Tag Archives: Advance Care Planning

Using Talking Mats to Support People to Think Ahead

End of Life

Many thanks to Dr Sally Boa, Head of Education, Research and Practice Development at Strathcarron Hospice in Stirlingshire, for this latest guest blog – linking to her great presentation at our TM is 21 event in August.  Sally’s presentation – Talking Mats and Palliative care – focused on using Talking Mats in Palliative and End of Life Care, and included information about the Talking Mats ‘Thinking Ahead’ resource – here Sally shares her own experiences:

Talking about death and dying and making plans for the future is difficult to do. This is partly because no one likes to think about their own mortality and partly because as a society we don’t talk about it. I work in a hospice where people are encouraged to talk about the care and treatment they would want as their condition deteriorates. Even here, these conversations can be difficult, particularly if someone has communication or cognitive difficulties, if there is uncertainty about prognosis or if there are different opinions within the family. The ‘Thinking ahead’ Talking Mats resource is a great tool to use to enable these conversations to happen. In my presentation at the ‘Talking Mats is 21’ event, I provide some background about how the resource was developed. I have used it to support those with communication difficulties to have a voice and also with people who simply find this a difficult topic to think and talk about. Use of the Mats helps people to think through the issues one at a time and see for themselves how they feel about things in relation to one another. Most importantly, it helps open up the conversation about the future and helps people to prioritise and see for themselves what they need to do in relation to making plans for the future. Then they can get on with living and doing the things that are most important to them.

making memories

A most memorable example of using Talking Mats with someone towards the end of life is when I was asked to work with ‘Gill’ who had severe communication difficulties. I used the ‘Thinking ahead’ resource with her and found out that she had made many plans in relation to sorting out her affairs (e.g. power of attorney, funeral arrangements). She hesitated when I showed her the ‘making memories’ symbol and at the time I couldn’t work out why. To finish the session, I used the ‘indoor interests’ symbols with Gill and we had a great conversation about all the things she enjoyed doing. When I gave Gill the ‘arts and crafts’ symbol, she became really animated, and was able to tell me that she wanted to finish creating a memory book of photos that she had been making up for her family. Using the Mats, Gill managed to convey why she had hesitated with the ‘making memories’ symbol. Following on from this, we had a conversation with the hospice creative arts coordinator who was able to support Gill to complete, not only her memory book, but also other creative pieces. In her last few days of life, Gill was able to identify and work towards really important goals and left some amazing memories for her family.

To find out more about our Thinking Ahead resource, which is available to those who have accessed our Foundation Training – follow this link – https://www.talkingmats.com/product/thinking-ahead/

 

If you haven’t accessed our Foundation Training yet – find out more here https://www.talkingmats.com/training/foundation-training/

 

Thinking Ahead – How Talking Mats can support Difficult Conversations

chatting

Rachel Woolcomb, our Talking Mats OT Associate, shares a recent personal experience where she used Talking Mats to support a difficult conversation:

The vision of Talking Mats is to improve the lives of people with communications difficulties. I have been reflecting recently on the definition of ‘communication difficulties.’

When I first heard about, and started to use Talking Mats 10 years ago, my perception was that it was fantastic for those that could not speak but I must admit I didn’t really consider using it with people who, such as myself, could use their voice to communicate.

Over the years as my understanding has developed, and I have looked further into the use of Talking Mats as a ‘thinking tool’ I have come to a different conclusion.

I would like to suggest that at some points in our lives, each one of us is likely to experience a communication difficulty. I don’t mean that we cannot physically speak, but that we cannot express what we really want to say in words. Perhaps a topic is too difficult to talk about with someone so we don’t bother, or we are overwhelmed by the subject that we don’t really know where to start.

One such subject is that of death and dying.

We know it will happen to us all one day but to talk openly with loved ones, is for some reason, too much to comprehend, too emotive, or considered bleak.

I am very fortunate enough to have grandparents in their 90’s however the conversation about their wishes for the future goes unspoken. It is a challenge for my parents to raise the issue therefore it remains the big unknown.

This is a common problem. In 2009, The National Council for Palliative Care wanted to address this issue and set up the Dying Matters Coalition in England and Wales, to help people talk more openly about dying, death and bereavement and to make plans for the end of life.

