Category Archives: Capacity

Work with adults ? Top 10 Talking Mats blogs

internship_and_studies_yellow

What are the top 10 blogs for using Talking Mats with adults? Over the years we have posted lots of blogs on different aspects of our framework . If you are working with adults with communication disability these blogs maybe particularly helpful

  1. Where is the best place to start using the Talking Mats health and well-being resource? 
  2. A blog from Denmark which highlights the effectiveness of using Talking Mats with people with dementia
  3. Goal setting with a woman with Multiple sclerosis  
  4. Using the  app with someone with aphasia 
  5. The development of a resource to help people with learning disability raise concerns 
  6. How can Talking Mats support Capacity to make decisions
  7.  Involving  people in their decisions about eating and drinking 
  8. Thoughts on using Talking Mats with people with dementia to explore mealtimes 
  9. Using Talking Mats with someone with a learning disability and dementia
  10. Use  in a rehab setting in South Africa 

If you want to explore our  resource and training more  please visit our shop

Let’s talk about capacity…

A Volkmer book

We are very grateful to Anna Volkmer for sending us this blog, Lets Talk about Capacity…
She has just had an excellent book published –  Dealing with Capacity and Other Legal Issues with Adults with Acquired Neurological Conditions http://www.jr-press.co.uk/dealing-capacity-legal-issues.html. In it she describes how AAC methods, including Talking Mats, can be used to support people in expressing their decisions.

Prior to 1959 people who were considered “non-compus mentis” were cared for under the “parens patriae” principle. Literally translated this meant that they were ‘parents of the country’ and decisions to protect them and their property were made by the Crown (the Lord Chancellor). These people were often described as “Chancery Lunatics”. In 1959 the “parens patriae” jurisdiction gave way to the Mental Health Act. This Act instructed that “the judge may, with respect to the property and affairs of a patient, do or secure the doing of all such things as appear necessary or expedient…for making provision for other persons or purposes for whom or which the patient might be expected to provide were he not mentally disordered” (section 102 (1)(c)). Unfortunately, this Act did not make adequate provision for non-financial decisions such as medical decisions. During this period it was case law that guided professionals in supporting their patients who lacked capacity in medical decision making. It was not until 2005 that the first Mental Capacity Act was given Royal Assent, accompanied by the Mental Capacity Act Code of Practice in 2007.

I returned to the UK from a 5-year stint working in Melbourne, Australia, just after the Mental Capacity Act had been published. Mental capacity was on the tip of everyone’s tongues and as the speech and language therapist working on a multi-disciplinary team I became an integral part of this process. Patients I was seeing, often people with primary progressive aphasia or other types of dementia, were asking about how to make future decisions. They and their families were keen to understand how the mental capacity act worked, how to prepare for the future and how to have their voices heard. On the other side of the coin I was working on an inpatient ward where staff were concerned about ensuring we were fully assessing the decision making capacity of people with cognitive and communication difficulties, often holding best interest discussion to plan for the future of these individuals. Many of these decisions related to dysphagia, but others related to accommodation and finances.

What concerned me was the lack of evidence available across the speech and language therapy arena in this area. There was little to none in terms of written research, let alone written advice or even examples of good practice tailored to speech and language therapy clinicians. As I asked around I found an enormous disparity in the services that speech and language therapy clinicians were providing across different trusts. I had previously written a book on dementia, and had included a chapter on assessments of decision-making. At this stage some of the only research related to communication and decision-making had come from Talking Mats. This had demonstrated that using the talking mats tools can support families and caregivers in conversations with their loved ones when discussing decisions to be made. They found that conversation enabled people in understanding, retaining and expressing themselves in decision-making discussions.

Following a particular stimulating discussion with the publishers at J&R press, they invited me to submit a book proposal on this topic. As I was developing this idea I found the topic of mental capacity was raised more and more often at study days and seminars I attended. At these study days I started linking in with more like minded speech and language therapists such as Mark Jayes, Hannah Luff and Claire Devereux. These were clinicians who all agreed on the diversity of our potential role in supporting our patients around mental capacity issues. These common interests enabled a collaboration. Our book is now published.

