIVITY 3.10 - Group exercise
[10 mins]
Workbook page 19
•
Same – people from all around the world, irrespective
of their background have similarities – basic human
needs water, food, shelter, love etc.
•
Different – What does the food look like? What does
the shelter look like etc. – it will reflect the
environment and culture within that environment
•
Unique – I like to wear my dress scarf this way, I like
to cook my rice this way etc.
INTRODUCE ACTIVITY 3.10 - Group exercise
EXPLAIN:
•
Culture is different beliefs, different words, different
religions and how we do the little things differently
•
Let's find out a little more about the differences
between us in this room, and at the same time gain an
appreciation of difference.
•
On page 19 of your workbooks you will find a list of
questions.
•
On your own answer the questions, then share your
responses with the people at your table to gain an
appreciation of cultural diversity.
Allow 10 minutes and then bring the group back and ASK for
one or two volunteers to share some of the interesting things
they discovered.
Module three: Communicating effectively – Facilitator guide
20
Facilitator Guide – Module 3 Communicating effectively
ASK participants to turn to page 20 in their workbooks and to
complete the missing words as you introduce them to more
information on Culturally sensitive strategies
Workbook page 20
SHOW SLIDE AND READ IT OUT
EXPLAIN:
• Traditions include food, cultural customs, events etc
Slide
20
Slide
21
•
Links can be with family carers, other community
groups, clusters in residential care
•
Aids – cards with photos and words in English and
other language
•
Resources – trans cultural aged care services.
•
Like groups of people, families also have their
cultures. We need to understand the ‘journey’ of
families living with dementia, i.e. caring for a
spouse or family member. If we understand we will
be able to communicate effectively.
EXPLAIN:
•
The condition of dementia shows itself in a person but
has an impact on many people around the person. A
person has the condition of dementia but the family or
significant others are ‘living’ with dementia.
SHOW SLIDE and EXPLAIN and EXPAND on each point
Workbook page 21 replicates the
information you are sharing with
participants
EXPLAIN:
•
Understanding their caring journey. It is different for
everyone.
Module three: Communicating effectively – Facilitator guide
21
Facilitator Guide – Module 3 Communicating effectively
Slide
22
SHOW SLIDE and READ IT OUT
highlight the uniqueness of individual carers
It is important not to judge carers.
Workbook page 21 replicates the
information you are sharing with
participants
EXPLAIN
• It is important for us to understand the family
carers and their stresses
Slide
23
SHOW SLIDE AND EXPLAIN each point
INTRODUCE Activity 3.11/DVD/clip 7
Activity 3.11 DVD
[15mins]
workbook page 22
•
To increase the awareness of the ‘journey’ that family
members experience when living with a person with
dementia, Let's watch a DVD.
•
After you watch there will be questions to answer on
page 22
•
Take a moment now to look at the questions, so that
you know what to look out for in the video.
Allow 1 minute then PLAY DVD
After the DVD ASK the group to answers the questions on
page 22.
Allow 5 minutes then discuss their findings as a total group
Module three: Communicating effectively – Facilitator guide
22
Facilitator Guide – Module 3 Communicating effectively
SHOW SLIDE AND EXPLAIN Common carer needs:
Slide
24
Activity 3.12 Carer needs
[10 mins]
•
Emotional support – listen and talk second – carers
need an accepting environment to ‘spill’ their feelings
(e.g. guilt, grief, ambivalence)
•
Knowledge about dementia & caring –
understanding what is happening in their world
(address confusion and incomprehension)
•
Information & practical support – additional support
and respite
•
Time out & self care skills – address exhaustion and
their own health
INTRODUCE ACTIVITY 3.12 Carer needs [10 mins]
EXPLAIN:
Workbook page 23
•
To help you become aware of the impact of dementia
on support systems and the range of needs of family
carers whether in residential or community aged care
services, let's do a quick activity.
•
Turn to page 23 in your workbooks and using your
own knowledge, list some common family carer needs
under each of the headings listed
You will have 10 minutes for this activity
Allow 10 minutes, after which, bring the group back together
and discuss their ideas.
SHOW SLIDE AND EXPLAIN:
Slide
25
•
There is a space on page 24 to take notes as I explain
practical application
EXPLAIN:
workbook page 24
•
Listen first and talk second – usually carers have a
lot of emotions that need to be released before they
can take on board anything else
•
Be empathetic – ‘it must be hard when ….’ - do not
become defensive of your organisation or skills
•
Be non-judgmental – you do not know what the
history of past relationships have been like
•
Do not jump into defending – just listen and
empathise. You are not to blame.
•
Refer on … to your team leader or manager if further
time or information is required.
