The use of Talking Mats to support people with dementia and their carers to make decisions together

Abstract

Policy guidelines insist that people with dementia should be involved in decisions about key life choices and transitions. However, as dementia affects both cognitive and communication difficulties, it becomes increasingly difficult to do this, and innovative and effective ways to support people with dementia and their carers to interact with each other are needed. This project, funded by Joseph Rowntree Foundation, examined if Talking Mats, a low-tech communication framework, could support family carers and people with dementia to discuss issues around daily living with each other. The fieldwork phase took place from September 2008 to May 2009. Eighteen couples (person with dementia and their family carer) from Scotland and the North of England were involved. The couples were visited in their own homes and asked to discuss together four topics (Personal Care; Getting Around; Housework; Activities) under two different conditions: (i) using the Talking Mats framework and (ii) using their usual communication methods (UCMs). After the interviews, each participant was asked separately to complete a short questionnaire (Involvement Measure), which included five questions to evaluate how involved s/he felt in each type of discussion and a final question to measure satisfaction with the overall discussion. The findings show that both people with dementia and their carers feel more involved in discussions about how they are managing their daily living when using the Talking Mats framework, compared with their UCM. They also feel more satisfied with the outcome of those discussions. The use of Talking Mats could result in increased well-being and positive adjustment to accepting increasing levels of care for people with dementia. In addition, it could improve the relationship between the person with dementia and family carers, if all involved feel that the views of the person with dementia and the family carer have truly been acknowledged.

Negotiating disagreement in picture symbol supported decision making

“…In particular, delays, pauses and hesitations alongside mitigated and elaborated utterances after assessments, invitations, offers, requests or proposals indicate divergent views, disagreement and rejection, and are treated as such (Davidson;Pomerantz, 1984a, b;Schegloff). Murphy et al (2010) and Murphy and Oliver (2013), found that Talking Mats helped couples affected by dementia. Ferm and Saldert (2013) found that when using Talking Mats people used different co-operation strategies when discussing different topics and goals.…”

“…Similar discussions about daily living activities could also take place by couples at home, without Talking Mats or a facilitator. Independent of context, both partners in a couple have the right to express their views and feel involved (Murphy and Oliver, 2013;Olaison and Cedersund, 2008;Österholm and Samuelsson, 2013).…”

“…Implementing the UN convention of the rights of persons with disabilities (UN, 2015)[FIGURE 1 NEAR HERE] Talking Mats can lead to more effective communication for people with a range of conditions including aphasia, Huntington's disease and dementia (Ferm, Sahlin, Sundin and Hartelius, 2010;Murphy, 2000;Murphy and Boa, 2012;Murphy, Gray, Cox, Van Achterberg and Wyke, 2010;Murphy and Oliver, 2013) and thus, could be useful for people affected by PD as well. Talking Mats can be used by two people where one leads the conversation and the other expresses their opinions, in groups involving people with disability and in conversations between a person with disability, a conversational partner and a facilitator (Ferm, Eckerholm Wallfur, Gelfgren and Hartelius, 2012;Hallberg, Mellgren, Hartelius and Ferm, 2013;Murphy et al, 2010).…”

How Can We Develop AAC for Dementia?

“…Talking Mats is a communication framework which can help people with dementia (and other communication difficulties) to express their views and opinions [19,20,21]. The system uses a mat, such as a doormat or carpet tile, to which symbols and pictures can be attached by hook and loop tape.…”

Supporting Conversation for People with Dementia by Introducing a Computer-Based Third Element to the Interaction

“…Talking Mats is a low-technology communication framework to help people with communication difficulties to express their views and opinions more effectively [14,15]. The system uses a mat, such as a doormat or carpet tile, to which symbols and pictures can be attached by hook and loop tape.…”