Conversations with Care Homes

Conversations with Care Homes

Conversations with care homes a series by My Home Life England 

‘Conversations with Care Homes’ is a series by My Home Life England (MHLE). In Episode 7 we focus on how best to support care home residents living with dementia during COVID-19. The pandemic has posed additional challenges for those living with dementia – for example the disruption of familiar routine, the need to socially distance and wash hands more regularly, and the impact of staff wearing more PPE. We share stories, tips, methods and signposting for how best to support residents living with dementia at this difficult time.

You can see more Videos from My Home Life here >>

A message from My Home life to the care home community:

You are doing an incredible job in challenging circumstances. You continue to make such a positive difference to people’s lives – thank you. We see you, we appreciate everything that you are doing, and we want you to know that My Home Life England is always here for you. Keep up your fantastic work and please do get in touch if you are able, we’d love to hear from you.

Please get in touch! If you have any stories to share, please contact us at or call 02070405776 For more information about My Home Life England, please visit our website or find us on Twitter & Facebook – @myhomelifeuk

About My Home Life 

My Home Life was founded in 2006, by National Care Forum in partnership with Help the Aged (now Age UK) and City, University of London.

It is a social movement for quality improvement in care homes that has spread nationally and internationally.

The success of My Home Life lies in our four evidence-informed guiding principles: Developing best practice together, Focusing on relationships, Being appreciative, and Having caring conversations.

“A diagnosis of dementia for a person is also a diagnosis for the whole family.”– Four letters that make communicating with a person with dementia more real.>>

Queens Court Care Home under lockdown

Queens Court Care Home under lockdown

Interview with Shaaron, 18  May 2020

Shaaron Caratella is our care home specialist advisor to REAL Communication Works.

Originally an RGN nurse in the NHS, she went on to gain a BSc in Nursing Studies, a Diploma in Orthopaedics and an MSc in Health Sciences. Her passion for the good care of older people shines out of her and she has been the Manager of Barchester Queens Court Care Home for 23 years, what she doesn’t know about nursing home care, is hardly worth knowing.

Queens Court locked down early in March and this means that my fortnightly conversation group with residents, which has been going for about a decade, also had to be temporarily suspended. I really miss the lovely residents in my Sarah’s Chats group, but have stayed in touch with them with intermittent postcards from the coast. Reassuringly, one of our group has even taken up occasional correspondence with me!

Last week, Shaaron and I had a phone conversation, as I was keen to hear how she and everyone else is coping. She sounded comparatively cheerful, given the circumstances, which pose so many challenges….

“The staff have been really shell-shocked. We have lost some staff through natural wastage – one of our full-time staff left to work at a different care home early on in the Lockdown. Only the really brave care workers were coming in for about the first month and I was very concerned about the psychological state of the staff – we were all very sad.

‘We had to implement special protocols for infection control from day one’.

And then there are the reports… the endless reports. Everyone wants reports, Public Health England, Merton Council, the CQC, the London Capacity Tracker. Everybody wants it written down, which means a lot of extra work.

The laundry has been really challenging, because nothing can be worn or used more than once without fastidious cleaning, so the washing machines have been very busy and our maintenance man has been living from moment to moment to ensure that everything keeps running. He has never had to work so hard.

Barchester Healthcare has been really good and has really invested in the care staff. They had a strategic plan by mid-March. We do a daily Covid update with all manner of detail, including infection control and deep cleaning, right down to meeting and greeting.

Every Monday, we do a thank you for the care staff that comes straight down from the (Dr) Pete Calveley, ourChief Executive and the reviews have been very useful. There is been a lot of good feelings towards care homes and we have been celebrating the kindness. We are trying to be mutually supportive. There is a huge amount of respect for the staff and a huge amount of responsibility for them, too. But they understand it. They get it. Right from the early days, the staff and residents have been very supportive to each other, even though the first two months were a baptism of fire – it was relentless.

