Section one: Discover what effective communication can look, sound and feel like

Introduction

Care workers are great communicators. In fact, communication is one of the most important skills that you will need if you want to succeed in this career and make a different in people’s lives.

What is communication?

Communication is the act of sharing information and it can be done in a number of ways, like speaking and writing (types of verbal communication) and body language, eye contact and tone of voice (types of non verbal communication).

Care workers need to be good at communicating so they can build trust with the people they support. This means being a good listener and being respectful of the ways people choose to share information. Good communication helps people feel valued, included and safe.

Many parts of the Code of Practice for Social Service Workers (a document which describes the values and behaviours care workers need to demonstrate) highlight the importance of good communication. Here are some examples.

I will communicate in an appropriate, open, accurate and straightforward way (Code 2.2)
I will maintain clear, accurate and up-to-date records in line with procedures relating to my work (Code 6.2)
I will listen to feedback from people who use services, carers and other relevant people and consider that feedback to improve my practice (Code 6.10)

If you want to read more about types of communication click on the headings below to reveal or hide information. Then scroll down to the first topic.

Verbal communication includes sharing information through speech or the written word.

Care workers share verbal information carefully, by making sure they speak and write clearly. You’ll learn about skills used in verbal communication in the first topic, including the importance of word choice and tone.

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Topic one

1. What are the important communication skills in care?

There are many skills that relate in some way to communication. Care workers may bring some of the necessary skills with them to their first role, and then will likely develop others in the workplace.

To get started, here are two vital skills which relate to communication. As you work through this topic and learn about other skills, we suggest you think about which ones you have now, and which ones you’d like to develop if you continue to follow this career path.

Active listening

Empathy

Communicating at the right time, in the right way

Care workers need to be able to select and apply particular communication skills in the right moments, sometimes using several at once.

They use their professional judgement to help them. This means they combine their knowledge from training, their Code of Practice and past personal and professional experiences to make sure they communicate effectively.

We’ve selected some key verbal communication skills below that help care workers day to day. As shown in the illustration, skills that care workers will bring to mind on a regular basis are word choice, tone, using values and separating fact and opinion.

Click on the boxes below to explore these in more detail.

Choosing your words carefully

Speaking and writing in the right tone

Using your values

Separating fact from opinion

Click on the rows below to hide or reveal activity questions and further resources.

Choose one or two of the skills described in this section. Can you describe when you have used these in your personal life, or in a previous job?

We recommend you record your notes in the MyLearning App.

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Topic two

2. How can effective communication be promoted in care settings?

Effective communication brings many benefits, not just to individuals but to the overall quality of care in each care service. In this topic we discuss two examples (led by young people, and people with dementia) of how better communication can be promoted in different types of care service, leading to improvements for everyone.

How young people are helping Scotland to change the language of care

Children and young people with experience of care can teach us a lot about how it feels when professionals get into bad habits with the language they use.

Here’s a helpful quote from The Promise Scotland which is an organisation responsible for improving care for children and young people so they grow up loved, safe, respected and able to realise their full potential.

Scotland must change the language of care. Language must be easily understood, be positive and must not create or compound stigma. Scotland must stop using professionalised language to describe meetings and experiences. As one example, children must not be told they are going for ‘contact’ when they see their mum or dad. This use of disrespectful language can lead to low self-esteem and compounds a self-stigmatisation as children realise that their peers do not use this type of language.

The Promise

We recommend you open this pocketbook called Changing the Language in Care which was created by young people and staff at Rossie Young People’s Trust.

Here are some examples from the guide.

“Instead of saying education, please say school, or college. All of my friends go to school or college, not education.”

“Please don’t ask about an incident, if we need to talk about my behaviour, then describe what I was doing.”

Acknowledgement

Thank you to the young people and staff at Rossie Young People’s Trust for agreeing to share this important resource.

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How people with dementia can teach us to communicate more effectively

In Scotland, over 90,000 people have dementia. It’s more common in older people, but can affect people in their 40s and 50s or even younger.

Below is some more information from Alzheimer Scotland.

Dementia is not part of the natural ageing process.
It affects the brain, making it harder to remember things or think as clearly as before.
It’s an umbrella term for over 100 different types of illnesses and disease symptoms.
Symptoms of dementia may include memory loss and difficulties with day to day tasks, language and problem-solving.

The Scottish Dementia Working Group (SDWG) is a national campaigning group led by people with dementia. Their webpages contain a number of helpful guides to help you communicate more effectively. An example is this guide about organising dementia friendly meetings.

To help you learn more about the impact of dementia on communication we’ve included a chapter from our Informed about Dementia video in the activity section below. It will give you a chance to listen to people sharing their experiences about living with dementia. You’ll also be asked to answer some questions about George, a fictional character, as he visits his doctor.

Play the video for Chapter Two. A transcript is available too.

Informed about Dementia Chapter Two Transcript

Narrator:

This chapter will help you
• recognise the changes that are commonly experienced by people with dementia, communicate with people in a way that recognises their strengths and takes account of their difficulties
• recognise individual needs and diversity
• understand the effect of stigma and address this wherever possible.

