Care home workers poor English

OldFrill Up to 70-80% of all dementia patients suffer from Alzheimers. Vascular causes account for 20%. The other 198 causes of dementia are concentrated into, probably less than 5%of total dementia cases. and some types will be incredibly rare.

Most dementia patients are able to talk to the end. It is what is happenng in their minds that is confused - and it is this that means trying to teach people with severe memory loss anything new is going to be useless.

As well, if the only reason we want to do this is because they have difficulty understanding people caring for them who do not speak their own language well or understand their past, then quite frankly we are treating the problem from the wrong end.

What we need to do is make sure that caring for older people is a much better paid profession, with opportunities for training and advancement so that it attracts its staff from people already in this country who are native English speakers and have lived in the country long enough to remember life in the UK in the in the decades since the 1980s.

BSL is developed (not exclusively) for the deaf. Makaton more (but not exclusively) for the hearing. They are not in competition. This can be misunderstood.
There are over 200 dementias. Some people can live with dementia for many years and medication is promoting this.For them the decline is slow and they are open to developments that may help them in the future. Makaton fits for some people. In some cases of dementia where the body and brain are deteriorating at different speeds then the body deteriorates faster than the brain so to talk, to write is physically impossible but to point, to indicate is possible.
As I've said before, Makaton is fluid, it can be adapted to the individual. They may only need to utilise a tiny part of the whole.
People on this thread have said they are/have used Makaton with those living with dementia and it's been beneficial. I have seen it benefiting those living with dementia. That, to me, is worth more than any academic paper, and l find it highly frustrating that you extol words rather than action.
I wish you well.

My grandad could not say words at the end as he had dementia but managed to read and write. His last words written to me as his carer just as he went on to the Liverpool Pathway were, "Time to say my thank yous." He would not have been able to learn Makaton (or anything) as an elderly man but would remember things from his youth when all his recent memories were gone; this happens often with dementia. We use Makaton still with our ASD grandson because when his language skills fail him, he can still communicate. We can also use pictures on cards on difficult days. I think there are lots of ways you can communicate with those with Dementia but there seems to be a lack of imagination in lots of care homes.

Sometimes a gentle touch, such as holding a hand and talking softly is all that’s needed to calm a person confused with dementia…

Makaton is used in most early years settings these days to some extent, it's a very useful tool for early communication, I have absolutely no idea if it's of any use for those with dementia.

M0nica

growstuff Towards the end my uncle had no memory at all, short or long, I am not entirely sure he knew who I was, although he never ever failed to recognise his wife.

When I visited we sat in the conservatory and talked about everything we could see in the garden. He had been a keen gardener and bird watcher and still remembered birds and flowers. But to suggest he could manage to learn anything, when if I walked in as the carer removed his coffee cup, he could not rememeber whether he had had his coffee or not, would be fancyful in the extreme.

There would be no point of using a new language, even a sign one, when so few of the target group would be capable of mastering it.

I agree.

nightowl

Vulnerable older people who are being cared for at the end of their lives should not be expected to learn any new way of communicating. They deserve to be cared for by people who can communicate with them in their own language, however much or little they appear to understand.

We need to treat care workers as professionals and give them a proper career structure with training and a salary scale commensurate with that (as others have said). But of course it won’t happen because no value is attached to old people and nor by extension, to those who care for them.

Well said nightowl. I agree too.

OldFrill

^"There would be no point of using a new language, even a sign one, when so few of the target group would be capable of mastering it."^

Where is the evidence for this?
Why are people who are familiar with using it say it's helpful.

Why has Makaton been absolutely slammed by organisations for the deaf?

By the time, somebody has dementia, they are not cognitively capable of mastering a whole new language. For dementia patients, language isn't the problem. It's memory and sequencing ideas which can be communicated to others. Most of them still have the language they've used all their lives - they just can't use it effectively. They can't learn a whole new language and there would be no point in doing so. This isn't the same communication problem experienced by some young children.

Since reading this thread, I've been reading some academic research papers on Makaton, including claims that it can be used with dementia, and I'm increasingly cynical. It would be interesting to find out exactly how Makaton fans would propose teaching it to people with dementia.

"There would be no point of using a new language, even a sign one, when so few of the target group would be capable of mastering it."

Where is the evidence for this?
Why are people who are familiar with using it say it's helpful.

growstuff Towards the end my uncle had no memory at all, short or long, I am not entirely sure he knew who I was, although he never ever failed to recognise his wife.

