We have been working with Care Opinion to develop the accessibility of their site for people with dementia through picture supported stories.We are very grateful to Life Changes Trust for funding this partnership.
What is Care opinion ?
Care Opinion is an independent third sector organisation that supports feedback on health and care services. They promote honest and meaningful conversations between users of health and care services and their provider organisations. If you want to see how Care Opinion works then take a moment to watch this excellent video
Why is our partnership important?
Both organisations believe it is important that everyone can tell the story of their experience of using health and care services. This can be hard as there can be barriers to telling a first-hand account of an experience. These barriers can include
- difficulties with expression and finding the correct words
- difficulties with memory
- difficulties with writing or typing on a computer
Care Opinion is skilled and experienced in supporting feedback through their web platform and supporting health and care improvements through responding to and sharing that information . Talking Mats is skilled and experienced at supporting people with communication difficulties including people with dementia, to express their views. Partnership working between the two organisations has enabled a fusion of ideas and learning from each other to develop and action our vision of a care opinion platform that is more accessible and relevant to more people. This is particularly important when Alzheimer’s report ‘Fix Dementia Care: Hospitals’ reports that at least 25% of hospital beds are occupied by someone with dementia ,that they stay twice as long as other people over 65 and the experience of being in hospital is recognised as being a particularly frightening and confusing time.
What have we done ?
We have created an alternative picture story space on the Care Opinion website that is adapted from the work of Talking Mats. The picture story sets were made up after thinking about the topics that arose on the care opinion website .Then we worked with our expert advisor groups which included
- people with dementia,
- their carers
Our aim was to find a structure that would be comprehensive whilst keeping thing simple and not overwhelming .After a period of consultation and trialling the sets with people with dementia and their carers we have ended up with two sets one that covers the ‘environment’ and one that covers ‘care’
Who can use this and what support will they need?
We know people with dementia have a very diverse range of needs and that people will require different levels of support to give their feedback on the care opinion site ranging from technical support, scribing, to reducing number of pictures, to pre-preparation using paper pictures. Some people with later stage dementia may find it hard to use it to give their own feedback but hopefully, the pictures will mean that they will still be involved and understand some of the things being talked about if people are submitting feedback on their behalf.
We felt important that that the picture story space is an inclusive feature available to all to use if they want to. Whilst this feature was designed for people with dementia we have already had feedback that other people are finding it helpful.
The Picture Stories and Talking Mats
Several people have asked us if this is a Talking Mat and our response is that it is inspired by our work but it is different and for that reason we call it a ‘picture supported story’ .It is different partly, for technical reasons but also because the contexts in which people choose to give feedback will be varied e.g. some will do it by themselves, some supported by family and friends. Above all we want this to be freely available and recognise that that means people will use it in a variety of different ways some of which will surprise us!
We are still developing support materials and webinars to go along with the site to help people get the most from it.
However, there will be some people particular those with more severe communication difficulties who will need increased support to access the story space. Effectiveness for this group will improve if there is some preparation work to prepare their feedback .Using the paper set combined with the principles of Talking Mats to support communication will help. It is for this type of support we recommend attending a Talking Mats foundation training so people are confident and skilled using the pictures in a Talking Mats framework.
For the last month the picture story feature has been available on the site and we are starting to get a range of stories on it. I particularly like the one that was submitted by a school pupil on work experience supporting a person with dementia to share his experience of going to an inter-generational quiz at the local nursery which had been a very positive experience for all involved.
So please give the site a go, submit your stories or encourage others to use it and please tell us how you got on. Click here to start
Thanks to Rosie Murray for this great blog describing how she used a collaborative Talking Mats ‘Wall’ to help students comment on how different activities inside and outside college make them feel.
As a student, I trained in the Talking Mats approach, after finding it incredibly useful in clinical placements. I am now a speech and language therapist at St John’s College in Brighton. This is a college for young adults with autism, learning disabilities and SEBD. Our learners have a wide range of communicative needs and cognitive abilities. I was approached by our nursing team in the lead up to world mental health awareness day, as they were organising a ‘tea and talk’ session for our learners of all abilities.
We organised a range of activities, such as symbolised conversation starters. However, we felt we needed something to allow our less verbal learners to make their voices heard. I thought back to my training, and remembered Joan Murphy talking about large, collaborative Talking Mats – or ‘talking walls’. We discussed this idea, and felt it would be a great way for students to feedback on how different activities inside and outside college make them feel.
It took some considerable planning. Due to the emotional needs of some students, our top scale required us to avoid words that were too upsetting for individuals. In the end we settled on ‘good’ (with a widget ‘calm’ symbol) and ‘worried’. We also wanted it to provide a genuine opinion, so although we considered including activity options that were clearly negative, e.g. ‘fire alarms’, we took the opportunity to show our learners that we all have different opinions on things, and that this is good. We hypothesised that because of this, learners would be skewed towards giving positive opinions, and this informed the order of presentation of the top scale and the activities themselves.
On the day, we had 15 different activities to give an opinion on, each with different border colours for differentiation, and of course blank tiles so our learner’s could come with their own activities. Students were encouraged to write their name on the back of a chosen activity, and a consistent script was used to present the wall to each learner. Makaton signing was used alongside the script to support understanding.
Learners of all abilities offered their opinion, and it generated discussion between learners of differing abilities. It signposted staff to particular likes and dislikes of learners, and showcased the power of talking mats to all staff. For example, one of our learners is a cheerful young man, who uses minimal verbal utterances to communicate. When the board was presented to him, he very clearly selected ‘talking’ as an activity, and clearly indicated that it makes him worried. This has allowed us to reflect as a staff team about how we can support him to communicate with minimal anxiety.
