Communication: Dignity in care videos

What is the video about?

Good communication can help people to maintain their dignity. Take Matthew, a young man with Down's Syndrome who lives in a shared house. In this film, Matthew's encouraged to use a diary so that he knows what he's going to be doing on any particular week. It's a good way for staff to find out what's been happening in Matthew's life. It's equally important to make time to support people that you offer care and support to. The film shows how, for older people, past memories of being at the beach can be used as a useful communication tool.

Communication in practice can mean asking people how they prefer to be addressed and to respect their wishes; giving people information about the service in advance and in a suitable format; and not assuming that you know what people want because of their culture, ability or any other factor.

• Video transcript Open

  Narrator and words on screen

  How do we communicate?

  Through language and speech

  Through written information

  Through actions

  Through technology

  Janis White, Director, Equal Partnerships Ltd

  It’s about listening to the person, in whichever way that person communicates.

  Alka Chohan, Care Worker, Age UK

  You have to be a good listener, and understand the person.

  Narrator and words on screen

  We communicate in many different ways. Good communication helps people maintain their dignity.

  Gill

  We’ve got Dirty Dancing at the theatre, Cats at the theatre, Grease…

  Words on screen

  Communication about things that are happening in our lives

  Narrator

  We need to communicate about what’s happening in our lives

  Gill Williams, Personal Assistant, Equal Partnerships Ltd

  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.

  Title

  Make time to get to know the person

  Narrator

  Make time to get to know the people you support.

  Karen Turnbull, Activities Coordinator, Harton Grange Residential Care Home

  Well I do my best to treat everyone as an individual and look at what they want.

  Ailsa

  I’ll be beside myself with glee… Come on, let’s get in.

  Karen Turnbull, Activities Coordinator, Harton Grange Residential Care Home

  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 -

  Ailsa

  Have I got to hold his hand?

  Karen

  If you want to.

  Karen Turnbull, Activities Coordinator, Harton Grange Residential Care Home

  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. Elsa’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.

  Ailsa

  We went to the beach every chance we got.

  Karen Turnbull, Activities Coordinator, Harton Grange Residential Care Home

  Things I’ve discussed with Ailsa over the years. About her family time.

  Ailsa

  I’m trying to think what it is, what is it, what am I going to do. Do I teach?

  Tommy

  Well…

  Karen

  You did teach, didn’t you?

  Ailsa

  I did teach, but I don’t seem to do anything now.

  Karen

  You’re retired, now.

  Ailsa

  I’m retired.

  Karen

  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?

  Karen

  Just wait one minute till I put yourself into a chair.

  Ailsa

  We’re human beings who can walk you know. Yes, but I’ve got a gammy back.

  Karen

  You just sit for two minutes because you have hurt your hip.

  Ailsa

  I have hurt my hip, yes.

  Narrator and words on screen

  Communication between all those supporting a person is important.

  Jean, Carer

  Are you having your frame Robina or your stick?

  Robina

  Yes, my stick.

  Jean, Carer

  Your stick, let me get your stick.

  Catherine Gunnewicht, Manager, Care Concern Homecare Ltd

  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.

  Jean, Carer

  I’m just going to bring in a couple of things and then you can choose.

  Catherine Gunnewicht, Manager, Care Concern Homecare Ltd

  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.

  Jean

  Which one of these would you like?

  Robina

  That one.

  Jean

  John should be here in a minute.

  John Baker, Care Worker, Care Concern Homecare Ltd

  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.

  Robina

  Oh that’s really delicious. Oh, look at the rain.

  John Baker, Care Worker, Care Concern Homecare Ltd

  Obviously there are handovers and after a while they get fairly routine.

  Jean

  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.

  John

  Right.

  John Baker, Care Worker, Care Concern Homecare Ltd

  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.

  Catherine Gunnewicht, Manager, Care Concern Homecare Ltd

  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 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.

  Narrator

  Use technology to help people communicate

  Words on screen

  Communication through technology

  Sharon Hedley, Manager, Laverneo Care Home

  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.

  Sharon

  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!

  Moira

  (laughs) There it is.

  Sharon

  See, he’s watching what we’re doing isn’t he?

  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’. There’s Peter, he can hear you and there’s Roy.

  Moira

  Hi Roy.

  Roy

  Hello Moira, you alright?

  Moira

  Yes.

  Sharon Hedley, Manager, Laverneo Care Home

  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.

  Roy

  Training on a Wednesday to become a mentor.

  Moira

  Yes.

  Sharon Hedley, Manager, Laverneo Care Home

  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.

  Moira

  And over the other side from where I am, is where the other two staff go.

  Narrator and words on screen

  Language and cultural needs should be taken into account.

  Jacqui Guyon, Homecare & Support Services Manager, Age UK

  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.

  Saeed Maleck, Equality and Diversity Coordinator, Age UK

  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.

  Jacqui Guyon, Homecare & Support Services Manager, Age UK

  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.

  Words on screen

  People need to be supported by people who can understand them

  Narrator

  Care workers’ language skills are important for communication and understanding people’s needs

  Jacqui Guyon, Homecare & Support Services Manager, Age UK

  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.

  Alka Chohan, Care Worker, Age UK

  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.

  Words on screen

  Importance of non-verbal communication

  Narrator

  Care workers should be supported to develop good non-verbal skills.

  Alka Chohan, Care Worker, Age UK

  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.

  Title: Key learning points

  Good communication is essential in ensuring dignity in care

  It is important that people have time to express their needs and preferences and that staff understand the person they are supporting

  It is vital that staff develop other ways of communicating with people who have a cognitive impairment of limited speech

  People with dementia or people with learning difficulties can be assisted to choose things by being offered a selection of things or show pictures

  END

Who will find this useful?

Care staff, commissioners, family carers and anyone who offers care and support, along with dignity, in the community.