Module three: Communicating effectively – Facilitator guide
23
Facilitator Guide – Module 3 Communicating effectively
SHOW SLIDE and EXPLAIN and EXPAND on each point
Slide
26
EXPLAIN:
Workbook page 25 replicates
what the slide represents
•
Families can give us important information about the
person’s background, personality, habits,
preferences, meaning of symptoms, caring
strategies, what brings pleasure and may be able to
identify problems early.
•
Often families like to assist practically. They may
need to know that it’s OK.
SHOW SLIDE
Slide
27
ASK The participants to read it to themselves
ASK - What does this slide mean to you?
DISCUSS RESPONSES
CHECK AND TOP UP
•
Sometimes we can fall into the trap of trying too hard
to understand what the person is saying (the words)
rather than overall what the person is conveying by
their body language (the music).
•
Work with the feelings.
Workbook page 26 replicates
what the slide represents
Module three: Communicating effectively – Facilitator guide
24
Facilitator Guide – Module 3 Communicating effectively
EXPLAIN:
Slide
28
•
We have arrived at the end of the module, and have
just a couple of final things to work through:
1. A review of what we have learnt
2. Discover some useful 'on job' / workplace activities
•
Let's start by reviewing the key messages from the
module
SHOW SLIDE and READ IT OUT
Invite questions and comments regarding the groups
understanding of dementia and its impact
INTRODUCE ACTIVITY 1.6
Module Revision
[10 mins]
Workbook pages 28 and 29
INTRODUCE ACTIVITY 1.6 Module Revision [10 mins]
To help you to self assess your understanding of the content
in the module and to reinforce the learning that has occurred,
could you please turn to pages 28 - 29 and complete the
simple Multiple choice quiz.
Allow 5 minutes then provide the answers
1- D
2-A
3-A
4-D
5-D
6 -D
7-C
8-D
9-B
10 - C
!
EXPLAIN:
• To assist you in continuing the good work you have
put into this module, we have developed some
workplace activities.
•
Turn to pages 30 - 31 in your workbook, and lets learn
more about these.
Facilitator note - explain the workplace activities to the group,
check their understanding of what is expected of them.
Thank the group for the participation
Session Close
Module three: Communicating effectively – Facilitator guide
25
Facilitator Guide – Module 3 Communicating effectively
Activity 3.2 Drawing Exercise diagram
Template for laminated Card / Participant Handout
Module three: Communicating effectively – Facilitator guide
26
Facilitator Guide – Module 3 Communicating effectively
Activity 2.3 Role Play – Communicating Needs
Template for 6 laminated Cards Explain that the group will be divided into small groups of 3-6 people.
Each small group will be given a card with instructions. They are to follow the instructions and the rest
of the group is asked to guess what the ‘message’ is that the small group is telling them without using
words (and only acting).
Group 1
I’m tired and I want to rest
Group 2
I have a headache
Module three: Communicating effectively – Facilitator guide
27
Facilitator Guide – Module 3 Communicating effectively
Group 3
I don’t want to play Bingo
\
Group 4
I just want my own space
Module three: Communicating effectively – Facilitator guide
28
Facilitator Guide – Module 3 Communicating effectively
Group 5
I am frightened
\
Group 6
I don’t know what you want
me to do?
Module three: Communicating effectively – Facilitator guide
29
Facilitator Guide – Module 3 Communicating effectively
Activity 3.4
Case Study Anne and John - Answer Guideline
John did not recognise Anne as she
approached.
He heard the words that she spoke
but they did not make sense to him
and an anxious frown appeared on
his face.
He again had a sense of not knowing
where he was or what he was
supposed to do.
If you were Anne, list three ways you would start to communicate with
John
1. Anne came close but not too close – body language and spacing
2. lowered herself to his eye level and gently smiled
3. Gave him her hand to hold
Other forms of verbal or non-verbal communication may be mentioned.
Anne came close, but not too close, lowered herself to his eye level, gently
smiled and gave him her hand to hold while inquiring about his needs.
John still did not recognise Anne, nor understand where he was but
seemed to comprehend that he was in a place that cared for him and
meant him no harm – and his frown melted into a sigh of relief.
Module three: Communicating effectively – Facilitator guide
30
Facilitator Guide – Module 3 Communicating effectively
Activity 3.7
Work book Scenario Mr Chou - Answer Guideline
You go to see if Mr Chou wants any assistance
in getting up this morning. You know he
usually requires a bit of support by way of
prompting and guiding to ‘get going for the
day’. You knock on his bedroom and he says it
is OK to enter but in a quivering tone.
Mr Chou is looking very unsettled this morning.