Talking Mats have produced a set of topic cards called ‘Thinking Ahead.’ https://www.talkingmats.com/product/thinking-ahead/

These were created in consultation with Strathcarron hospice to help people with advanced illness or long term conditions to think ahead and plan for the future. The three topics in the set are: Affairs, Care and Treatment and Personal Values.

My Mum was interested in my role with Talking Mats and wanted to understand what it was all about. We had already started to talk about the challenges of having difficult conversations, especially about death, and therefore over a drink, in a relaxed coffee shop, we embarked on a journey of discovery using a Talking Mat. My Mum as the Thinker and myself as the Listener .

Rachel cafe photo

She used the Talking Mat to help her think about things she had not considered and was able to make plans about what she wanted to do next. I heard her wishes and her thoughts, on why certain things were important to her. It was a very special time, facilitated by a Talking Mat.

My challenge to you as readers of this blog is to ask yourself ‘what do I have difficulty talking about’ – A Talking Mat just might be the answer!

Another resource you might find helpful is ‘Let’s Talk about Death and Dying’ –  www.ageuk.org.uk

Rachel will be running a ‘Talking Mats as a Thinking Tool’ workshop at our Talking Mats is 21 Event is in Stirling on Thursday 15th August 2019. Dr Sally Boa from Strathcarron Hospice will also be running a ‘Talking Mats in End of Life Care’ workshop at this event. Thanks to funding from NHS Forth Valley endowment committee the event is free but you do need to book your space https://www.eventbrite.co.uk/e/talking-mats-is-21-tickets-62362171935

21st save the date

You can come to the morning only, afternoon only or come for the whole day.

If you can’t come to our event watch out for out blogs and social media celebrating the reach of Talking Mats for 21 days before the 15th of August.  Please join in with your contributions using the hashtag #TMis21. For 21 days after our event we will be having a special Birthday offer! Watch this space, more to follow …….

An Interview with Joan Murphy, Founder of Talking Mats

Joan pic

Last week, Laura Holmes, our NW England Associate, had the pleasure of interviewing our inspirational Founder, Joan Murphy. Joan will be retiring after our Talking Mats 21 event on 15th August 2019 and so this was a great opportunity to find out more about her Talking Mats experiences:

Are there any stand-out moments for you, from your Talking Mats time?

Talking Mats are now used in many countries across the world and it has been great to have the chance to travel widely. One particular moment which stands out for me was during one of two trips I made to China with Sally Boa. I was asked to demonstrate Talking Mats with a man who was in hospital having had a stroke. He had no speech and was using a wheelchair. I used Talking Mats to find out what the man felt he could/ couldn’t do. The man shared that he felt he could walk. I had to present the symbol three times as the family members and medical staff watching were adamant that the man could not walk. On the third time, the man pushed the table, moved his wheelchair back then stood up and walked around the room. His family and medical team were completely shocked and realised that no-one had actually thought to ask him if he could walk. This was a massive turning point both for the man – and also for his family and medical team, who could now see the power of using a Talking Mat.

Have you done any Talking Mats yourself that helped you to make an important decision for you or your family?

Absolutely – quite a few! My husband and I both used Talking Mats for our Power of Attorneys and shared them with our lawyer and grown-up children. My husband and I also used Talking Mats to talk about the Scottish Referendum as we had opposing views – it really helped as it made us listen to each other without interrupting. We then went on to use the mats as part of a presentation. Various members of my family have used mats to explore personal issues and decisions 

What are the top tips you have gained from your Talking Mats journey – from working in the NHS and then more recently as a social enterprise?

You have to have humour. And be able to listen. It has been essential to be able to work in partnership with Lois and the other Talking Mats team members. The team are such nice people to work with and we have lots of laughs. Setting up as social enterprise was vital for Talking Mats – in terms of having the freedom to be creative. It felt as though someone had a big rubber band which was able to be released. It was a huge risk and there have been lots of leaps of faith along the way.

comfort zone

 

Do you have any top tips for people using Talking Mats in the Listener role?

