Joan Murphy

Successful Grants 2005-2009

1. Effectiveness of Talking Mats® with people with dementia

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1.  Effectiveness of Talking Mats® with people with dementia

The Joseph Rowntree Foundation funded a 15 month research project which aimed to establish the effectiveness of Talking Mats with people at different stages of dementia. The project involved 31 people with dementia - 10 with early stage, 11 moderate and 10 with late stage dementia - and compared how well people at different stages of dementia could express their views using i)Talking Mats, ii) an unstructured (ordinary ) conversation and iii) a structured conversation. The topics discussed were about four aspects of their well-being - namely Activities, People, Environment and Self.

The project found that:

• Conversations using Talking Mats were more effective for people with dementia than both structured and unstructured conversations;
• Talking Mats enhanced the reliability of information provided by people with dementia;
• The amount of time spent 'on-task' increased when using Talking Mats, thus reducing distractibility;
• Talking Mats reduced instances of repetitive behaviour such as repeating words, phrases, ideas or actions;
• Conversations using Talking Mats lasted longer than ordinary conversations
• People with early and middle stage dementia could use Talking Mats effectively;

• People with late stage dementia showed improvements when communicating with Talking Mats, but not everyone with late stage dementia could use Talking Mats effectively.

The researchers concluded that Talking Mats can be used by many people at all stages of dementia and that the framework improves their ability to communicate compared to ordinary conversations. Talking Mats may therefore play an important role in improving the quality of care by providing a simple, low cost tool which family and staff can use to engage with people with dementia and help them express their views about a range of topics.

A new Talking Mats package containing symbols specifically for using with people with dementia has been produced and tailored training programmes for those who work with people with dementia are available.

The full report, Communication and Dementia: How Talking Mats can help people with dementia to express themselves by Joan Murphy, Cindy Gray and Sylvia Cox is published by the Joseph Rowntree Foundation. It is available as a free download from www.jrf.org.uk

Decision making with people with dementia

Despite awareness of the importance of protecting the rights and freedoms of people with dementia there are few studies seeking the opinions of people with dementia about day-to-day care. Most family members want to involve their relative with dementia but may struggle because of the communication and cognitive problems. Some of the most difficult decisions that have to be made are related to the ability of the person with dementia to carry out tasks of daily living, and problems with these aspects of life are the main reasons for the person with dementia having to consider accepting care.

Following previous research the Joseph Rowntree Foundation funded this project whose aims are:

• To determine if the Talking Mats framework helps people with dementia feel more involved in decisions about how they managing their daily living than usual communication methods.
• To determine if the Talking Mats framework helps family carers feel they involve the person with dementia more genuinely in decisions about managing their daily living than usual communication methods.

Twenty people with dementia and their family carers will be involved - 10 in England and 10 in Scotland. The participants will be people at early/moderate stage dementia still living at home. In each location, each dyad (person with dementia and family carer) will be asked to discuss together how the person with dementia feels they are managing their daily living activities using both their usual way of communicating (Non-TM), and also using the Talking Mats (TM) framework. All discussions will be video recorded.

The results will be analysed both quantitatively and qualitatively:

If successful this project will demonstrate that Talking Mats could allow people with dementia and their family carers to jointly discuss and make decisions about how people are managing daily living issues and will be of great significance for Care Home, Social Service and Health staff in providing services.

Tyrrell J, Genin N, Myslinski M. Freedom of choice and decision-making in health and social care: Views of older patients with early-stage dementia and their carers. Dementia: The International Journal of Social Research 2006; 5(4):479-502

Joan Murphy

Sylvia Cox

Stirling

Joseph

Rowntree

Foundation