He has a worried look on his face. He appears
confused, not knowing who you are and where
he is and what he should do next. He just
looks ‘lost’ and ‘worried’.
Answer the following questions and explain
what you could say to Mr Chou using a 24
hour Reality Orientation approach?
Q1. How do you think Mr Chou feeling from your observations?
Very anxious, worried and confused.
Q2. How is this feeling ‘showing’ in his behaviour and the way he is relating to you?
His tone of voice, his worried
worried face,
face, his hands on his forehead and looking around
perplexed
Q3. What ‘need’ do you think he has?
He needs reassurance.
reassurance. He needs to know he
he is safe. He needs to know where he is, what is
going to happen next and who I am.
Q4. What could you say to Mr Chou using a 24 Reality Orientation approach?
Good morning Mr Ch
Chou I am Peter. (Pause).
ause).
Isn’
Isn’t it a nice warm spring
spring morning?
morning? (Pause)
I am here to help you get ready for the day. (Pause) I can assist you to get up?
up?
I assisted you yesterday morning in your bedroom just like I am doing now.
Module three: Communicating effectively – Facilitator guide
31
Facilitator Guide – Module 3 Communicating effectively
Activity 3.9
Case Study Beryl at the Gate Answer Guideline
Beryl was at the front gates yet again, pleading for
passers by to help her get home to her children. When
staff approached, Beryl demonstrated an agitated
concern about the safety of the children and the need to
prepare
their dinner before it got too late. Previous staff had
attempted to alert Beryl to the fact that the children
were now in their sixties and could prepare their own
Q1. How do you think Beryl was feeling from your observations?
Worried and very anxious. Her children needed her or they would
starve!
Q2. How is this feeling ‘showing’ in her behaviour and the way she is
relating to you and other staff?
She was very distressed
distressed and pleading with people to help her get
home! She became increasingly cross with staff because they
could not understand and kept telling her, her children were
grown up. This was all very confusing for her. She must go or
they will starve!
Q3. What ‘need’ do you think she has?
She needs to be there for the children. For their safety and so they do not starve. She needs
reassurance that her children are OK and she is not irresponsible as a mother.
Q4. What could you say to Beryl using a validation approach?
Take her concerns about her children seriously and ask her about them. Acknowledge that she
is feeling anxious about their safety and need for food. Reassure Beryl that the children are
When Sandra approached Beryl she suggested to her that she understood her concern about
the children and proceeded to ask about them in a personalised way. She further reinforced to
Beryl that the children loved her very much and that their dinner was being taken care of and
all was well. She additionally reinforced that she was there to care for Beryl. Beryl’s level of
distress diminished significantly and Sandra was able to interest her in a nice hot ‘cuppa’ to
discuss some favourite recipes.
Module three: Communicating effectively – Facilitator guide
32
Facilitator Guide – Module 3 Communicating effectively
Module 3: Instructions for activities
Activity 3.1 Compare different approaches by care workers
Aims of the Activity
To contrast for participants the difference between effective and poor communication.
Materials required
Scenarios
Time required
15 minutes
What to do
Explain that we can communicate effectively or poorly.
Find activity 3.1 in your participant handbook.
Ask participants to read the following case study and comment on the different ways the
care workers responded to Mr Wood in each scenario.
Case Study
It is time for dinner and Mr Taylor is watching television. A care worker has come to let him
know dinner is ready.
Consider these scenarios …
Scenario 1
The care worker says to him, as she quickly moves across the room, ‘Do you want to finish
watching your show or do you want to have dinner? They’ve made your favourite,
Shepherd’s pie. Your show is almost over, so you’d better come now before your dinner gets
cold.’ She waits for a moment as Mr Taylor looks up, completely bewildered. The care
worker sighs and walks out of the room mumbling ‘I might as well talk to a brick wall.’
Scenario 2
The care worker walks into Mr Taylor’s room and smiles at him as she turns the television
down. She then kneels in front of Mr Taylor and says ‘There is Shepherd’s pie for dinner.
Your favourite!’ He responds with a smile. She says, ‘Do you want to eat dinner now or wait
til this show is over?’ Mr Taylor nods yes, and then follows her to the dining room.
In a large group, ask participants to comment on the communication in each scenario.
• What was good and why? What was poor and why?
• What was the impact on the person with dementia?
Debriefing (questions)
Now you have seen discussed examples of effective and poor communication and the
impact it has on other people. It is important to remember this when we are communicating
with people with dementia.
Ask if there are any other comments or questions.
Module three: Communicating effectively – Facilitator guide
33
Facilitator Guide – Module 3 Communicating effectively
Activity 3.2
Drawing Exercise
Aims of the Activity
To highlight for participants the verbal and non-verbal elements of communication.
