Category Archives: Dementia

Creating a Talking Mats Podiatry Resource Set to support Patient Involvement & Engagement

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Many thanks to Karen Mellon, NHS Fife Lead Podiatrist for Learning Disabilities and Care Homes, for this guest blog describing our exciting Fife Health Charity funded Talking Mats Consultancy project, aimed at supporting patients with a learning disability (LD), or dementia, to be more involved in decisions around their care. 

I was initially introduced to Talking Mats by my Learning Disability SLT colleagues who were using the resource to support patient engagement.  I could see the real benefits of how it could support our interactions with patients with a LD or dementia and empower people to be more involved with decisions around their care. Our SLT colleagues had undertaken the Talking Mats Train the Trainer program and were then able to train our podiatrists in using the resource. Having used the existing resources we found that we weren’t able to discuss/explore people’s views deeply enough, for example, when they developed a foot ulceration, or were at risk of ulceration.  This was the spark that ignited the idea to look at developing a specific podiatry resource to enable these conversations.   

The aim was to promote patient engagement in their care – both in preventative care and when specialised input is required. By creating the resource we aimed to explore what really mattered to the person and what for them were acceptable goals and outcomes. By developing a specific Talking Mats resource we were able to explore treatments options and impact of conditions and actively engage the person in expressing their views thus creating a person centred care plan. Evidence shows us when people are involved in decision making they are more satisfied with their care, which in turns improves their quality of life. 

Having consulted with Talking Mats we jointly created an initial resource which we piloted within NHS Fife over a 6 week period. People living within care homes and people with a learning disability were the target audience for the pilot. Using the resource, we were able to understand more about the impact that foot ulceration was having on patients, and patient’s views on treatment options.   

One example of this positive impact involves a 60 year old patient with learning disabilities and dementia. She lives independently with one hour support each day to assist with personal care. She has been known to podiatry for some time due to repeated ulceration. Specialist footwear has been supplied and regular input is in place to reduce the risk of re-occurrence, however at times the foot does break down.  

In May the patient experienced a break down on her foot. She is a very pleasant lady who always comes across as if nothing bothers her and everything is fine; she doesn’t like to “cause a fuss”. It was felt the use of a Talking Mat might give us greater insight into the impact the wound was having.  

Podiatry example mat

As a result of completing the Talking Mat we were able to discover the patient was in fact experiencing difficulties with the type of dressing and was experiencing pain. We were able to address this and change  the dressing type to an adhesive dressing, which took up less room in her shoeand started her on Paracetamol 4 times a day to address her pain. Follow up discussions reveal the patient was much more satisfied with the dressing, it was more comfortable and easier to keep dry when showering. She also reported to be experiencing much less pain.  

As a result of the mat, we were able to identify concerns she had, but didn’t want to share as she didn’t want to be a burden.  We were able to address this and create a plan which was acceptable to the patient and improved her wellbeing.   

I hope this resource will go on to benefit other professionals and carers working with people who may be impacted by their foot health. By using this resource, we can help our patients explore their views and wishes, therefore enabling co-production in care. The resource promotes preventative care as well as specialist intervention. Going forward there are many other areas of foot health that could potentially be explored in developing further resources – such as paediatrics, nail surgery, musculoskeletal. 

Following the feedback from the pilot, the Podiatry Talking Mat Resource set is now being finalised, and we are exploring the best ways to take this to wider Podiatry Services. Please get it touch with us at info@talkingmats.com  if you are interested.   

To find out more about the work and projects supported by the Fife Health Charity follow their Social Media accounts at: 

 Facebook – @fifehealthcharity 

Twitter – @FifeHealth  

 

Talking Mats and Mental Health: Top 8 Blogs

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In the UK we are emerging out of lockdown and there are concerns about the impact on the mental health of people at all ages and stages of life This is a good time to reflect on the wide variety of blogs that have signposted how useful Talking Mats can be in helping people to think, structure coherent responses, and express their viewsIf this is an area of interest to you then take a look at these blogs to find out more: 

  • Jo Brackley, NHS Clinical Lead for SLT Secure Services (Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust)  describes how Talking Mats helps people with mental health open up and have richer conversations, with increased novel information gained.  https://www.talkingmats.com/covid19_securehospitalsetting/  
  • Susan GowlandSLT at NHS Fife Forensic Learning Disability Servicedescribes how Talking Mats support patients to express what they think in forensic learning disability setting.   https://www.talkingmats.com/forensic_ld_setting/  
  •  Georgia Bowker-Brady, Advanced Specialist SLT (Berkshire Healthcare Foundation Trust) describes how using Talking Mats in dementia care and acute health patient inpatient services helps patients organise their thoughts and express what is going well for them, as well as what isn’t.  https://www.talkingmats.com/acute-mental-health/  

We would love someone to carry out some research in this field, so if this sparks a research, or blog idea, please get in touch with us at info@talkingmats.com 

First Talking Mats Advanced Online Module

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Our first Talking Mats advanced online module has launched. We are pleased we had developed our online foundation training well before lockdown. There has been such great feedback from people who have completed our online foundation course and they have been asking for more. They like the bite size chunks, being able to pace their own learning and the reflective practice approach. Now we are adding to our online course with an advanced Talking Mats module focusing on Talking Mats use in safeguarding. This course is structured around the Talking Mats Keeping Safe resource and how to use it.