Be quiet – and Listen! It’s also important to feel relaxed and to have a sense of humour whilst using it. A Talking Mat is not a test – it is serious, and can be used to explore difficult issues, but it should be fun.

humour

Talking Mats is a low-tech AAC system – do you think it has a place in the modern world?

It is absolutely crucial! Low-tech resources are fundamental in terms of being able to have and develop conversation skills and social closeness.

What do you want for Talking Mats in the next 10 years?

World Domination! Talking Mats has the potential to be used everywhere in the world, by everyone. However I would like to see Talking Mats continue to have a small core team, but increasing Licensed Trainers across both the UK and the rest of the world.

 

Our Talking Mats is 21 Event is in Stirling on Thursday 15th August 2019.  Thanks to funding from NHS Forth Valley endowment committee the event is free but you do need to book your space https://www.eventbrite.co.uk/e/talking-mats-is-21-tickets-62362171935

21st save the date

You can come to the morning only, afternoon only or come for the whole day.

If you can’t come to our event watch out for out blogs and social media celebrating the reach of Talking Mats for 21 days before the 15th of August.  Please join in with your contributions using the hashtag #TMis21. For 21 days after our event we will be having a special Birthday offer! Watch this space, more to follow …….

 

Thinking Ahead: supporting people to plan for the future

transitions

This new resource has been developed by Strathcarron Hospice and Talking Mats to help people with advanced illness or long term conditions to think ahead and plan for the future.

It consists of a booklet and 3 topic symbol sets: Affairs; Care/treatment; Personal values

3 topics
It can be used to help people have conversations about:
• the extent to which their personal affairs are sorted;
• what they would or would not consider about future treatments and care;
• what is going well/not going well in relation to their personal values

It is widely recognised that having discussions about end of life issues can enable people to remain in control for longer and help them to identify the care and support they need and want as they approach death. In spite of this, in Scotland:

  • 74% of people have not discussed what their wishes would be if they did not have long to live
  • 79% of people don’t have any written plans for their end of life care, financial wishes or funeral plans
  • Only 35% of people have written a Will

It can sometimes be difficult for people to start conversations about planning for end of life and people this is exacerbated if people have specific difficulties communicating their thoughts and feelings because of symptoms, fatigue and emotional factors. Before initiating this type of conversation it can be helpful to check the extent of a person’s understanding of their illness and whether or not they want to talk about the future.

The importance of having conversations and making plans for end of life has been highlighted as being relevant for people in the early stages of life limiting illness as well as for those nearing the end of life. There is evidence that people who have Advance or Anticipatory Care Plans in place are more likely to receive the care that they want and treatment can be less invasive. ACP is a process rather than a one-off conversation. It is acknowledged that ACP discussions should take place in appropriate settings with sufficient time to enable to people to consider and weigh up different options. ACP should also be developed in line with peoples’ personal values and goals (Sinuff Tasnim, et al.(2015) “Improving end-of-life communication and decision making: the development of a conceptual framework and quality indicators.” Journal of pain and symptom management 49.6 2015): 1070-1080).

Perhaps we should think about planning ahead whether or not we have advanced illness or long term conditions??

Training

To get the most out of the resource we run half day advanced training courses which will include the Thinking Ahead Resource. This course will be relevant to you if you:

  •  have attended a Talking Mats foundation training and are experienced in using Talking Mats with adults
  • want to extend your use of Talking Mats and consider its role and application to advance care planning
  • want to discuss sensitive topics around end of life care

 

Please contact us at 01786 479511 if you are interested in future dates.

Talking Mats – 2 learning opportunities for February

learning

Do you want to introduce Talking Mats to people with a communication disability and autism, but know they will need support to learn it?

We are holding a 2 hour seminar on the 1st of February in Stirling to share ways of supporting people with autism to learn to use Talking Mats and express their thoughts.Twilight ASD Seminar

 

Do you want to help people think about the future and what they might want to have in place at end of life?  Talking Mats and Strathcarron Hospice have developed a powerful new resource to support these sensitive conversations and an advanced course is being held in Stirling on the 21st February   and in London 27th of March http://www.talkingmats.com/training/specialist-seminars/

3 topics

 

These opportunities are only open to people who have attended Foundation training