Materials required
The diagram to draw.
Time required
15 minutes
What to do
1. Explain how complex the process of communication is and how this activity will illustrate
this fact.
2. Find activity 3.2 in your Participant Handbook.
3. Tell the participants that this exercise has 2 parts and participants will work in pairs.
4. Divide the group into 2 and ask Group1 to go out of the room while you instruct Group 2.
If there are uneven numbers ask one participant to volunteer to be an observer. Tell this
person to note down communication strategies they seen being demonstrated (ensure
other participants do not hear these instructions).
Group 2 Senders
5. Explain they are the senders in this exercise. Give each sender a copy of the abstract
drawing. Tell the senders they must not let their partner see this drawing and that they
are to explain in words to their partner how to reproduce the drawing. In the first part they
are to sit back to back with their partner and when explaining, they cannot use words that
describe shapes such as circle or triangle. After completing this part, reinforce that they
are not to show their partner the drawing but should go onto part 2 of the activity.
6. In this part, the pairs can sit facing each other or side by side, the sender can use any
words they like and can use gestures etc, anything except showing the drawing to their
partner. When they have completed the drawing the second time, the sender can show
their partner the original drawing.
Group 1 Receivers
7. Ask Group 1 to go outside and explain they are to be receivers in this exercise. Tell
them that this is a communication exercise and they are to pair up with a sender. Allay
any performance anxiety.
8. Commence the activity by inviting Group 1 to come inside and pair up with their partner
from Group 2. Five minutes back to back and then signal time to go face to face for five
minutes.
9. End the activity after 10 minutes.
10. Ask the pairs to discuss with each other what helped and what hindered in regard to
communication and accurately drawing the diagram.
When back to back:
Q. What made it hard for the receiver when back to back?
Q. What made it hard for the sender?
Module three: Communicating effectively – Facilitator guide
34
Facilitator Guide – Module 3 Communicating effectively
When face to face
Q. What was it like for the receiver when back to back?
Q. What was it like for the sender?
11. Divide the whiteboard into three columns and write the headings ‘Feelings’, ‘Difficulties’
(barriers), ‘Helpful’ (enablers)
12. Discuss in a large group the results of paired discussion. If participants mention a
feeling e.g. frustrated, write it up. If they mention a difficulty (could not see them) or
something that was helpful (when I could see their face), write it up.
13. Ask how this relates to the experience of communicating with a person who has
dementia.
Q. How many of these barriers can interfere with communicating effectively with a
person who has dementia?
Debriefing (questions)
Reinforce that communication is complex and there are many factors involved, both verbal
and non-verbal elements.
This activity highlights the impact of removing or adding barriers to communication e.g. not
seeing someone’s face.
The impact on a person with dementia is not only the possibility of these factors occurring
naturally but additional barriers or difficulties due to the illness causing the dementia.
Now we will look at the impact that dementia can have on communication and you can
communicate effectively.
Ask if there are any other comments or questions.
Facilitator Tips
•
This activity can generate a lot of humour and fun. Be careful to make sure participants
remember the main points of the activity and not just get ‘lost’ in the fun.
Module three: Communicating effectively – Facilitator guide
35
Facilitator Guide – Module 3 Communicating effectively
Facilitator’s Tips
Activity 3.3
Role Play – Communicating needs
Aims of the Activity
To enable participants to experience what it may be like to be dependent just on non-verbal
communication to get a message across.
Materials required
A set of laminated cards with instructions on each card.
Time required
10 minutes
What to do
1. Explain that the group will be divided into small groups of 3-6 people. Each small group
will be given a card with instructions. They are to follow the instructions and the rest of
the group is asked to guess what the ‘message’ is that the small group is telling them
without using words (and only acting).
2. Find Activity 3.3 in your participant Handbook.
3. Divide into small groups
4. Give each small group a card with instructions and give them 5 minutes to prepare their
‘performance’.
5. Ask each small group to ‘perform’ and ask the other participants to guess the ‘message’
the small group is trying to tell them without using words.
6. Discuss as a large group how this activity relates to the way people with dementia
communicate with you and other care staff.
Debriefing (questions)
Reinforce that people with dementia may only be able to communicate to us by using nonverbal body language. You need to observe their body as well as listen to their words.
Ask if there are any other comments or questions.
Facilitator Tips
•
Participants will often ‘giggle’ when giving their performance. This usually occurs
because they are nervous in front of other people. Tolerate a certain amount of this but
try to put the focus on the other participants trying to guess what the message is.