Through these connections I became aware of other work being done; Mark Jayes holds a NIHR doctoral fellowship award and is conducting research in the development of a communication and capacity assessment tool kit. Claire Devereux is the chair of the Southern Psychiatry of Old Age Clinical Excellence Network, together we have held a workshop with the clinical specialists where we developed a consensus document on role of the speech and language therapist in capacity assessment. This is to be published in Bulletin magazine later this year. Hannah Luff is a clinical lead speech and language therapist at South London and the Maudsley NHS Trust and is currently a member of the review panel looking at the NICE SCIE dementia guidelines.

The wonders and value of networking never ceases to delight, enthuse and inspire me! And you can purchase our book at the following website (there is currently a discount rate until 21st February):

http://www.jr-press.co.uk/dealing-capacity-legal-issues.html

You can follow me on my blog https://annavolkmersbigphdadventure.wordpress.com/ or on twitter @volkmer_anna

Talking Mats Specialist Seminars

bespoke-training

Following the success of previous seminars we are holding further specialist seminars in Stirling and London for anyone who has done the Talking Mats training. The topics will be:

  • Talking Mats and the Eating and Drinking resource (morning)
  • Talking Mats and Capacity (afternoon)

During the Eating and Drinking seminar, we provide background on how and why the resource was developed and showed some DVD examples of people using the resource. This really brings things to life and shows how important it is to give people (with and without speech) the opportunity to consider and talk about different aspects of eating and drinking. We also give people hands-on practice in using the symbols from each topic. Each participant will receive a copy of the full Eating and Drinking resource, including symbols, a mat, and explanatory booklet.
journey

During the Capacity seminar we will discuss the fundamental principles of the Capacity Act and participants will have a chance to consider how Talking Mats can help people to:

  • understand
  • retain/remember
  • weigh up information
  • communicate their views/wishes and feelings.

They will also be given the opportunity to work through some practical examples and think about options to help people understand issues and make decisions.

making_decisions

If you have completed a Talking Mats training course and would like to attend either of specialist seminars, please click on the relevant course and fill in the registration form.

Stirling on Friday 29th April Stirling Seminars flier Apr 2016
London on Friday 10th June London Seminars flier June 2016
Registration form Seminar registration form 2016

 

How can Talking Mats support capacity to make decisions?

decisions

The inability to make a decision could be because of a learning disability, mental health problems, brain injury, dementia, alcohol or drug misuse, side effects of medical treatment or any other illness or disability. Click here for further information.

Both the Mental Capacity Act (2005) in England and Wales and the Adults with Incapacity Scotland Act (2000) identify the following components which determine whether or not someone has capacity to make their own decisions.

capacity diagram
There are a number of additional assumptions that are central to determining whether or not someone has the capacity to make their own decisions:
• Every adult has the right to make decisions unless proved otherwise
• Everyone should be supported to make their own decisions
• People should be given the support they need
• People are entitled to make their decision – good or bad
• Each individual has a different capacity to make decisions about different aspects of their life.

We have been running seminars on how Talking Mats can be used to support a person’s capacity to make decisions.The diagram below illustrates some of the comments we received form participants at a recent seminar about the benefits of using Talking Mats to support decision making.
Click on the diagram to enlarge.

Why does TM support decision making

The process of completing a Talking Mat helps people retain their view and if they have memory problems the picture of the mat is a good prompt to enable recall.

Its worth noting that our brain processes visual images 60,000 faster than text!

Talking Mats Specialist Seminars


Recently we delivered two Talking Mats specialist seminars in London:

  • Talking Mats and the Eating and Drinking resource
  • Talking Mats and Capacity

Both seminars were very well attended with lots of discussion from a wide range of professionals.

During the Eating and Drinking seminar, we provided background on how and why the resource was developed and showed some DVD examples of people using the resource. This really brought things to life and showed how important it is to give people (with and without speech) the opportunity to consider and talk about different aspects of eating and drinking. We also gave people hands-on practice in using the symbols from each topic.journey
Each participant received a copy of the full resource, including symbols, a mat, and explanatory booklet.

During the Capacity seminar we discussed the fundamental principles the Capacity Act and participants had a chance to consider how Talking Mats can help people to:

  • understand
  • retain/remember
  • weigh up information
  • communicate their views/wishes and feelings.

They were also given the opportunity to work through some practical examples and think about options to help people understand issues and make decisions. making_decisions

If you would like to attend our next specialist seminars, we are holding them in Stirling on 17th February: Stirling Seminars Feb 2015 flier