Learners too took away some important lessons from using the wall. They saw that while some activities are VERY popular (e.g. computer time), some are quite polarised, e.g. animals. This highlights the important issue of mutually respecting each others differences. Since the event, staff have discussed ideas they have on how to utilise this tool. We are considering how we could use Talking Mats as a tool in our peer mentoring sessions between learners of higher and lower verbal ability, as we feel it would be beneficial for both mentee and mentor. We are looking forward to using Talking Mats as a flexible tool for the college in the future.
Please let us know of any other innovative ways of using Talking Mats!
We have recently revised and updated our on-line Talking Mats foundation course . It now runs over 6 weeks and is designed to take an average of 12 hours of your time. Participants can go at the pace that suits them so for example in the last course one person completed in 2 weeks and another used the full 6 weeks .
The feedback has been really positive about lots of different aspect of this way of learning and included comments about
The structure of the course
‘It has been very well laid out, all modules flowed well together. There was a clear progression to build up our skills and the tutor offered really constructive feedback’
‘ ‘It was good to be able to do it in my own time – my work schedule became more hectic than I had anticipated but I was able to still do it in the evenings and weekends
’ The website was easy to use and useful to have the forum and see all the different uses of talking mats. This has inspired me to use the tool outwith work and within the voluntary sector.’
‘When I could not access my laptop I could access on my phone ‘
Knowledge and application of Talking Mats
‘This course has strengthened my knowledge about who, when and how to involve Talking Mats in my work’
‘Talking Mats has already allowed me to find out more about my clients’ needs.’
‘Using Talking Mats has resulted in enabling my client to explain her fears and has encouraged her to come into and access the dental department’
‘I have never experienced this kind of outcome before with a person , who has got severe comprehension and cognitive problems (Circle 2). I noticed, that doing the concrete submats made her more able to follow me in conversations talking about issues in circle 3, By handing over the control to the thinker, it is wonderful to be able to balance, and empower the conversation. That gives me satisfaction and joy.’
I’ve found the experience of actually using Talking Mats in practice immensely satisfying,. Each time it’s surprised me how engaged the thinker appears to become, and how readily their voice comes through when it has the space and time to do so’
‘ I wouldn’t hesitate now in using Talking Mats , even with people who have strong verbal skills if I felt it could be a useful way of getting them to focus on and think around a particular topic.’
Wider reflection on personal communication
‘My communication skills have benefited – this course has really encouraged me to think about phrasing, question types, clarity etc.’
‘It has led me to reflect on how complicated some of the things I ask of people are.’
‘I can evaluate whether communication is effective and how I can improve this.’
So if you want a course that you can do without travel and that enables you to
- Understand the Talking Mats communication framework- in particular who to use it with and for what topics and questions
- Be able to use Talking Mats for a range of purposes within your setting.
- Gain confidence in using tool based on best practice interview techniques and which evidences your commitment to person centred working
- Have increased awareness of your own communication style particularly interacting with people with communication difficulties.
If this is you book on our next course starts the 5th Dec
Further reading Check out Natalie Leader blog about her experience of completing the course from Tasmania
Talking Mats is a useful tool to help parents see their child’s point of view.
The stage for each parent when their child also has an opinion about what is best for them can come as a surprise and is sometimes challenging. For parents of children with disabilities it can be even more so. This story is an example of how Talking Mats helped parents hear their own child’s voice amongst the background noise of the voices from health, education social and voluntary services.
David was in his final year of primary school. He attended a small village school and was transitioning to a large mainstream secondary. He has mobility problems due to cerebral palsy and uses a wheelchair. He can walk very short distances with effort using a walker and in his primary school used this method to move around the classroom and go to the hall for lunch and PE. This was a functional way to meet 2 of his targets : changing position and walking practise. His parents wanted this to continue when he transitioned to secondary school, although the health professionals involved felt it was going to be too difficult given the greater distances in the new building. An electric wheelchair was proposed for this new context. David’s parents were finding this next step challenging.
One of the professionals involved wanted to find out what David felt was important in his new school and used Talking Mats as a way of supporting him to think about various factors. The top scale used was ‘important/ not sure/ not important’.
David’s mat clearly showed that what was important to him in his new school was being with his friends. When his parents saw his mat they realised that this would be impossible if he was to move from class to class using his walker and it helped them make the transition to seeing him in an electric wheelchair. It also helped them see things from David’s point of view. They were more than happy to fit walking practise into a different part of his busy day because they had heard what was important to him.
Talking Mats allows different voices to be seen and heard.The name has been changed to protect identity.
Talking Mats is at its heart a Person Centred approach and makes this abstract concept real for practitioners and accessible to more people.
The skills we teach in our training are core to its values:
- Being explicit about the purpose of the conversation
- Using open questions
- Active Listening
- Acknowledging that this is the persons view today and it is likely to change with time
‘ To improve the lives of people with communication difficulties by increasing their capacity to communicate effectively about the things that matter to them’
Our vision statement matches what is quoted in the introduction of the new Core Skills framework ‘Person-Centred Approaches’ produced by NHS Health Education England, Skills for Health and Skills for Care http://www.skillsforhealth.org.uk/news/latest-news/item/576-new-framework-to-promote-person-centred-approaches-in-healthcare
Talking Mats foundation training gives practitioners a tool to turn the values expressed in this powerful document into practice Read how one health authority made this a priority http ://www.talkingmats.com/person-centred-approach-to-health-planning
To support your organisation evidence they are using a Person Centred Approach look at our website www.talkingmats.com or contact email@example.com