Module three: Communicating effectively – Facilitator guide
36
Facilitator Guide – Module 3 Communicating effectively
Activity 3.4
Case Study – Anne and John
Aims of the Activity
To highlight the importance of the communication skills required to first engage or make
contact with a person with dementia.
Materials required
None. Use Activity 3.4 in the Participant’s Handbook.
Time required
10 minutes
What to do
1. Explain the importance of our first contact with a person with dementia.
2. Find Activity 3.4 in your participant Handbook.
3. Read the case study of Anne and John.
4. Answer the questions and then share your answers with a partner in pairs.
5. In a large group seek feedback from some of the small groups.
6. Discuss in a large group the important communication skills required when first
engaging with a person with dementia.
Debriefing (questions)
Reinforce the basic communication skills required to engage effectively in conversation with
a person with dementia.
Ask if there are any other comments or questions.
Facilitator’s Tips
• As an outcome of this activity Participants should have at least five clear communication
skills required to engage effectively in conversation with a person with dementia.
Module three: Communicating effectively – Facilitator guide
37
Facilitator Guide – Module 3 Communicating effectively
Activity 3.5
DVD/clip 6
Communication Skills
Aims of the Activity
To show participants staff using a range of effective communication skills in typical work
settings.
Materials required
DVD Clip and Activity 3.5 in the participant Handbook.
Time required
20 minutes
What to do
1. Explain that it is important to see how care staff put into practice effective
communication skills.
2. Find Activity 3.5 in your Participant Handbook.
3. Watch the DVD.
4. Answer the questions.
5. Discuss each question as part of a larger group discussion.
Debriefing (questions)
Reinforce communication skills demonstrated in the DVD and covered thus far in the
module.
Ask if there are any other comments or questions.
Facilitator’s Tips
Draw out the communication skills illustrated in the DVD and help participants to give
examples of these skills in their work.
Module three: Communicating effectively – Facilitator guide
38
Facilitator Guide – Module 3 Communicating effectively
Activity 3.6
Five senses
Aims of the Activity
To make participants aware of the range of our senses that can be used for reminiscing.
Materials required
None. Use Activity 3.6 in Participant Handbook.
Time required
15 minutes.
What to do
1. Explain when using reminiscence not to limit it to a few senses but options of availability
of all our senses.
2. Find Activity 3.6 in your Participant Handbook.
3. Complete the questions.
4. Discuss each question as part of a large discussion group.
Debriefing (questions)
Reinforce the range of human senses that can be used in reminiscing with people with
dementia.
Ask if there are any other comments or questions.
Facilitator’s Tips
•
You may need to keep bringing the focus of the group discussion back to reminiscing
with people with dementia if participants get a bit carried away with their own
reminiscing.
Module three: Communicating effectively – Facilitator guide
39
Facilitator Guide – Module 3 Communicating effectively
Activity 3.7
Scenarios – Reality Orientation
Aims of the Activity
To practice the use of reality orientation in a case scenario.
Materials required
None. Use Activity 3.7 in Participant Handbook.
Time required
15 minutes.
What to do
1. Explain we need to practice using reality orientation.
2. Find Activity 3.7 in your Participant Handbook.
3. Complete the questions.
4. Discuss each question as part of a large discussion group.
Debriefing (questions)
Reinforce how useful reality orientation can be in communicating effectively with people with
dementia.
Ask if there are any other comments or questions.
Facilitator’s Tips
• You may need to discuss the benefits of reality orientation as well as the limitations in
certain circumstances.
Module three: Communicating effectively – Facilitator guide
40
Facilitator Guide – Module 3 Communicating effectively
Activity 3.8
DVD/clip 5
Relating and communicating
Aims of the Activity
To show staff using effective communication skills already outlined in module.
Materials required
DVD Clip Relating and Communicating.
Time required
15 minutes.
What to do
1. Explain that we need to communicate effectively.
2. Find Activity 3.8 in your participant handbook.
3. Ask participants to watch the DVD and answer the questions.
4. Show the DVD clip.
5. Discuss each question as part of a larger discussion.
Debriefing (questions)
Reinforce communication skills reinforced in the DVD.
Ask if there are any other comments or questions.
Facilitator’s Tips
None.
Module three: Communicating effectively – Facilitator guide
41
Facilitator Guide – Module 3 Communicating effectively
Activity 3.9
Case Study Beryl at the Gate
Aims of the Activity
To practice the use of validation in a case scenario.
Materials required
None. Use Activity 3.9 in the Participant’s Handbook.
Time required
15 minutes
What to do
1. Explain we need to practice using validation.
2. Find Activity 3.9 in your Participant Handbook.
3. Complete the questions.
4. Discuss each question as part of a large discussion group.
Debriefing (questions)
Reinforce how useful validation can be in communicating effectively with people with
dementia.