The situation with families has been very challenging. Although they have been able to Skype or phone, the lack of visitors is really a problem in the care area. Of course, their new isolation means that a few of the residents have become quite depressed, but we’re doing our best to keep them connected to their families and to one another. Our good relationship with families has paid off. We are on first name terms with them now in a way that we never were before. There is a huge amount of trust and our team knows that, so we try even harder to be there all the time for our residents.

As far as health matters in the home are concerned, we are proud that the results of Whole Home Testing showed that we are Covid negative. Residents have had some hearing aid issues and some have needed to be seen by the optician – it’s good that our GP visits all dressed in PPE. It’s been very good for the team to use all their skills including hairdressing. Since it’s been warmer, the residents have been socially distancing in the garden and having ice cream and doing a quiz or just taking in the sun.


‘There’s been a lot of kindness and we all laugh and giggle together. Of course, you feel absolutely exhausted at the end of the day, but there’s nothing like a glass of wine to cheer you up’!

Hospitals aren’t discharging residents to some care homes – they are only using contract beds, even in this time of Covid. Of course, hospital staff don’t have time to develop the deeper relationships with the residents the way that we do. Sadly, they can forget – and lack respect for, the great age and needs of these special older people in our small community.

Face Masks and Dementia Care

What is the person saying?

By Sarah Reed 

How facemasks affect how we communicate.  The importance of emotional perception, expression and reciprocity in non-verbal communication is bound to impact the outcome of any doctor/patient or carer/cared-for interactions. 

Studies have demonstrated the impact of doctors’ and carers’ empathy and person-centred care on the enablement and health outcomes for the person in receipt of care with both chronic and acute conditions. In a large randomised controlled trial in 2014, it was found that the “wearing of facemasks by doctors had little effect on patient enablement and satisfaction but had a significant and negative effect on patients’ perceptions of the doctors’ empathy”.

We must hope that eventually, mask makers will recognise that clear panel masks are really the only ones worth using and start manufacturing them. However, in the meantime, the following tips are good for all our interactions with anyone at any time whether they have dementia or not, but are especially important now with the additional social distancing that masks create.

In communication, most of us rely on language – often at the expense of many other types of communication. However, nonverbal communication is just as important as the words we use. During these times of the Covid-19 pandemic, the use of facemasks has become ubiquitous and they present serious communication difficulties which should not be under-estimated, for the wearer and the person they are talking to, alike. 

Lockdown is one thing, but facemasks are prisons that limit the range of our actions and words.

In covering our facial expressions, face masks hide our emotions. For example, pleasure, sadness, frustration, annoyance and fear are all emotions that we show on our faces without ever having to say a word. And unspoken communications tend to be the same across most cultures. Given the increasing use of facemasks, this means of communication is becoming increasingly challenging.

Non-verbal communication is often the most effective element of communication when connecting with a person who has limited or impaired cognition or is living with dementia. People with dementia increasingly lose their ability to communicate verbally, but their body and para-linguistic interpretive skills are retained longer in most conditions and may even be retained right to the end of their life. They are usually able to interpret facial signals correctly and can be skilled interpreters, understanding when we are relaxed or stressed or conveying other subtle messages, making sense of things from the sound and inflection of our voice, our speed of speech, our posture and the way we move around. We know that when people have difficulty understanding, they will fill in the gaps by reading our facial expressions, the sound of our voice and body movements and posture.

Carers who are more alert to nonverbal cues are often well-practiced at reinforcing the other person’s perception of their sincerity, compassion, appreciation, dedication and competence. This improves their relationships with those they care for as well as their colleagues and also increases their ability to provide meaningful care.

Nonverbal communication provides unique opportunities to connect, so it is important to pay greater attention to our nonverbal communication in this time of social distancing and masked faces.

The following tips can impact and improve interactions with older people while wearing masks. Being focused on the challenge of this is key to success.

1. Pause and be mindful. Be self-aware

If things are busy and stressful, try not to let that be reflective in your voice. Make sure there is enough time for any interaction. Taking a moment or two for yourself immediately before an encounter can make a big difference to the experience. Creating a mental ritual to focus your attention before seeing someone, can help. For example, reflecting on the many varieties of communication that older people and their carers encounter in care settings, such as expert-layperson, healthy-sick, independent-dependent, cognitively healthy–cognitively impaired, young-old and family and so on, might be an option.

