She’s talking to me!

Pam Courcha

What happens when home carers are trained to use contact reflections

Existential empathy is for the human condition. it is a bearing witness to human suffering with humility and acceptance. it is where the last response is to ‘be with’ Prouty 2002

No-where are there so many opportunities to facilitate contact than in daily life (residential care)Portner 2002

gentleness that flows from attempting to establish contact prior to performing care tasks (residential care for people with dementia)

Dodds 2008

Contact functions: reality, affective, communicative

Contact reflections: situational, facial, body, word for word, re-iterative

Contact behaviours: clients behaviours indicating pre-expressive expressive or “grey –zone” functioning

training practice group meeting

What happened

• The care task

• Trying out a different way of communicating

• Using contact reflections

• Personal development

Good care practice

Initially I was a wee bit sceptical I thought we’re already doing that but as we got into it I saw what the difference was. Olive

It’s that whole attitude you have to have with people. Linda

Achieving care tasks

Personally I’ve found that using contact reflections during the care part – you are able to do it a lot easier and better with no drama at all, quietly get through it Elaine

The Care Task

Using concrete or minimalist statements

I said we’ll go to the kitchen and see what’s for tea - she got up and smiled. Olive

A boiled egg Linda

Trying out a different way of communicating

Here and now/being present

It’s what’s happening in the here and now in the room with them that’s important, not what happened yesterday. Elaine

I felt it was with him, I felt it was. Linda

Non verbal communication

Getting into his eye line. Linda

Trying Out a Different Way of Communicating

Being open to clients

I’m actually thinking about her more and how she feels Linda

Quiet, calm and simplicity

I’ve learnt to be quieter and calmer, and everything...shorter instead of bamboozling them with all this nonsense that I talk about normally. It’s just to take my time...the one word communications ...if you pack it all down and simplify things Elaine

What I used to do

I’d never go in and ask a direct question any more. I go and have a wee chat or just have a bit of time. Elaine

Anxiety about getting it right

In the beginning we thought oh is this working is it really working and then we started talking about it we saw that it did. Olive

It was difficult at first. Linda

Personal development

Reflection

I think especially for the man Gary Prouty, I thought that’s amazing that he’s found that this can work and he’s bothered to tell everybody, it was good, I enjoyed that. Linda

Developing skills

(An opportunity) to learn a new tool that might help to make their lives a little bit better… I mean I was taken aback (getting a response) because sometimes you’re lucky if you get a hello. Olive

Personal development

Frequency of Using Contact reflections

Elaine Linda Olive

Situational 3 5 1

Facial 1 1 0

Body 1 3 1

Word for Word 1 2 1

Re-iterative 0 0 0

Using Contact Reflections

Using a contact reflection  

Andrew was sitting on the toilet with his hands over his face. I reflected this by putting my hands over my face. (body reflection - no response) I reflected you’re not happy (empathic reflection) and Andrew banged his zimmer on the floor. (affective contact). Linda

He was just sitting staring at the wall in bed and I said ’you’re sitting looking at the wall’ (situation reflection) and he said ‘yes’ (communicative contact) Linda

You said you’re fed up…(word for word reflection) …and she’ll start to talk (communicative contact). Olive

The lady had really bad dementia ..it was just sitting and holding my hands how she was holding her hands (body reflection) and she reached out and caught my hands. (affective contact) I think it calmed her down because she was going ‘Am I alright? Am I alright?’ Elaine

Judging when to use a contact reflection

They might think you’re a bit daft repeating everything they’re saying. Linda

Using a contact reflection

Changing attitudes

• Olive: I mean what I’ve found is it’s made me think

• Linda: Definitely made me think• Olive: Really thinking about it and doing it more • Linda: Yeah instead of saying ‘what are you doing

standing there’ you say ‘look at all the snow.’

Changing relationships

At firstShe’s vacant not responding to anything

LaterI was brushing her hair “your hair’s white”Nancy said “it used to be black”She’s talking to me!

At the endThere aren’t any problems now getting her to eat or do anything