Category Archives: Personalisation

Digital Talking Mats and Dementia

Jean and David laughing

Talking Mats received funding from The Health and Social Care Alliance Scotland to look at how using the Digital Talking Mats can help people with long term conditions, including dementia,  to manage their health and well-being and to recognise their own strengths and abilities. We also hoped that participants would be able to have more control over their lives and have improved communication with families and professionals.

11 people living with dementia and their partners were involved in the project. Each participant had a tablet device and was given a personal digital Talking Mats licence which gave them access to 13 topics in the Talking Mats Health and Well-being resource. We visited each participant at home, taught them how to use it and asked them to complete at least 1 digital Talking Mat per week for 6 weeks on any topic they wished. The design of the digital Talking Mat allowed them to email their mats directly to us. We visited each participant a second time to discuss how easy it was to use the digital Talking Mats and their views on their completed mats. We asked those who wished to, to continue sending us completed mats beyond the initial 6 weeks and we visited them again in 6 months to discuss how they were managing.

In total we received 94 digital mats across all 13 topics from the participants living with dementia who reported that the use of the Digital Talking Mats during this project gave them a better understanding of their own individual health and social care needs.

A woman with dementia said ‘It (Health mat ) made me realise things are not so bad and made me think I will continue with my exercise classes, carry on walking, socialising and eating well’

dementia health mat

As well as helping participants self-manage their lives, an unexpected outcome of this project was that many people found that using the Digital Talking Mats helped them see the positive things in their life and not just the negative. It also highlighted that despite having a deteriorating illness, things were not getting worse.

‘This mat (Environment) showed me how happy I am in my own home and my neighbourhood’
environment

The following are some of the comments we received throughout the project.
• It helps me sort out my thoughts – very useful
• I get so much out of the process
• I come up with insights which might help me in the future
• I can now talk to (my wife) in a way I couldn’t before
• I’m more relaxed now
• I come up with niggly health things that my partner didn’t know
‘It made me realise things are not so bad’.

If you know of anyone living with dementia would like to obtain the Digital Talking Mats please fill in the attached Personal Digital Licence 161117 DTM personal licence form with explanation and send it to us at info@talkingmats.com

Click here for the full report of the project which also included people with stroke and learning disability

Supporting families involved in the criminal justice system.


child thinking

Sally Kedge, Speech and Language Therapist from Trouble Talking New Zealand shares two powerful case examples of using Talking Mats with children and families caught up in the criminal justice system.

This week it was hot in New Zealand, so I sat under a tree in a school playground in the shade with an eight-year-old girl to do a Talking Mat. I’m a speech-language therapist engaged by the child protection agency who have guardianship of her. This doesn’t happen that often in NZ but the team involved with this girl and her brother realised that as well as dissociative behaviour related to the impact of trauma due to family violence exposure, there was also significant difficulty with language acquisition for both children. The mix of a trauma history and a language disorder was resulting in significant difficulty expressing emotions and explaining what had happened when behavioural outbursts happened.
Some of my work with this child has been to help the team understand how her language profiles impacts on her life, and to develop her language skills at school via a programme she carries out with a teacher-aide and a friend. My role has also involved helping her understand her own life story and to equip her to process this, as it hasn’t been a pretty ride so far.
At a multidisciplinary planning meeting for her and her sibling recently, the team were concerned to make sure the children had accurate information about when their father was going to be released from prison. Their mother has recently been released too but no one knows where she is currently. I suggested a Talking Mat might help us to find out what she knows at the moment about her parents and how she felt about the next few months, as there are likely to be some changes happening in her world. We wanted to give her accurate information so she didn’t need to fill in the gaps herself.
Using a Talking Mat helped me establish that currently this child feels many things in life are going well. This is good progress. However, we identified a few things that she felt were not going that well at school (‘in the middle’) and I was then able to talk to her teachers about preparing for the new school year starting in February. We figured out that she is looking forward to seeing her dad but doesn’t know when she will see him or where he is going. A conversation with her Social Worker and the drug rehabilitation residence has allowed me to put together some visuals and a timetable to show what is going to happen next. Dad can have these as well as her carer and others in her team.

