6 Top tips on how to facilitate good interaction with older adults

top-tips-facilitate-good-interaction-older-adults

Robin Dynes, author of ‘Positive Communication: Activities to reduce isolation and improve the wellbeing of older adults’ provides some tips you can use to help facilitate good interaction with older adults and create a friendly environment

 

  1. Take any health and cultural issues into account

Age related health problems such as the onset of dementia, hearing loss, speech problems and the effects of medications can complicate understanding and the ability to communicate. Be aware of any difficulties individuals may have and take these into account. Make adjustments to any activities to allow for different mental and physical abilities. Even in today’s enlightened age many older adults, and, indeed, young people, have difficulty reading and writing. Find out all you can about the person you are supporting and adjust your communication methods to suit. This includes learning about their cultural background and what is or is not acceptable to them when communicating. For example, in some cultures it is disrespectful for younger people to make direct eye contact with an older person. In this instance it may be prudent to sit slightly to one side, keeping your eyes lowered but so the person can see your expressions, rather than facing the older person when talking.

 

  1. Use simple direct language

Avoid complex sentences. Simple sentences are easier to understand if the person has hearing or cognitive deficits. Express complicated thoughts or instructions in short sentences. Be patient, pause briefly between sentences and allow time for the person to take in what you are saying. Be prepared to repeat what the person has missed. Literal language is easier to understand than idioms or metaphors. Express one idea and message at a time and keep them in a logical order. For example: ‘We will go for a walk now. Later, we can have tea.’ Is better than ‘We’ll have tea when we come back from our walk.’ Use direct questions: ‘Did you bake a cake this morning?’ rather than ‘What did you do this morning?’ The more precise you are, the less difficulty the person will have understanding. The challenge is to simplify your language without talking down or being patronising.

 

  1. Speak clearly and make eye contact

Take care to articulate your words and speak clearly. Pronounce each word carefully rather than mumble or slur your speech. Look directly at the person’s face. Adjust your volume and pace, adapting it to the needs of the person. There is a temptation to shout if the person has hearing difficulties or when repeating something to emphasis what you are saying. But remember there is a difference between speaking clearly and shouting. Shouting is disrespectful and shows your impatience, speaking clearly at a suitable volume and pace shows respect.

 

  1. Watch your non-verbal communication

Be aware of your body language. A tense, worried or impatient expression will communicate anger, impatience or frustration even when speaking in a calm voice. A calm, relaxed speaking style will help keep the focus on the conversation without making the person feel anxious. A high-pitched voice usually communicates stress and a slightly lower pitch will help you sound relaxed. Make your facial expression match the message you are communicating.    

 

  1. Be a good listener

Older people often need time to retrieve a word they are looking for or to express what they want to say. Rather than supplying words, give the person time to think of their own expression or find another way of saying what they want. Not always easy to do, especially if you are busy. Remember, nobody likes to be interrupted or have words put into their mouth. Also avoid calling attention to any verbal mistakes the person makes by correcting them. If you have understood what is being said let the wrong words pass by. Observe the person’s tone of voice, facial expression and body language to help you interpret what they are saying. Check that you have understood correctly. For example ‘Am I right in thinking that you would like ….’

 

  1. Choose a suitable environment

Older adults often find busy environments with background noise difficult. It makes it hard to concentrate and difficult to hear what is being said. Eliminate background distractions including the radio and TV. Choose a quiet space for your activity or conversation. Make sure you have the person or group’s attention and they are not focused on completing another task.

 

Finally, not all older people have hearing or other communication problems. Many have very good mental and physical health and communicate without any difficulties. Use only methods which are appropriate to each situation and person.

 

Robin Dynes is a counsellor and freelance writer who has worked as a Social Inclusion Officer for Skills and Learning. Robin developed an outreach curriculum to meet the needs of people with disabilities, older people and other vulnerable people.

 

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How to build confident and compassionate dementia care teams

confident-compassionate-dementia-care-teamsLuke Tanner, author of Embracing Touch in Dementia Care, writes here about the importance of touch and physical contact when caring for someone living with dementia.
What happens when we deprive this type of comfort from those in need of it? How do we build confident and compassionate teams of carers? 

Whilst researching my book on touch in dementia care, I observed professional carer’s with exceptional skills in their use of touch. These carers were not trained in any fancy massage techniques or procedures. They were merely doing what came naturally to them. It was as natural as seeing a father cuddling up on the couch with his child, children playing together, partners consoling each other, a mother soothing her baby, or friends congratulating each other. Upon discussing their use of touch I discovered that they had learnt these skills simply through living their life. Their ability to offer tender loving care grew from the tenderness, love and care they had received themselves. This loving and comforting touch is universal, which means it is shared by all humanity.