Ask if there are any other comments or questions.
Facilitator’s Tips
• You may need to discuss the benefits of validation as well as the limitations in certain
circumstances.
Module three: Communicating effectively – Facilitator guide
42
Facilitator Guide – Module 3 Communicating effectively
Activity 3.10
Cultural diversity – our everyday activities
Aims of the Activity
To highlight the importance of being aware of cultural differences and how to accommodate
them for people with dementia.
Materials required
None. Use Participant Handbook.
Time required
10 minutes
What to do
Explain that this activity will make us aware of the definition of culture and what it means to
us in our everyday life and how we relate that to people with dementia with cultural and
linguistic diversity.
Find Activity 3.10 in your Participant Handbook.
Divide into small groups of 3 -6 people.
Complete the activity as a small group.
Discuss your answers in a small group.
In a large group seek feedback from the some of the small groups.
Discuss in a large group the importance of being aware off cultural and linguistic diversity in
working with people living with dementia.
Debriefing (questions)
Reinforce the importance of being aware of cultural and linguistic diversity.
Ask if there are any other comments or questions.
Facilitator’s Tips
•
•
Be aware of your modelling in regard to cultural and linguistic diversity.
Do not tolerate any form of cultural and linguistic discrimination amongst your
participants in your learning environment and address the situation if it arises from
comments made etc. in discussions.
Module three: Communicating effectively – Facilitator guide
43
Facilitator Guide – Module 3 Communicating effectively
Activity 3.11
DVD/clip 7 Cares Experience
Aims of the Activity
To increase the awareness of participants to the ‘journey’ that family members experience
when living with a person with dementia.
Materials required
DVD Clip Carer’s Experience
Time required
15 minutes.
What to do
1. Explain that we need to understand what it is like for people (family carers) living with
dementia (assisting and caring for a person with dementia).
2. Find Activity 3.11 in your Participant Handbook.
3. Ask participants to watch the DVD and answer the questions.
4. Show the DVD clip.
5. Discuss each question as part of a larger discussion.
Debriefing (questions)
Reinforce the importance of understanding the ‘journey’ of families living with dementia.
Ask if there are any other comments or questions.
Facilitator’s Tips
•
Be aware that some participants may be care workers and family carers. If so, be aware
of the effect of the DVD on them and watch their body language or behaviour. Offer them
services for additional support outside of the learning session if required.
Module three: Communicating effectively – Facilitator guide
44
Facilitator Guide – Module 3 Communicating effectively
Activity 3.12
Carer needs
Aims of the Activity
To make participants aware of the impact of dementia on support systems and the range of
needs of family carers whether in residential or community aged care services.
Materials required
None. Use Activity 3.12 in Participant Handbook.
Time required
10 minutes.
What to do
1. Explain the impact of dementia on people with dementia and their needs. Although
illnesses causing dementia are in the individual, dementia affects the whole family. This
applies equally in residential and community and care services.
2. Find Activity 3.12 in your Participant Handbook.
3. Divide the participants into small groups of 3 – 6 people.
4. Complete the questions.
Q. List three ways you could provide help and support to family carers in one of the
following categories:
• Emotional support e.g. encourages expression of feelings, don’t judge, listen and
refer to services if appropriate.
• Information about dementia e.g. help carers understand the link between symptoms
and brain damage, explain what you know in simple terms, explain what you know
about support services, refer if appropriate
• Practical support e.g. give information about aids, strategies and services, refer to
services and accept rejection graciously
• Respite and self care skills e.g. explain the role of respite, encourage but do not
push, explore options and refer.
5. Discuss each question as part of a large discussion group.
Debriefing (questions)
Reinforce the impact of dementia on families and their range of needs.
Ask if there are any other comments or questions.
Facilitator’s Tips
•
Be aware that some participants may be care workers and family carers. If so, be aware
of the effect of the discussion on them and watch their body language or behaviour. Offer
them services for additional support outside of the learning session if required.
Module three: Communicating effectively – Facilitator guide
45
Facilitator Guide – Module 3 Communicating effectively
Activity 3.13
Module Revision
Aims of the Activity
•
•
To help participants to self assess their understanding of the content in the module.
To reinforce the learning that has occurred in this module.
Materials required
None. In Participant Handbook.
Time required
10 minutes.
What to do
Explain the importance of participants being able to assess their understanding of the
material taught in this module. The review activity also helps to reinforce what you have
learnt.
Find Activity 2.13 at the end of the module in your Participant Handbook.
Either instruct participants to answer the questions individually and then go through them
as a large group
or
Go through the questions one at a time and ask participants to complete them one at a
time as you progress. After allowing time to answer the question the group can discuss the
correct answer.
