Tag Archives: Hospice

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 …….

Using Talking Mats to make Personalised Care a Reality for Occupational Therapists

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Rachel Woolcomb, our Talking Mats OT Associate, tells us about the recent Royal College of Occupational Therapists’ Report and considers the ways Talking Mats can support:

The Royal College of Occupational Therapists have recently published a new report. “Making personalised care a reality: The role of occupational therapy.”

As the OT Associate for Talking Mats, I took the opportunity to review the document and consider how Talking Mats can help OT’s in fulfilling the recommendations made.

The report recognises that people living with long-term conditions bring different and equally important, knowledge and expertise to the decision –making process.

It challenges OT’s to ensure that they really listen to, and hear the views of the people they work with.

talking_mats

A Talking Mat can help facilitate this. It helps people to understand what is being discussed, to reflect and organise their thoughts, to say what matters most to them and record their views. It helps OT’s to really listen, to learn new information, to involve the person in their own planning and support decision making.

Read more about how Talking Mats can help OT’s to make personalised care a reality in the TMOT Resource 1:  TM Personalised Care – Copy.

The RCOT report is available here: https://www.rcot.co.uk/news/delivering-personalised-care-frontline

Rachel would love to hear from you if you have any examples of how Talking Mats have helped you to provide personalised care, or if you want to know more about OT and Talking Mats. Her email is: Rachel@talkingmats.com.

If you are feeling inspired and would like to find out about accessing Talking Mats Foundation Training, take a look at our upcoming courses across the UK, as well as online and organisational training options: https://www.talkingmats.com/training/

 

 

 

 

 

 

 

 

Using Talking Mats to Empower People with Dementia to Actively Participate in Decision Making

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Many thanks to Mary Walsh, Health Service Executive (HSE) Senior SLT at St Mary’s Hospital, Dublin for this fantastic blog post about their project involving use of Talking Mats to support people with Dementia to participate in decision making related to their needs:

In September 2016 Aideen Lawlor (SLT Manager) and I (Senior SLT) won the Dementia Elevator award with a project entitled “Empowering Persons with Dementia to become more Active Participants in Decision Making Related to Their Present and Future Needs.” with Talking Mats being an integral part of this project. In November 2017, the prize money was used to fund my training to become an accredited Talking Mats trainer so that I could then train others in TM Foundation Course on a prioritised basis.

This project is now complete with 6 speech and language therapists (SLTs) from a variety of settings working with persons with dementia all trained in using Talking Mats. As part of their training, The SLTs used TM with patients/ residents with particular reference to the Assisted Decision Making (Capacity) Act 2015. TMs were also used to help the clinicians to get to know their patients, in care planning, in improving increased opportunities for interaction and in improving choices and decision making. In effect, we were checking it out!

All the SLTs found that when TM principles are followed, that it helped to empower people with dementia to make decisions about their care. Some of the reported findings:

  • That the pictures help maintain attention and aid comprehension.
  • That it facilitated strengths rather than a deficit model.
  • That photographed completed TM provided a pictorial record for meetings – very positive.
  • That it provided a significant catalyst for change in some instances.
  • That it helped people with dementia and responsive behaviour get needs met
  • That video recording sessions with consent greatly enhances reflective practice and may be helpful in key decision making

Dublin blog photo

The next phase is to expand the number of SLTs who can provide training in Talking Mats across the Republic of Ireland. Funding from the national SLT professional body training grant scheme has been sought for these 6 SLTs to become trainers for Talking Mats. This will result in cascading training on a priority basis, increase evidence base/ knowledge re using TM and embedding TM in variety of clinical settings with SLTs leading this practice.

Mary Walsh,

Senior speech and language therapist,

St. Mary’s Hospital,

Phoenix Park, Dublin 20,

Ireland

mary.walsh6@hse.ie

Aideen Lawlor

Speech and Language Therapy Manager

aideen.lawlor@hse.ie

If you are feeling inspired and are interested in accessing Talking Mats training, we offer Foundation Training courses throughout the UK and Ireland as well as online – take a look here for more details:

www.talkingmats.com/training

Once you have accessed Foundation Training you can apply for our Accredited Trainers course to enable you to deliver Talking Mats training to others in your area.

Thinking Ahead: supporting people to plan for the future

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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 to support conversations in a hospice setting

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We are currently working to develop a Talking Mats resource to support conversations relating to Advance Care Planning (ACP) with staff and patients from Strathcarron Hospice. People who use hospices often have specific difficulties communicating their thoughts and feelings because of advanced illness and emotional factors.

Sixteen staff from the multidisciplinary team at Strathcarron Hospice were trained to use Talking Mats by Sally Boa who is Head of Education, Research and Practice Development at Strathcarron Hospice and also one of our accredited trainers.The staff trained used it successfully with patients in the hospice and found that they could use it with a range of patients for a variety of purposes: getting to know someone; identifying goals; discharge planning.

A sub-group of staff attended a workshop with members of the Talking Mats team to discuss the potential use of Talking Mats to support conversations relating to ACP. Topics and options were agreed. These were then presented to a wider forum of staff from Highland Hospice for validation and checking. Three main topics to support ACP conversations were identified: Affairs; Care and Personal Values. New symbols are being developed and the resource will be trialled with a range of patients in the hospice setting.

Our hope is that Talking Mats can be used by trained staff in a hospice setting to support people to express their views and help them plan for the end of life and that it will also be helpful for many other people to consider future options in their lives.

We will write an update once the new resource has been completed.