Coping with communication disability in residential care

ABSTRACT  The project was developed as a response to requests for help received by Action for Dysphasic Adults (ADA) from staff working in residential homes and from the families of residents with dysphasia and other communication difficulties. They all expressed a need for staff training on how best to help clients and for information on communication disability. There is no statutory provision for training in communication awareness or in disability in residential homes and elderly residents often have difficulty in accessing speech and language therapy services (Maxim & Bryan, 1994). The project aims are twofold: (1) To develop a training package on communication awareness and communication disability which can be delivered to care staff and managers in one single or two half-days; (2) To evaluate the effectiveness of the training package. A training package was devised to develop knowledge and useful skills in communication awareness and communciation disability. It was designed to allow trainees to discover key aspects of communication through discussion, role play and exchange of information between trainer and care staff. ‘Training 1’ explores communication through role play and discussion. ‘Training 2’ uses video material to illustrate communication disability and helping strategies. Optional components on aphasia, Parkinson's disease and Alzheimer's disease can be chosen to suit the profile of the residents at a particular home. All care staff attending training are given a booklet containing key points from the training package. Contact was made with care staff and managers from 16 residential homes for elderly people. These homes reflect the heterogeneity of residential care: public and private sectors, inner city and suburban settings. The homes had varied population profiles. One home was specifically for Asian men and women, another for ‘black elders’; some homes had few residents with communication disabilities, whereas others had a high percentage of such residents. Pre- and post-training questionnaires were devised to obtain information on the home and the perceived benefits of training from managers and care staff. One hundred per cent of care staff and managers found the course useful. Only 50% of care staff had received any training at all for their job and only two homes had already provided training on communication disability. The care staff almost unanimously report better understanding of the normal communication process of residents with communication disability. Most managers and care staff would like more training for all staff, but those on night shifts and part-time staff have difficulty attending training sessions. The booklet and care plans for individual residents are therefore essential aspects of ensuring that all staff have access to useful information. The training package can be given with limited time input from a speech and language therapist. The next stages of the project are: (1) To produce the pack, booklet and video in a modified form; (2) Appoint a project manager to market the training; (3) Set up a training group to train trainers. In consultation with local speech and language therapy managers, trainers will be appointed who are speech and language therapists with previous experience of elderly clients.