1. She’s talking to me! Pam Courcha What happens when home carers are trained to use contact reflections

2. 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

3. 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

4. LearningActionReflection training practice group meeting

5. What happened The care task Trying out a different way of communicating Using contact reflections Personal development

6. 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

7. 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

8. 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

9. 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 P ersona l development

10. 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

11. Frequency of Using Contact reflections ElaineLindaOlive Situational351 Facial110 Body131 Word for Word121 Re-iterative000

12. 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

13. 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

14. 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.’

15. Changing relationships At first She’s vacant not responding to anything Later I was brushing her hair “your hair’s white” Nancy said “it used to be black” She’s talking to me! At the end There aren’t any problems now getting her to eat or do anything