Another child with a similar history also did a Talking Mat with me last week. My purpose was to help the team find out how he feels his current care situation is going. A very mixed picture emerged with some concerning cards placed in ‘not going well’. I asked the boy at the end if he knew anyone who could help him with those things and he said, ‘no one’. I was able to explain that I am one of the adults who need to figure out how to make life easier for him and I would talk to some other adults and come back to see him. The photo I took of the Talking Mat allowed me to follow up with the team and I took the photo back to the boy to explore further some of the ‘not going well’ cards. At this second visit, this boy initially did not want to speak at all, but he engaged fully in looking at the photo of the Talking Mat with me.

sally kedge blog
We used a scale of 1 – 5 (how much of a problem is this for you – 1 = not much, = 5 = really really bad) on a piece of paper that he could mark with a pen to explore the ‘not going well’ items in the photo. He picked out ‘mood’, ‘people coming to his house’ and ‘learning at school’ as ‘really really bad’. We agreed that these needed to get sorted out for him to make life easier and we agreed who I could talk to about these things. Once we got that agreed and written down, he initiated some conversation about less heavy topics and started playing. I’m now following up with the team. Easier said than done, but without the Talking Mat I don’t think we would have got his views so clearly.
Our Talking Trouble Aotearoa NZ team is involved with children, young people and adults involved with care and protection, justice, mental health and behaviour agencies. We have been very excited about the wide range of opportunities that Talking Mats has provided us and the professionals we work with to explore people’s views on their own situations, their preferences, and their well-being. This year we’ve been exploring how Talking Mats might be used in our contexts:
– in sexual assault health assessments undertaken by specialised health professionals
– for Social Workers in our Youth Justice and Care and Protection Communication Projects
– When finding out about how people feel about talking and understanding in legal contexts such as courts and Family Group Conferences when we are engaged as court-appointed Communication Assistants (equivalent to ‘intermediaries’),
– and in our own speech-language therapy assessments and interventions.
The social workers, paediatricians, teachers, lawyers and others we work with have also been excited about exploring how Talking Mats can assist in these contexts. We’re looking forward to more training from the Talking Mats team next year.

sallykedge@talkingtroublenz.org

Come and hear Sally speak at our Criminal Justice Seminar on the 17th of April 2018. Contact info@talkingmats.com  for more information.

Care Opinion: Picture Supported Stories

care jpeg

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
  • staff

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.

Soft Launch

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 

Talking Mats & ASD – developing social communication.

learning

Talking Mats and Autism- Have you sometimes tried it and it didn’t work?

There is a growing interest in teaching TM to people with ASD. We know that some important adaptations might be required to make this a meaningful experience, and are keen to share our learning so far.

Being asked for thoughts or views can be difficult for some people with communication difficulties.  In particular, there is a group of people with autism where some of the core principles of Talking Mats have to be taught in stages.   Some thinkers will just ‘get it’ and find it a valuable tool for sharing their thoughts and for supporting decision making.  For others there may have to be adaptations and /or  specific teaching e.g. the vocabulary of the top scale.  We heard recently of a student in a specialist centre who couldn’t use Talking Mats.  However the staff would include him in groups where it was used and make sure he was around others doing Mats.  After a few years, he did learn the principles and go on to use it effectively.

We have gathered ideas and knowledge from practitioners working in the field of autism and included these on our web-site under Free Stuff on Communication Disability.  ASD guidelines  It’s important that these guidelines grow and adapt as we learn more about using TM with an even wider range of people.

We’ve arranged a twilight session here at Stirling on the 1st of February 2018  to bring together practitioners working in the field of autism to extend our knowledge and encourage a staged approach to effective use of Talking Mats.
We’re delighted that Ruth Chalmers, Principal Teacher for Autism Spectrum Info and Support Team (ASIST) in Fife will be joining us to talk about developing social communication skills using Talking Mats. There will be time for small group chat so bring along a case you want to discuss.
Please share the attached flier 201802 AsD seminar with your network and we hope you can join us

Please come along and   If you are interested in attending this twilight session 4.00pm to 6.00 pm (cost £20.00),  please notify us at info@talkingmats.com

What really matters

rabbit

This story, which highlights the importance of finding out what really matters to people, was shared by one of the staff attending the second day of an enhanced Talking Mats training course. She works in a NHS facility for people assessed as needing hospital-based continuing care.

I was working with Bill (not his real name) who is a man with severe cognitive impairment resulting from a head injury and stroke. He was very angry and agitated and we couldn’t work out what was wrong. At times he was physically aggressive when we couldn’t understand him.

One day he drew a picture of a rabbit and was very insistent about it but we didn’t know what it meant. We contacted his sister about him being angry about a rabbit. She asked around to other family members and friends but no one could think what it meant.

Bill continued to draw a rabbit and then other pictures including money and TV  so I made an improvised Talking Mat using his drawings as the options and began trying to find out what really mattered to him. I gradually connected that the TV was about about programme called Dickinson’s Real Deal (a TV programme about antiques) and that in the past Bill had had an ornament of a rabbit which he thought was worth a lot of money.

We phoned his sister again about a possible rabbit ornament and she then remembered that he had collected figurines in the past. She finally discovered the rabbit in her garage.

Once we were able to reassure Bill that his rabbit was safe his frustration lessened,he was much less angry and became more settled.

This lovely story shows us how important it is to never assume that someone is just ‘being difficult’  but that if we can try to find out what really matters to them we can make a huge difference to their lives and ours.