Dementia is a condition that affects the brain and the way people behave, act and think.

No two people will have the same experience.

It will not progress at the same rate or have the same impact.

Dementia can be described as a journey, and for some people there may be signs long before they get a diagnosis.

Everyone’s journey is unique but may follow a path starting with finding out it’s dementia, and follow a route through living well, living well with increasing help and support, and end of life and dying well.

A person with dementia may begin to find their usual activities more difficult.

They can, however, expect to have a good quality of life, to retain their relationships and interests, and to feel good about themselves and the people closest to them.

We all have a role in contributing to that quality of life, and being able to recognise some of the ways dementia can affect people will help us to be sensitive and responsive in the way we work with them.

There are a number of common signs that you may recognise as you meet people with dementia at work, in your community and at home.

They may have problems remembering a range of things, from the day of the week to where they are or what they said. They might repeat things and even get lost.

Visiting unfamiliar places can be challenging, particularly if they are noisy or busy.

The person can feel confused, uncertain, anxious and distressed as a result of their symptoms.

They may need time to think and to process information.

It is important to the person to feel our understanding and support. Their families and carers might feel bewildered and afraid, or sad and overwhelmed. They will need our support as well.

Gradually, people with dementia may lose the ability to do everyday things, like paying bills, cooking and shopping.

Doing things in the right order can start to become a challenge and this may have an impact on activities such as caring for their appearance.

They may stop doing things that they’ve enjoyed or that were part of their daily routine.

With support and encouragement, people can carry on with many interests and activities for much longer, which can continue to provide satisfaction and a sense of purpose.

We take communication for granted. We think nothing of finding the right words to use as we write messages, speak to friends, families or colleagues. For some, there may be difficulties in finding words as language starts to need more thought and effort.

If we use jargon, we are likely to alienate and confuse the very people we want to support. So, keeping sentences short and using everyday words can help. Following up verbal information with written or visual information can also be useful.

A smile, a gesture or a touch can also communicate encouragement and connection.

Dementia is progressive and the person will gradually become less able.

This usually happens very slowly.

Little by little, the person may need more help. Eventually, they will be unable to manage activities like eating, drinking and going to the toilet.

But this won’t happen suddenly. Someone can live with dementia for many years.

At the moment, there is no cure. But there is a lot that we can all do to support their quality of life and that of their family and carers.

We’ve mentioned that dementia affects a range of ages, not just older people. It is also found in cultures around the world and affects both men and women, and people from across all socio-economic groups.

Sadly, people with dementia can be exposed to stigma and negative stereotypes from the media and from the public.

For example, people are often labelled as “dementia sufferers” or “dementia patients”, which gives us a different picture from “people living with dementia”.

It is easy to dismiss and belittle people with dementia if we listen to or use these labels.

It is very important that we support and encourage positive attitudes and behaviou towards people with dementia.

We want Scotland to be dementia friendly.

We’ll now hear from people with dementia as they describe the impact that dementia is having on their lives.

Woman living with dementia:
It’s my writing. I can no longer… My ability to write.
And I can start off writing and then it’s… for some unknown reason, it goes away and I can’t read it back.

Man living with dementia:
And then you get the thing, this thing they talk about, “the fog”. You can be in the middle of a conversation or giving a talk or whatever, then suddenly it… I can’t think of how to explain it or quantify it.

It’s like a shutter coming down in your brain. And you know there’s nothing you can
do about it. Everything stops.

You stop hearing properly, you stop seeing properly. You can’t think.

Woman living with dementia:
When I’m under stress, that’s when my speech will go.
When I forget to take my water and hydrate myself. When I’ve… And that then…you see the old…
At the beginning, where they diagnose you, you see that all creeping back. It’s as if you’ve got to keep a fine, controlled thing on it.
But it doesn’t work for everybody. Everybody is different in their dementia. And there’s some people that have dementia that it affects their speech.

Second woman living with dementia:
My speech sometimes is getting slightly…
You know, it sometimes… Some days it’s not all that great.
My writing can be a little bit difficult. Especially on Christmas cards. So I’ve started them ages ago so I can get those done.
Some days, I can’t write.
I mean, I know… It goes squiggly. I mean, I know that I’m not writing properly.
And I’ve just got to stop and start again. And I’m OK maybe in a day’s time.
You’ve just got to react accordingly. So that’s the only way I can do it. You know?

Narrator:
Exploring the experiences of people with dementia shows us ways to provide the best possible care and support.
We want to illustrate how small changes in our thinking and behaviour, and our communication, can make a big difference.
An appointment at a doctor’s surgery is something that we are all familiar with.
And yet the quality of the experience can have significant consequences for a person with dementia.

This was George’s experience.

[Scene changes to a GP surgery reception. George enters.]

Receptionist
– Good morning. Can I help you?

George
– I’ve come to see the doctor.

Receptionist
– What’s your name, please?

George
– George McDonald.

Receptionist
– I can’t see your name on the list for today. Which doctor is the appointment with? Is it your own doctor?

George
– Um…

Receptionist
– What time is the appointment and is it with your own doctor?