2. Be Calm. Smile inside – and outside

Show absolute respect. It is essential to approach the person from the front. This will help them to process who you are and what you are saying. Respect the person’s personal space and make sure you speak to them on the same eye level.

Good eye contact is most important. Use your eyes and eyebrows. Let your eyebrows tell the story. Remember to smile! The person may not be able to see your mouth, but they will be able to read the emotion in your eyes which will allow them to feel more comfortable and in control. They are very likely to be able to detect your body language, so remember that any sudden movements can cause distress and make it harder to communicate.

Be straightforward and try to stay calm. Project a positive, calm attitude and avoid any body language that shows frustration, anger or impatience. Try not to interrupt them and give them your full attention. Be flexible and patient.

Don’t just rely on giving information verbally. Using images, gestures, even written words, phone translation/text apps can be helpful. If the person is still able to read, it may be useful to leave any written version of verbal information that you use with them, so that they can refer to it later.

3. Speak clearly

Avoid noisy environments that might overwhelm with additional stimulus. It is useful to remember that 11 million people in the UK have hearing problems or are deaf. There are a number of hearing apps available on the market which can help. Firstly, create a safe space. and maintain your social distancing with a clear path. Ensure that any physical barriers that could block your view or further challenge your voice being heard behind the mask are removed.
Observe first, even if briefly.

Remember to smile! Always ensure that the older person is wearing their glasses or hearing aids. Your tone of voice includes your speed, tempo and pitch which can be as impactful as the words you are speaking.

Slowly communicate one point at a time. Use short, simple sentences and underline your words with appropriate gestures. Make your statement or ask your question and then pause. Keep your voice even, gentle in tone, and moderate your speed of speech. Go slow!

Lip-reading cues that many with hearing disabilities use to compensate will be absent, so make sure you articulate your words clearly without sounding forced, which may be taken as condescension.

Consonants matter! Speak louder if necessary but without raising your voice or its tone, because this might be perceived as aggression. Using NLP (Neuro Linguistic Programming) techniques of mirroring and matching the person’s gestures, vocal tone or mood can be re-assuring for them and help them feel better understood.

The messages we convey might be harder to interpret so we need to develop new habits, ensuring that we underline everything we say with gestures and pantomime. Going slowly with the person will make connection easier.

4. Remember to listen well

Listening is a vital part of communication as well. Making space to listen is very important in any encounter. However, in one randomised trial in 2010 it was found that “64% of the nurse participants had a weak knowledge of verbal communication skills and only 36% had relative knowledge about listening and speaking skills. This is while verbal communication skills are considered as the foundations of communication in everyday life”. your view or further challenge your voice being heard behind the mask are removed.

Observe first, even if briefly.

Remember to smile! Always ensure that the older person is wearing their glasses or hearing aids. Your tone of voice includes your speed, tempo and pitch which can be as impactful as the words you are speaking

5. Remember that our bodies speak as well

It is vital that we think about the ways in which we typically communicate, such as gestures and tone we use when we are not inhibited by distance and PPE. Once we become more aware of our characteristic gestures and body language, it is easier to align our nonverbal signalling with our spoken message.

Body language is vital to deliver meaning well and communicate effectively. Together, hand gestures and posture are very important. Our non-verbal cues should send message of kindness and empathy. Try to relax your shoulders. Remember to avoid crossing your arms in front of your body and keep your hands off your hips and out of your pockets.

It is always helpful to nod and add ‘mm’ and ‘yes’ when appropriate, as it acknowledges that you are listening and understanding.

Happiness can be seen by raised eyebrows, raised cheeks and crow’s feet. Remember to smile! On the other hand, eyebrows pinched together and eyes drooping can indicate sadness and when in a “V” shape can express anger.