Debriefing (questions)
Emphasise the importance of assessing our learning and understanding as we progress
through the Course. This module highlights the importance of communicating effectively.
Remember to watch your body language, the tone of your voice and give one message at a
time. Never argue.
Recognise and use cultural and linguistic diversity to help you with developing successful
strategies in assisting and caring for people with dementia.
Remember the caring journey is unique for each family.
Ask if there are any other comments or questions.
Facilitator’s Tips
•
If there is disagreement about the answer to a question, it is usually because people
have interpreted it differently to what was intended. Try to point this out to the person.
•
Sometimes saying to the person, ‘I understand you have answered that way because of
your interpretation, but what you think the intent of the question was?’ This can help
clarify the answer.
Module three: Communicating effectively – Facilitator guide
46
Facilitator Guide – Module 3 Communicating effectively
Module Revision Answers
This activity will help participants to self assess their understanding of the content in the
module and to reinforce their learning that has occurred.
Multiple Choice. The correct answer is bolded and underlined.
1. People with dementia may need increasing assistance to communicate. They may:
A. Mix up their words
B. Lose the ability to speak
C. Lose the ability to understand what you are saying to them
D. All of the above
2. Communication is made up of three parts:
A. Body language 60%, Tone and Pitch of Voice 30%, Words 7%
B. Body language 33%, Tone and Pitch of Voice 33%, Words 33%
C. Body language 10%, Tone and Pitch of Voice 30%, Words 60%
D. Body language 25%, Tone and Pitch of Voice 25%, Words 50%
3. Using an accepting attitude will:
A. Put the resident at ease
B. Mean you get paid more
C. Threaten the person with dementia
D. All of the above
4. You need to talk clearly to a person with dementia. This can mean:
A. Using short and simple sentences
B. Giving one instruction or piece of information at a time
C. Speaking slowly and clearly
D. All of the above
5. You need to create a calm and soothing environment so that:
A. You minimise distractions and noise
B. The resident doesn’t feel threatened
C. Communication will be easier
D. All of the above
Module three: Communicating effectively – Facilitator guide
47
Facilitator Guide – Module 3 Communicating effectively
6. Communicating with body language includes:
A. Facial expressions e.g. smiling
B. Eye contact
C. Gestures e.g. pointing
D. All of the above
7. It is important to communicate with residents at a level that they understand. You should:
A. Talk to the person as if they are deaf
B. Talk to the person as if they were a small child
C. Talk to the person as an adult
D. All of the above
8. The communication technique known as reality orientation:
A. Brings the person out of their world into yours
B. Cues the person to here and now
C. Should be used gently over 24 hours
D. All of the above
9. The communication technique known as validation:
A. Talks about the past
B. Acknowledges and empathises with the person’s feelings
and their reality or ‘world’
C. Gently brings the person back to reality
D. All of the above
10. The communication technique known as reminiscence:
A. Communicates with the person by using their short term memory
B. Brings the person back to reality
C. Uses past events to calm or distract a person who has dementia
D. All of the above.
Module three: Communicating effectively – Facilitator guide
48
Facilitator Guide – Module 3 Communicating effectively
Workplace Activity 3
Communicate effectively to a person with dementia
In this activity the participant will practice communicating effectively to a person with
dementia.
To do this activity they will need to demonstrate communicating effectively to person with
dementia. They should read the person’s File (including their social /lifestyle history and
Care Plan) so they know the background of the person and they communicate and behave.
They will need to complete the Workplace Activity 3 Worksheet provided in their Participant
Handbook by using information covered in this module and from the person’s file.
The time required for this activity is approximately 30 minutes.
Workplace Activity 3 Worksheet
Participants will need to do the following:
1. Select a person with dementia for whom they care in your workplace.
2. Locate the person’s File (including their social/lifestyle history and Care Plan).
3. Read the File (including and social / lifestyle history and Care Plan) to discover
information about the person’s social history and how to communicate to them effectively
on an individual basis.
4. Be observed by a more experienced care worker communicating effectively to a person
with dementia by demonstrating skills listed on the Workplace Activity 3 Worksheet.
5. Reflect on their communication by listing three reflections on the way they communicated
and its effectiveness.
Completed Workplace Activity Sheet
When they have completed their Workplace Activity 3 Worksheet, they hand to their
facilitator for feedback.