Closeness speaks volumes in every culture. We tend to try and keep the people we love and care for close, remain distant from the people we care little about and push the people we dislike further away! You don’t have to be very clever or have all your cognitive faculties intact to understand this language. It is a primitive language that all mammals share: a language that relies upon the faculty of empathy; an ability to identify with and respond appropriately to the feelings and needs of others. This faculty is absolutely crucial to care-giving as well as human kind. Without it we would be lost and alone. Mammals are social animals because they are born with this seed of empathy. Loving and affectionate touch is the water that helps this seed grow strong. Touch and empathy are so closely bound that many forms of touch are actually experienced as empathy. This is because we first came to know empathy through touch, in the very first days or even moments of our life. Lessons in empathic touch start early, before words begin.

Given that touch is such a natural and effective way of caring, you would think that professional care providers would cherish this exceptionally powerful caregiving tool. Sadly this is not the case in many care settings. Many of the forms of comforting touch described above are often viewed upon with suspicion, doubt and mistrust. Discussions with professional carers about their attitude towards touch often reveal a great deal of uncertainty about what kinds of touch are acceptable in care settings and a lot of concern about how other people (peers, family members, visiting professionals, local authorities etc.) might perceive their touch. In short there is a lot of fear about “getting too close” and a great deal of uncertainty about how close “too close” is. A professional carers use of touch is further affected by lots of other issues ranging from beliefs about “the elderly” and people with dementia, staff uniforms, the furniture and layout of a care home lounge, concerns about infection control, to task orientation and routine bound systems of care. Unless directly addressed, these issues often add up to an extremely confused or touch-averse culture of care. Confident and compassionate care teams cannot exist in these cultures of care because such conditions actually function to suppress empathy. Care without empathy is not only meaningless but inhumane; it is the kind of care that one might accept from a machine but despair over when it is from a person.

Whilst human contact can also be intrusive, abusive and exploitative and people with dementia can be more vulnerable to this kind of treatment, there is another greater and far more prevalent risk, and that is the risk of no contact at all. In protecting people with dementia from invasive or hostile physical contact, care providers can end up depriving them of any meaningful contact at all. This kind of deprivation is just as harmful as any other form of abuse. When we become overly fearful about carers getting ‘too close’, people with dementia can end up being kept so far away from other people that there is no longer anyone close enough to share their lives with. This is a desperate situation particularly during times of loss, uncertainty and pain.

Over the course of researching this book I have worked with care teams that effortlessly offer tender loving care as well as disempowered care teams, demoralised from years of having to suppress their own empathy and deprived of their own humanity. The result of this research is a book that will help care providers restore trust in touch and identify and remove the obstacles that stop human beings from being human to one another. I urge care providers to use this book to build confident and compassionate care teams that can communicate naturally and effectively in a language that people with dementia will always understand.

Luke Tanner is a massage therapist, body psychotherapist and dementia care trainer. He specialises in the use of touch and non-verbal communication to support the wellbeing of people with a dementia living in residential care settings. His book Embracing Touch In Dementia care was published by Jessica Kingsley Publishers in May 2017.
For more information about Luke’s work please visit www.touchincare.com
To register your interest in Luke’s next workshop for Dementia Carers on 13th September 2017 visit 
www.luketanner.co.uk/staff-training

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Ageing and Spirituality: What does it mean to grow old in the twenty-first century? by Elizabeth MacKinlay

ageing spirituality 21 century“Many of us have the potential to live out their later years with hope, resilience and growing into fullness of life, coming to new realisations of what it means to grow old in the twenty-first century.”

Elizabeth MacKinlay is a registered nurse, an Anglican priest and Professor in the School of Theology, Charles Sturt University. Here she discusses changes in the field of ageing and spirituality since the first edition of her book ‘The Spiritual Dimension of Ageing‘ was published in 2001. The updated second edition of this seminal text was published by Jessica Kingsley Publishers in February 2017.

The first edition of my book The Spiritual Dimension of Ageing was published in 2001 and since then we have continued to learn so much more about ageing and spirituality. What really started my interest in this field, both as nurse and priest, was the question of why, given the same medical diagnosis, two different patients could have very different outcomes, even with the same medical treatment. There seemed to be ‘something more’ that we needed to understand.
This continuing search has led to a number of studies since then and much listening to older people. The crucial factor in the different outcomes for those living with the same diagnosis often seemed to come back to matters of meaning and hope, which for me are strongly linked to the spiritual dimension, to the very depths of our being.

When I was researching for and writing the first edition of this book I was really seeing ageing from the outside. I was listening intently to the stories of people who were growing older, wanting to know what the actual experience was like. I was particularly interested in knowing how people saw meaning in life and the way they lived out spirituality in these later years.  Continue reading