The person with cognitive impairment may not recognise you at all in any encounter if you are wearing a facemask, even if they have spent time with you over many months, but we still need to make each connection count. As one wise soul once perceptively observed, “I may not remember what you said, but I will remember how you made me feel.”

Facemasks and perception of empathy

Here is an article from NCBI  – US National Library of Medicine National Institutes of Health. It is regarding a randomised control study that was conducted to explore the effects of doctors wearing facemasks on patients’ perception of doctors’ empathy, patient enablement and patient satisfaction. 

The report can be viewed here and it is titled  ‘Effect of facemasks on empathy and relational continuity: a randomised controlled trial in primary care’


About Sarah Reed

Sarah Reed is the founder and lead at REAL Communication Works.

Sarah lectures in Health departments at Kingston and City Universities. She now works with other highly skilled dementia care learning facilitators to deliver interactive REAL Communication workshops.

She has served on the SUCAB Service User and Carer Advisory Board in the School of Health Sciences at City University since 2017.

She is a Trustee of and thirty-year volunteer co-ordinator and monthly driver for national older people’s charity, Re-Engage (formerly Contact the Elderly). In 2015, she served on NCVO’s Volunteering in Care Homes advisory board. She is a member of the DH Quality Matters board.

Meaningful conversation is one key to happiness

Talking makes people happy.

When my mother was in the care homes she lived in for the last seven years of her life, I was keen to ensure that she was engaged in meaningful conversation by carers as much as possible, so that when the family could not be there, she felt stimulated and happy.

She had dementia and I observed was that the more advanced her dementia became, the less staff were likely to engage in conversation with her. Often this was because the younger carers had no training in how to start or maintain a meaningful conversation with a person living with more advanced dementia – and of course, their life experiences were so different. It was this observation that largely prompted me to develop Many Happy Returns conversation trigger cards and REAL Communication workshops.

The workshops focus on a range of communication issues, including overt and unspoken language, body language, voice, tone and inflection, the complexities of memory and how it works, compassion and empathic engagement, why listening is so important to us all and how to do it better and the vital importance of a person’s life story and why it matters quite so much to any older person with dementia as well as those caring for them.

Self-care is part of communicating with oneself and more awareness of this and of self can help reduce the well-documented incidences of professional and unpaid carers’ burn-out.

As far as I know, there are no other conversation trigger cards like ours, which include carefully researched images from social culture with contextual background information and conversational prompts. Our REAL Communication workshops are unique. Both are based on research evidence. The following research results contribute to our work.
According to research from Washington University in St. Louis and the University of Arizona, outgoing, gregarious people who fill their lives with deep, meaningful conversations are lucky to have one of the keys to a happier life.

People who spend less time alone and more time talking with others have a greater sense of personal well-being, suggests the study, published in the journal of the Association for Psychological Science.


“Having more conversation, no matter how trivial, appears to be associated with a greater sense of happiness among the people in the study,” 

“Having more conversation, no matter how trivial, appears to be associated with a greater sense of happiness among the people in the study,” co-author Simine Vazire, PhD, assistant professor of psychology in Arts & Sciences at Washington University.However, the happiest people were those who often engaged in more meaningful and substantive discussions, as opposed to idle chit-chat and small talk.

Based on the conversation patterns of 79 college-aged men and women was tracked over a four-day period, the study was conducted by Vazire and three colleagues at the University of Arizona.

Using an unobtrusive recording device that participants carried in a pocket or purse, researchers taped 30 seconds of sound every 12.5 minutes, amassing more than 20,000 audio snippets of sound from the daily lives of participants.

Members of the research team listened to the recordings and coded the number of conversations each participant had, and whether each conversation was substantive or small talk. Each participant’s happiness level was scored using standard psychological tools for gauging personality and wellbeing, including self-assessments and reports from friends.

Participants scored as “happiest” in the study spent about 25 per cent less time alone and 70 per cent more time talking to others, as compared with the unhappiest participants. The happiest participants had twice as many substantive conversations and one third as much small talk as the unhappiest participants.

“Overall, these findings suggest that meaningful interactions with others are important for wellbeing,” Vazire concludes.