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The Keeping Safe Talking Mats resource was developed to check in with people and find out how their lives are going. It uses a holistic framework to do this and the conversation it supports is structured around three topics: 1) well-being; 2) relationships; 3) thoughts and feelings. The resource was trialled and tested in projects involving over 700 practitioners. Originally, it was designed for people with learning disabilities but feedback has been that it has been helpful with a wide range of people including, those with stroke, head injury, dementia and mental health issues.

The advanced online module involves 2 to 3 hours of learning that you do at your own time and pace. It involves short talks, reading, videos and reflective practice activities. You will develop confidence in using the resource as well as an understanding of relevant issues, such as diagnostic overshadowing, developing the capacity of individuals to raise concerns, the impact of trauma. You will be encouraged to reflect on how you can apply the Talking Mats Keeping Safe resource to your own area of practice

To apply for the course, you must have completed your foundation Talking Mats training.  If you haven’t completed this training book now – there is still the reduced price training offer if you book your place before the end of August 2020. Access to this advanced course will begin on the first of every month and you will have the full month to complete it.

Book your place now. The cost is £85 for the course and the Keeping Safe resource and £35 if you already have your Keeping Safe resource and just want to do the training.

Connection, communication and music

Claire cello EOD 2 (002)

I am passionate about connection, about communication, about music. That’s what drives me forward. I have been playing the cello for over 40 years; I’ve been playing professionally for about 25 years. Having the privilege and honour of playing at the bedside of people who I cared about who were nearing the end of their life changed my perspective on the importance of music. I realised that there was far more to music and to my playing the cello than ‘performing’ – than my ego. I learned that music could touch all who were involved; listeners and musicians alike in a deeply profound way – but I wasn’t sure quite HOW to harness music in an effective manner to insure I was not simply performing. This realisation took me into a wonderful course in the USA – ‘Music and Transitional Healing Program’ (MHTP.org) back in the early 2000s. I found what I’d been looking for – I learned about different types of music and rhythms and modes and when to play them depending solely on the state of the listener. I learned about entrainment and other very important tools in order to better ensure that all important connection with the listener. I learned to meet the listener where they are in the THAT moment – to aim to get in sync with them – and to then respond to whatever happens.

This learning eventually and unexpectedly led me to a PhD studentship at the University of Stirling where I played the cello live and pre-recorded at the bedsides of care home residents with dementia who were in palliative care, and someone who was closely connected with them. I wanted to know how the recorded vs live music might affect the listener’s connection with one another.

During my PhD, I trained in Talking Mats – I have since bought quite a few of the packs available and remain convinced regarding the effectiveness of this simple tool for enhancing connection and communication.

Now I am moving into the virtual world that we all find ourselves in. Lock-down has allowed me to have more time to fully enjoy playing my cellos (I specialise in baroque cello as well as modern cello – and I have a 6-string electric cello as well!). This strange gap in time has also prompted me to finally building a (still evolving) website (https://drclairegarabedian.com/) and to schedule events related to my work with music and people living with dementia (https://drclairegarabedian.com/events/). Although I have previously offered similar events live, this will be a new experience/learning curve in the virtual world!

I am currently managing a wonderful project through the Edinburgh InterFaith Association (https://www.edinburghinterfaith.com/time-to-talk); ‘Time to Talk’ – this Covid-19 listening service is funded Scottish Government funded through July 2020, and provides a skilled, trained, experienced listener for all care home residents and their families living in Scotland (11:00am – 7:00pm, 7 days a week).

I hope to see you at one of my upcoming events – please sign-up on my website for news of upcoming events and offers. Stay safe and healthy everyone!

Thanks to Claire Garabedian fro this guest blog and good luck from all of us in her new venture

Talking Mats in Swedish Home Care Services – A Research Project

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Many thanks to Professor Anna Dunér, Dr Angela Bångsbo and Associate Professor Tina Olsson for this guest blog describing their research project where Talking Mats will be used to enable service users living with dementia to be involved in decisions about their home care services. The project is based on a collaboration between Department of Social Work at the University of Gothenburg, Borås University College and the municipality of Borås, aiming to develop and evaluate the use of Talking Mats. 

Anna Duer  Professor Anna Dunér

Angela Bangsbo   Dr Angela Bångsbo

Tina Olsson  Associate Prof. Tina Olsson

 

In Sweden, as in many other developed countries, ideas of consumer choice and personalisation of services have been implemented in social care with the intention of achieving better choice and control as well as increased quality of the services provided for the individual. However, persons living with dementia are at risk of being excluded from the opportunities provided to other groups of service users. Thus, it is important to develop both needs-assessment procedures, and improve the performance of home care services, to enable older people living with dementia continuous choice and control in their everyday living.

We hope that Talking Mats will improve the communication between service users, care managers and staff in eldercare and lead to increased influence of service users over the decisions and planning of their home care services.

During 2020 we have funding for a planning study where we can develop and test the Talking Mats decision aid, identify, translate and test outcome measurements, and refine and test the procedures for a comparative intervention project. In 2021 we hope to attain funding for a three year study.

We have already received valuable advice and information about Talking Mats research from Dr Joan Murphy and hope to keep in contact with her and the Talking Mats team throughout our project.

If you are interested in Talking Mats Research, check out our recent blog with details of how you can get involved with our Virtual Network: 

https://www.talkingmats.com/virtual-talking-mats-research-network-launched/