My 87-year-old mum recently told me that she doesn’t like going out to social events as much as she used to, as she “doesn’t feel she has anything very interesting to offer people now.” She is, in fact, a very engaging person as she is well informed and listens to the news and radio regularly. She is also naturally curious and interested in others, so is skilled at asking questions and drawing people out to talk openly. However, her lack of confidence is very genuine, not probably helped by her sight and hearing deteriorating, which make being in larger gatherings more stressful. She also tells me that it takes her longer to gather her thoughts, so that by the time she has thought of something to say, the conversation has moved on.
I have noticed in the many care homes I visit, many older adults sit in silence in living rooms or at dining room tables. Some do seem to have lost the confidence to initiate a conversation, or perhaps, like my mum, don’t feel that they have much to talk about, especially when life in a care home can feel quite dull.
However, recently at West View care home in Devon, I was struck by how my presence at a table created an animated conversation at breakfast time. I had watched the same group saying very little to each other at a meal the day before. So, what did I do to change things up? I used pictures and in particular old calendars to generate interest. One of these calendars was a collection of vintage pictures of street and country scenes from the 1950s and 1960s. One picture had some old cars and aeroplanes, and the topic of ‘planes resulted in Mike, who had been sitting quietly beside me, talking about his long career as a pilot flying all over the world. I shared that my own grandfather had also been a pilot and that my grandmother flew Gipsy Moth aeroplanes in the 1930s. We looked at pictures of old aeroplanes from the internet on my phone, and Mike recognised and proudly named many of them. Monica remembered living in Hertfordshire not far from an aerodrome and described, as a child, going to the end of her garden with her brothers to watch the aeroplanes taking off in the distance. We found another connection here as I had gone to University in Hatfield, a town Monica remembered well. The next conversation was prompted by a picture of a woman on a farm and Monica had been in the Land Army and had many happy stories from that period of her life. We then all talked about our favourite animals, and the names of our first pets. By the end of the meal, all four people sitting with me had come to life in an animated way, whether they were talking or listening. Monica warmly thanked me, saying “It has made such a difference to have such a great conversation to start our day.”
What I did perhaps feels relatively simple, but it is surprising how many care team members I work alongside seem to lack the skill to initiate these conversations – to ask the right questions to spark memories and to create connections between people. Can this be taught? I wonder if these team members also lack the self-confidence that they have something interesting to say or contribute? Fortunately, there are usually some team members with lively personalities who are naturally very good at the ‘chat’ side of their role, which can make a huge difference to the atmosphere.
We have created a set of ‘Chat cards’ at Meaningful Care Matters to generate good conversational topics. (*1) Some examples include “Which of your parents had the most influence on you?”, “Would you rather go shopping or go for a walk in the countryside?” “What is your favourite season of the year?” We suggest that team members leave these cards out on tables and invite responses. The art of doing this is for it not to seem like a task or an interrogation, but ideally to warm up the topic by sharing your own experience first e.g. “Springtime always makes me feel a sense of hope with the lighter days and seeing the colourful spring flowers coming out. I wonder which of the seasons do you like best?” Sharing self in everyday conversation is one of the core skills and qualities we look for in implementing the Butterfly Approach. Contrary to older practices of not divulging anything personal about yourself when you are at work, we see the ability to create connections with people through your memories and experiences as essential to reducing the sense of ‘them and us’ between those living and working in care homes. We invite team members to bring themselves to work in a variety of ways. This might, for example, be a photograph of a grandchild or their dog or perhaps bringing in a new pair of shoes they have recently bought to wear at an upcoming family wedding.
We are considering adding more components to our Butterfly training which help people practice and improve their conversational skills, using pictures and props, so they feel more confident to initiate a chat which goes deeper than just talking about the weather or what’s on the menu. As Monica said to me, you can make a person’s day by taking them back to a happy memory or reminding someone like my mum that they DO have something to say which is worth listening to.
Consultant Trainer, MCM
References *1 – Meaningful Care Matters Chat Cards available to purchase https://meaningfulcarematters.com/product-category/activity-sensory-resources/
Photo Credit: People living and working at West View care home, Bere Alston, enjoying a chat.