“However, our research cannot determine whether meaningful interactions cause happiness, whether happiness causes people to have more meaningful conversations, or whether there is another explanation. We believe it’s likely that both are true – that happiness leads to more meaningful connections with others, which then produce more happiness – but this remains to be tested in future research.”

When we feel valued and appreciated, our sense of self improves and we are more likely to value and appreciate others more and in turn, this encourages them to value and appreciate us more. Nowhere is this ‘virtuous circle’ of value and appreciation more true and more obvious, than in care homes.
To conclude, meaningful conversations need inspiration.

When we inspire a person we are speaking with, we create a welcoming space in which they are encouraged to share, (but not required to). This gives them more freedom in how they respond. If you ask, “How was your weekend?” (an invitation), the person can only respond by answering your question.

Instead, if you share a story from an event you experienced at the weekend that may be relevant to the other person (an inspiration), then they can choose how they respond. It’s up to them. And that means it’s not up to you.

Weaving inspiration into our conversations frees us from the responsibility of knowing what to say next. Inspiration encourages us and the other person to ‘co-create’ a conversation together.

All we need is to be genuine in what we share, and share it in a way that encourages others to share as well.

How to communicate well with someone living with dementia (Part Two)

Photo by Nick Fewings on Unsplash


Part Two: Words aren’t everything

The Language of Dementia

Unfortunately, speech and language deterioration is almost inevitable for a person living with dementia. The reasons are multifarious — among others, the person’s natural language and vocabulary are increasingly challenged by reduced mental capacity. Reduced brain-processing power means that they may struggle to understand what is being said to them. Loss of short-term memory makes it harder for them to orientate themselves in a narrative, or in conversation. They may be unable to respond at we would consider to be a ‘normal’ speed. They might return to using another language learnt in their childhood.

But words aren’t everything

We can communicate better with a person living with dementia by using overt and subtle, non-verbal language that conveys meaning beyond the words — especially if it mirrors theirs. Mirroring non-verbal cues helps to give clarity to our engagement, making it easier for us to understand one another.

Over the years, I’ve heard a number of stories of people living with dementia who have become newly attached, or antagonistic to another person because the person reminds them of a family member or friend they once liked or someone they disliked. It is often something in the tone of the person’s voice that has created this attraction or repulsion.

And it is not just what we say, but how we say it — our tone of voice.

Tone of voice matters, because it helps us to express the feelings behind the words we use, and may reflect among other things, our social culture, where we come from, our age, social status, education and command of language, our sense of ourselves, our attitudes, our state of health and our current mood. The timbre of our voice may help or hinder our connection with someone, even if we may be hardly, if ever, conscious of it.

Over the years, I’ve heard a number of stories of people living with dementia who have become newly attached, or antagonistic to another person because the person reminds them of a family member or friend they once liked or someone they disliked. It is often something in the tone of the person’s voice that has created this attraction or repulsion.

What are the ingredients that make up tone of voice?

These include natural vocal musicality, pitch, depth and intensity, the clarity and sound of our words, the accentuation we use, the speed at which we speak and more generally, the personality and outlook we convey by these means.

Even the simplest of questions, such as “How are you today, John?” may be imbued with a range of meanings depending on the tone of voice used, from genuine authenticity to patronisation, from positivity or cheeriness, to sadness or negativity. How many underlying meanings are you able to convey, just by changing your tone of voice and accentuation in the sample question?

Being more aware of how we sound can help improve our relationships with everyone

How to communicate well with someone living with dementia (Part One)

Photo by Harli Marten on Unsplash


Part One: Beyond the words

“Nonverbal communication forms a social language that is in many ways richer and more fundamental than our words.” 


Leonard Mlodinow

Body and paralanguage always speak louder than the words we use.

When we are alert to these, communication can be more effective, helping us to better understand the main — and also the underlying messages being conveyed.