Module three: Communicating effectively – Facilitator guide
49
Facilitator Guide – Module 3 Communicating effectively
Workplace Activity 3 Worksheet
Communicate effectively to a person with dementia
Communicating effectively to a person with dementia
Example
Addresses the person by using their preferred name
Observed
demonstrating this
skill
1. Communicates using an accepting and positive attitude.
2.Talks clearly with a friendly tone of voice when communicating
3. Uses ‘positive’ body language and an ‘open’ posture
4. Creates a calm and soothing environment
5. Communicates at a level and in full view of the person’s face
6. Uses reminiscence and/or 24/7 reality orientation and/or
validation or a combination of all these techniques
appropriately in everyday conversations
7. Speaks in a way in which the person can understand
8. Speaks in a way that matches the ‘pace’ of the person
Name of Observer:
Signature
Date:
Three reflections on the way you communicate with people with dementia and the
reason it is effective.
Example I always make sure that they can see me and hear me. I know this is effective because I
get their attention and they look at me.
1.
2.
3.
Module three: Communicating effectively – Facilitator guide
50
Facilitator Guide – Module 3 Communicating effectively
Additional notes
Module 3
PPT 20 Transcultural aged care services
Meeting the needs of older people from culturally diverse backgrounds can be difficult,
especially in a residential setting where there may be many different cultural backgrounds.
Often second languages are forgotten so that people with dementia can only communicate
in their original first language.
In this situation, the use of interpreters is essential to gain a history and an understanding of
the person’s background. Family members can contribute but the older person may not have
shared their concerns with them. To promote the wellbeing of Aboriginal and Torres Strait
Islander people contact with their cultural group may be essential. The impact of dementia
on the cultural beliefs of the family should be established, e.g. do they understand it is a
disease; do they understand the disease process; do they consider it a mental illness?
• The person’s preferred language should be established and clearly documented.
• Daily conversations in the person’s preferred language should be conducted by using an
interpreter or a worker or carer who speaks the same language; or by using visitor
schemes, church groups, clubs or friends.
• Books, including picture books, in the person’s preferred language should be available.
These are sometimes available in both English and the person’s preferred language.
• Any signs or symbols that the person understands should be documented and used by
staff to help convey a message, e.g. a sign or picture for toilet or bathroom.
• Labels in the person’s preferred language should be used on cupboards or on items the
person uses, such as hairbrush, slippers, etc.
• Appropriate therapies, activities or events the person may enjoy should be discussed with
their family and participation of the person encouraged.
• Culturally specific events should be recognised and made available, such as posters,
food, films, books, or television programs.
• Music the person recognises and enjoys should be made available.
• Post traumatic stress may surface as memory changes and past events remembered.
• Experience of war, disasters, family abuse or trauma of any kind may cause changes in
behaviour: such as hiding when it becomes dark, hoarding items in case of famine,
refusing to undress in front of others or lashing out at authority figures. These behaviours
need to be understood and managed kindly and sensitively.
• Comfort and reassurance is constantly necessary for people living with dementia who
cannot express themselves because of language barriers. They will usually respond to a
worker or carer who conveys warmth and empathy and who genuinely tries to understand
their concerns.
• Some cultures forbid undressing or bathing in front of others. Privacy should be respected
For further information go to:
Alzheimer’s Australia
Website: www.fightdementia.org.au and look under ‘Cultural diversity’ and ‘Aboriginal and
Torres Strait Islander Groups’.
The Australian Government Health and Ageing - Partners in Culturally Appropriate Care
(PICAC)
Website: www.health.gov.au and look under ‘aged care, people with special needs’.
Module three: Communicating effectively – Facilitator guide
51
Facilitator Guide – Module 3 Communicating effectively
Module 3
PPT 21 Impact on families - supporting families
Sometimes families and friends become puzzled, upset, frustrated and/or exasperated
because of the actions and behaviours of a person with dementia. They may have difficulty
understanding why the person with dementia constantly repeats the same story over and
over, or why they talk about their life as it was many years ago.
If the person’s first language is not English, they may revert to speaking in their first
language, or they may speak a confused mixture of languages that makes it difficult for their
family to understand them. A family may tell you that in difficult situations, no amount of
cajoling or reasoning will change the situation.
As a result of this frustration and anxiety, and the constant demands of caring, families and
friends may show signs of carer stress. It is helpful to provide these people with information
about dementia, to create a better understanding of why such changes might be occurring.
As well as providing information about the disease, and sharing strategies that work, it may
be useful to give suggestions about where to obtain additional support and services to make
the task of caring an easier one. Some organisations provide support groups and
counselling to family and friends of people with dementia.
Alzheimer’s Australia
Website: www.fightdementia.org.au for a range of information and services to support
families.
Module three: Communicating effectively – Facilitator guide
52
Facilitator Guide – Module 3 Communicating effectively
Module three: Communicating effectively – Facilitator guide
53