George
– Well, I always come here and I’m sure it’s today. I can’t remember.

Receptionist
– Oh. OK. It was the 25th. I can give you another appointment at 11 tomorrow.

[Answers phone] Hello. Sandybank Medical Practice. Yes. Yes, thanks. That’s fine.

[To George]

– There you go, Mr McDonald. Tomorrow at 11.

[George leaves, and another man enters]

Receptionist
– Good morning. How can I help?

George’s neighbour
– That man lives just round the corner from me. They say he’s got dementia.

Receptionist
– He can’t be that old. – He’s younger than me.

George’s neighbour
– I’m sure he’s just in his fifties. It’s very sad.

[Ends]

Narrator:
No-one in this scenario is trying to make life difficult for George but the outcome for him is confusion and distress.

How would you feel coming into this situation?

Take time to consider the following. [Questions appear on screen]

• How do you think George is feeling at this point?
• How else could this have been handled to make sure that George feels respected and valued?
• What’s suggested by the neighbour’s response?
• How do you think this scenario could have been changed to make sure that there was a better outcome for George?

So, what are the key learning points?

A person with dementia commonly presents with memory problems and confusion.

Communication must take into account the person and their needs.

It is important that we do not assume that dementia only affects older people. In fact, early onset dementia is not uncommon and there is growing evidence of people with learning disabilities developing dementia at a younger age, as they are living longer.

Stigma can be associated with people with dementia and it can take a variety of forms.

So, how else could this have been handled to make sure George feels respected and valued?

Here’s one option.

[Scenario at George’s GP surgery repeats from the beginning]

– Good morning. How can I help you?

George
– I’ve come to see the doctor.

Receptionist
– Do you have an appointment?

George
– Yes.

Receptionist
– What’s your name, please?

George
– George McDonald.

Receptionist
– I can’t see your name on the list for today, Mr McDonald. Did you get an appointment card?

George
– Yes. I think so. Yes.

Receptionist
– There’s no rush. Take your time. I’m always the same when I’m looking for things.

George
– Er…could it be one of these? I get things so muddled up these days.

Receptionist
– Yes. It’s this one. I can see you’ve got the right time but the wrong day.
– It was yesterday. It’s easily done.
– You’ve got a lot of cards there. No wonder you got muddled up.

George
– I’m sorry.

Receptionist
– It’s no problem. Even the handwriting on here’s not very clear.
– Can you come back to the surgery tomorrow, Mr McDonald?

George
– Yes. You know, I’m forgetting things all the time now.

Receptionist
– I’ll give you a new card with a time for tomorrow instead, Mr McDonald.
– There you go. Tomorrow at 11 o’clock.
– Would it help you if I gave you a call in the morning to remind you?

George
– Well, yes. Thank you very much. You know, that would be a great help.

Receptionist
– OK. Take care. I’ll give you a phone in the morning.

George
– Thank you. Thank you very much.

Receptionist
– Good morning. How can I help you?

George’s neighbour
– I’d like an appointment, please.

Narrator:

This scenario demonstrates how small changes can make a big difference.

So what are the key learning points?

Recognising the person and responding respectfully can change the experience for people with dementia.

Good communication is critical.

It is important to speak clearly and simply.

Present one question at a time and allow time for responses.

By doing this, we can support a sense of working together.

We can all contribute to finding feasible and creative solutions to the difficulties encountered by people with dementia.

In this chapter, we’ve looked at some important effects of dementia on memory and
communication.

Chapter Three will look at how dementia can affect feelings and behaviour.

Answer the questions below about George’s experience visiting his doctor.

How do you think George is feeling after speaking to the receptionist?

How else could this have been handled to make sure that George feels respected and valued?

What is suggested by the neighbour’s response?

How do you think this scenario could have been changed to make sure that there was a better outcome for George?

If you want to keep a record of your notes we recommend using MyLearning. Click on the row below to show further resources.

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Topic three

3. Communication through creativity

Everyone has different communication preferences and some people might find verbal communication difficult. Care workers can support people to use communication tools, or take part in creative activities to express themselves while also learning new skills.

In this topic we’ll show you information and videos about art, life story work, poetry and music. We want to thank everyone who created these videos for everything they have done to educate others about the power of these approaches.

Click on each row below to hide or reveal information about creative communication.

Heart for Art is for people with dementia and helps to promote their creativity, self-worth and achievement.

Pieces of art are great conversation starters and can inspire a sense of connection among the artists, their friends, family members, care workers and members of the wider community. Artwork can represent memories, favourite places, emotions, hopes, fears and so much more. Creating a piece of art can also be therapeutic for someone living with a significant health condition or illness, and can enable them to express themselves without having to rely only on words.

Thank you to CrossReach and Heart for Art for sharing this video which you can play below. You can also follow this link to learn more about Heart for Art and see an online exhibition.

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You’ve now completed the first section of this resource. Scroll down to find the next section.

We encourage you to take some notes on the MyLearning app as you go along of the things you find interesting, or answers to some of the activity questions. This could help you later as you prepare to start your career.

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Discover what effective communication can look, sound and feel like

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