When talking with a person living with dementia, they are particularly important to understand, for a few reasons. Firstly, the person’s reliance on non-verbal communication may accelerate as their natural language skills become increasingly compromised by the condition. Secondly, their sense of self alters subtly over time. Thirdly, the speed at which the person is able to process and absorb information is reduced. Finally, emotional feelings may rise to the surface (sometimes quite unexpectedly) in situations that challenge them in some way. All these facors contribute to how the person is able to hear, listen and respond.

Approximately 60% of our interactions use non-verbal communication.

These include proxemics (the space between us), kinesics (our body and head movements), hand gestures and posture. Facial expression and eye contact are key, of course. Perhaps crucially, a person’s tone of voice, intonation, pitch and speed of speaking, hesitation noises, gestures and facial expressions, make a significant difference to how we perceive both them and their message. We rely more heavily on this paralanguage to make sense of the world and our experiences than we might realise, or like to admit.

For any person, a diagnosis of dementia can feel like the beginning of the end.

Hardly surprising perhaps, given the prevailing, dismal medical model with which dementia is often viewed: as a journey of emptiness and inexorable physical and mental decline.

This depersonalised stereotyping over-simplifies the experience, presenting a one-dimensional view of personhood, overly dominated by cognition and short-term memory loss. Of course, as the disease progresses, the person’s thoughts and words inevitably become more tangled and confused.

However, a broader (and more humane) definition recognises that a person is far more than their thoughts alone and that together with their many long-term memories and experiences, the essence of the person remains, despite changes to the brain.

To keep well-connected to a person living with the condition, we need to become increasingly attentive to their non-verbal clues — as well as our own. We need to try to be more aware of what we are both communicating, beyond the words.

Communication Masterclass

Communication Masterclass

SCIE and REAL Communication Masterclass

 SCIE (Social Care Institute for Excellence) is running a Communication Masterclass, a customised  Real Communication Workshop program.

This is an open course for dementia care practitioners that focuses on how to communicate more effectively with a person living with dementia.

The interactive workshop includes exercises, games, discussion and reflection in an open studio environment. The workshop techniques are designed to make it easier for professional carers to positively contribute to the quality of life of those they care for. 

This is also CPD-accredited course will give you a range of easy-to-use and effective dementia communication strategies and techniques.

Content includes:

  • Techniques to establish trust and safety to support the person and their family.
  • How the brain’s different memory systems function
  • REAL communication framework and techniques: reminiscence, empathic engagement, active listening, life story.
  • REAL approaches to working with family carers and friends to deliver a better quality of life for all.
  • REAL communication techniques for mapping a person’s life story
  • Adjusting REAL communication techniques to a person’s needs as their dementia advances
  • Understanding how feelings are at the root of communication challenges
  • Strategies for self-care.

Learning outcomes

Participants will learn:

  • the deeper principles of communication that make care more meaningful
  • how to provide more relevant support to an individual living with dementia at home or in a care setting
  • how to connect more effectively with families and/or the person’s advocates
  • how to deliver better care through improved understanding and communication

The REAL framework is based on evidence gathered over a decade working with people living with dementia and their carers. Research showed that reminiscence, empathic engagement, active listening and life story are key to the wellbeing of any older person living with dementia.

When accompanied by the Senses Framework (My Home Life example here), everyone’s lives improve.

You can also learn more about SCIE’s Dementia training courses for health and care in collaboration with REAL Communication Works here

Chatterbox Cards and the Memory Café

Chatterbox Cards and Memory Café volunteering

My visit to the Alzheimer's Society Memory Café

There’s an Alzheimer’s Society Memory Café at a Housing Trust in north London. Everyone who attends is living with dementia, to varying degrees and I’ve been lucky to spend time there with the regulars to facilitate conversation using Many Happy Returns 40s and 50s Chatterbox cards.

My first visit included one family carer and four housing trust staff members. There were about 18 of us in the room, sitting around small tables with oilskin cloths, on each of which was a small glass vase with a single bright yellow fabric chrysanthemum. The colour of hope, I thought wistfully.

Everyone was wearing a badge and as always, we all introduced ourselves. I noted unusual names – most of those present were local, but a few had arrived here from the Commonwealth or as refugees from war. I knew that meant we would likely hear some intriguing stories.