When I visited we sat in the conservatory and talked about everything we could see in the garden. He had been a keen gardener and bird watcher and still remembered birds and flowers. But to suggest he could manage to learn anything, when if I walked in as the carer removed his coffee cup, he could not rememeber whether he had had his coffee or not, would be fancyful in the extreme.

There would be no point of using a new language, even a sign one, when so few of the target group would be capable of mastering it.

Dignity - people needing care should be treated with dignity.

Thank goodness the staff at my dear relative's nursing home understood this.

I totally agree nightowl.

nightowl

Vulnerable older people who are being cared for at the end of their lives should not be expected to learn any new way of communicating. They deserve to be cared for by people who can communicate with them in their own language, however much or little they appear to understand.

We need to treat care workers as professionals and give them a proper career structure with training and a salary scale commensurate with that (as others have said). But of course it won’t happen because no value is attached to old people and nor by extension, to those who care for them.

Vulnerable people at any stage should be offered any reasonable improvement to enhance their quality of life.
To suggest anyone wants to "teach" someone at end of life is ridiculous.

nightowl of course, well said!

Vulnerable older people who are being cared for at the end of their lives should not be expected to learn any new way of communicating. They deserve to be cared for by people who can communicate with them in their own language, however much or little they appear to understand.

We need to treat care workers as professionals and give them a proper career structure with training and a salary scale commensurate with that (as others have said). But of course it won’t happen because no value is attached to old people and nor by extension, to those who care for them.

Just as all people are different, people with dementia/Alzheimer's present differently.
However, there are recognised phases although not everyone seems to go through them.

I personally think the call handler should not have run through the whole triage routine. The call came from a care home and those who made the call would've undoubtedly sounded very distressed. The call handler surely realised she wasn't getting very far with her questions and should have despatched an ambulance.

Every person living with dementia is different, and there are over 200 different dementias. Of course Makaton will not suit all but it is a fluid communication system that can be adapted to the individual. Please don't be so fast to dismiss or criticise a system that you know little or nothing about. Anything that may help someone living with dementia is to be embraced. It's not like there are many options to improve the quality of life of sufferers.

That's what I think MOnica. I've only had experience of dealing with one person with dementia. I know some people have had much more experience than I have.

From my one experience, I don't think any new system could have been taught. It would have been impossible anyway to have had a sustained and coherent conversation, no matter which communication system was used. The issue was trying second guess what the person was trying to communicate. We did have a code system for "hungry", "thirsty" and "toilet", but its success was partly because people could second guess what the person wanted. She didn't have any problem with expressing herself verbally, except that the words which came out weren't always what was wanted!

I'm sure people with more experience of dementia patients are better than I ever was, but it seemed to me that a lot was about trial and error and an awful lot of patience. That's why I think carers need skills in "communication", whatever form that takes.

I think it will depend on the type of dementia the person in care has Alzheimers or Vascular and how it presents.

I looked after an aunt and uncle, both with vascular dementia. my uncle, ex-miltary, an organiser and efficient, was easy to manage. I would issue him with written instructions every day, ehich he would read, check and regularly refer to, while my aunt whose minded worked entirely differently, would lose attention afetr the second line, rapidly lose the sheet and then constantly ask me what was happening.

It is worth remembering that most dementia patients keep their ability to talk and have conversations to the end or close to the end and to try to teach them a sign based language when they have perfect command of their mother tongue and are no longer capable retaining new information, would be well nigh impossible.

I have been a carer for two ladies with early dementia. At that time I had not heard of Makaton, however we worked with our own simple sign system which was a big help and rather fun as a matter of fact

Makaton run online courses and workshops. There are also Makaton trained teachers all over the UK who offer classes.

It's probably the subject for another thread, but I think training and career progression (with appropriate financial compensation) should be massively improved for care workers - maybe something like in-service nursery nurse/pre school training - so long as employers are prepared to pay for their upskilled workforces.

Yes, I agree with you.

M0nica

But any language to be remembered, must be used regularly. Children - and adults - will soon forget a language that they do not use on a regular basis.

I couldn't agree more - and I say that as a former language teacher. I include all forms of communication.

Parsley3

icanhandthemback

If everybody learned Makaton from babyhood alongside spoken language, people with dementia would have a better chance of being able to communicate as it is usually short term memory that goes first. Babies would also be able to communicate their needs better before they could speak. It isn't something you could teach a person with dementia later in life but would be worthwhile promoting in early years.

Makaton is taught in nurseries. My granddaughter has used it from the age of one and at 20 months now she uses it along with the spoken word. It is an excellent tool to aid communication.

But not all babies go to nurseries. Who would teach people how to teach it?