The room was quiet and expectant. My first prompt was to seed thoughts of childhood – toys and games and freedom – adult authority. Tentatively to begin with, the group started sharing memories of favourite toys from childhood. Descriptions of dolls and dolls’ houses, of dolls’ prams and dressing up family pets to wheel around in them, of cap pistols and Painting by Numbers, these soon became stories of constantly being sent outside regardless of the season, (even when unwell) of running around unsupervised, of climbing trees, of innocent ‘gang’ games, and in winter, of mucking about in the (helpfully warm) local tube stations.

One man who said his family could afford no toys at all, described his pet Collie, 'Sailor'. "Rather an odd name for a dog I suppose!"

As often the case, despite their relative poverty, they described lives of happy, unfettered freedom hardly known by children today. One man who said his family could afford no toys at all, described his pet Collie, ‘Sailor’. “Rather an odd name for a dog I suppose!” he laughed, “he never ever went on a boat. I trained him and he was at my side all the time. He would do that thing that Collies do, crouching down to listen. He was really clever.” There was a lady who had grown up in Greece. Her language has reached that stage where her words sound quite feasible but are nonetheless, challenging to understand – or even hear, spoke with poignancy and pleasure about playing with her sisters in the sunshine on her local island beach.

Then we spread the Many Happy Returns Chatterbox cards arbitrarily around the tables. Every group – by now animated and chatting away happily, carried on. As always, prompted by the subjects, pictures and information on the cards, the volume in the room rose swiftly and dramatically as these fascinating older people revealed their histories to one another.

Their memories now spread across the landscape of their lives, their relationships, jobs, children and grandchildren.
As always, the volunteers expressed astonishment at the instant connection prompted by the cards, at the enjoyment and pleasure they observed, and at the sheer amount of conversation and animation. As always, the participants commented on the cards and how well they prompted meaningful memories.

People didn't really want to stop sharing and lingered on beyond the finish time to continue chatting

As always, like all good parties, people didn’t really want to stop sharing and lingered on beyond the finish time to continue chatting.

And as I have often found, as I trudged back to the bus stop, I felt a real sense of satisfaction that the chatterbox cards had once again delivered. Prompting so much fun and excited communication for everyone that day at the Memory Café. I also felt a deep sense of privilege and wonderment to be able to bear witness to their hidden treasure troves of life experience and history.

You can find out more about the the Many Happy-Returns Chatterbox Cards here >

REAL Communication workshops for carers

REAL Communication workshops for carers

REAL Communication workshops for carers help develop communication skills through interactive, experiential and blended learning programs.

Facilitating REAL Communication workshops for carers is always a privilege. Being interactive, what happens is always a Quid Pro Quo: a real exchange of learning and experience.

Good communication is absolutely central to good care. Nowhere is this more true than in the care of people living with dementia, for whom there is no cure and almost no palliatives. For family carers and care workers, good communication is vital: they all live with stress, anxiety, loss and grief on a daily basis while the person is still alive.

The REAL Communication* framework and mantra developed to address these issues:

  • We cannot care for a person if we don’t care about them;
  • We cannot care about them if we don’t know who they are

Care is always a triumvirate between the person being cared for, professional health and social care staff and relatives and friends. As all evidence shows, when these relationships work well together, good care always results. Conversely, if these relationships fail, poor care is inevitable.

Older people who are vulnerable and frail need sensitive relationship-centred care and robust advocacy, especially if they have dementia. They have rich life experiences that can have a deep affect on how they view their relationships with everyone around them – and life in general.

When we have empathy for the person, listen to them well, understand how their memory systems function; when we show kindness and recognise, appreciate, honour and celebrate their life experiences, they are encouraged and empowered to live life more fully, regardless of their condition.


*The REAL Communication Framework 

REAL is an acronym for: Reminiscence, Empathic engagement, Active listening and Life story.

All REAL Communication workshops include the REAL framework. This means that any carers attending our workshops will further develop and improve their communication skills and abilities.

The resulting learning outcomes will further encourage the provision of improved  communication. This enhances relationship-centred care and delivers improved quality of care received by the person living with dementia.

Our  unique approach sits at the heart of the Norfolk & Suffolk Dementia Alliance blended learning programme, recognised by the Performance Learning Institute gold award in 2014.

Image: Will van Wingerden

Find out more about REAL Communication Workshops here >

SCIE have great resources – and here’s why

SCIE have great resources – and here’s why

By Sarah Reed 17 June 2013

I recently tweeted that SCIE have great resources – and here’s why:

We’ve just celebrated Carers Week 2013, and it’s important to remember that getting anything right in meaningful dementia care for a person can be a challenge. The cognition, awareness and linguistic goalposts are continually on the move and the very personal and unique nature of the condition is challenging.

Help is at hand. The lovely people at SCIE have invited me to write this opinion piece after I tweeted “@SCIE_socialcare is probably THE best care resource on the web – excellent in every way! Thank you.”

I really meant it. The resources on the site are extraordinary. Want to know more about reablement? They’ve got it. Need guidance on how carers can work with care staff over dementia care? This is where you’ll find it. Keen to up-skill yourself in co-production? Here’s the seminal advice.

SCIE has gathered a stellar group of care specialists and persuaded them to share their deep experience and knowledge on a wide range of subjects, which any carer can use whether working professionally or in an entirely domestic setting with a family member of friend. This is where you’ll find some of the most expert trainers.

I publish Many Happy Returns’ “conversation trigger” Chatterbox 1940s and 1950s cards for people with dementia; I also run REAL Communication Works™ skills development workshops, to promote better interaction with people with dementia for health and social care care-givers, and University students. The participants are often thirsty for knowledge and it’s great to know that I never need to swamp them with paperwork to support the programme. I just point them in the direction of the SCIE website. Job done –and a few trees saved, into the bargain!

And when writing articles or developing other resources of my own, it’s vital to get it right in every respect, so the SCIE website is my first port of call to check that my point of view is supported and endorsed by the best of the best-practice experts.

SCIE always remember the people they serve – the people who use services and their carers. It’s good to be reminded and as growing numbers of people are caring for their families at home, this is more important than ever. Here’s the story of one such couple; they happen to be my parents.

My Dad was a stiff-upper-lip kind of man

When a loved one develops dementia, those closest to them are likely to experience feelings of confusion themselves, as well as anxiety, guilt, grief and bereavement – even before the person dies, as the illness progresses.

No sooner do they come to terms with one stage of the loved one’s illness than the person’s behaviour changes again or their cognition declines further and the grieving starts all over again. A sense of loss is one of the most powerful feelings that people experience when someone close to them develops a dementia.

My father spoke about this with me on a number of occasions during the decade that my mother had dementia. Had SCIE been in existence at the time I know how it would have helped us.

He said that not only had he lost the person he had married in 1940, he’d also lost their future together. He missed the years of happy companionship they’d enjoyed, but equally, he was frustrated by the constraints on his freedom.

After three years at home, my 85 year-old mother was admitted to a care home. For my father, whilst relieved, this rendered the family home an empty vessel, with only the ghosts of their former lives for company. Of course my mother’s life was hardly better, coping with an utterly different and mystifying life, in the company of strangers.

My father seemed overwhelmed by sadness and anger. I noticed his underlying resentment and unhappiness that things had not turned out as he hoped. He was lonely and isolated and he worried a lot about the potential cost of ongoing care.

Unable to recognise that he was under a lot of stress and unable to to ask for the emotional support he needed, he would bottle up his feelings. He began to weep openly.

We encouraged him to spend time with friends, but he found it difficult to do things that would normally have included my mother. He tried to muster his old energy, but without his beloved partner of sixty years, he gave up.

A few years on, after a short illness and three years ahead of my mother, he died.

“Who’s in that box?” she asked at the funeral.

Sarah Reed is a dementia communication specialist and trainer; and founder of social enterprise, Many Happy Returns