Training

A communicative approach to conversations with amelesians?

Introduction

The Amelesia training programme, “A Communicative Approach”, is available for purchase: Please Click Here

• as a stand-alone one-off purchase
• with a bespoke training-the-trainers package

If you would like to indicate your support for the proposition that we must reconceptualise dementia and receive free monthly updates on the progress being made by this work, please click here to register your support.

Teachers and trainers: you may wish to purchase the Amelesia training programme for your own use with your own students. You can adapt it to your own contexts. It is easy to use. It comes with all the components necessary to insert within an existing module of learning or it can stand-alone as an enrichment to other programmes of study, such as community service, social care studies PSHE (Personal, Spiritual and health Education). It can be incorporated into a university course on dementia studies.

The training programme is available for purchase as a stand-alone, one-off purchase at a the price of £150. Once your payment has been received (by Bank Transfer) you will be able to download the programme in the form of a Zip file containing the course content/components.

Train the Trainers: 

Opportunities for training the trainers are bespoke and available on request. The programme is very easy to use and does not require any induction by the author.

You are very welcome to contact Mina Drever by email – minadrever@amelesia.com – if you wish to discuss the training programme. Please send an initial email to make an appointment for a telephone conversation.

What is Amelesia Training?

This is an eight-week programme that teaches us that we can have good, meaningful conversations with people diagnosed with decline in mental functions as a result of damage caused to the brain by diseases such as Alzheimer’s. It adopts the Communicative Approach to Conversations rooted in theories of foreign and second language teaching and learning that place the learners in simulated real-life contexts. It incorporates games, problem solving tasks, role plays, group work, sharing opinions, scaffolding and a linguistic underpinning of question formation. It draws on real experiences of the people involved in the interactions. Its central tenet is placing learners-speakers in real situational context in which appropriate and specific language must be used, for example when visiting a doctor. In this training programme participants are asked to imagine themselves as people diagnosed with dementia-like symptoms and as ‘normal’ visitors, before and after learning linguistic conversational gambits that lead to sustained dialogue.

It incorporates six thirty-minute weekly ‘friendly’ visits to people affected by these conditions living in residential care homes. Four-to-five hour face-to-face training is incorporated during the eight weeks.  It has dual applications: it can stand alone or it can be incorporated as a module in existing training programmes, at all levels, for all professionals working in the field of mental decline.  As a stand-alone it is ideal for 16-18 year old students in the sixth form or studying in colleges of further education. As we learn to hold two-ways dialogues we begin to view people affected by these conditions in a radically different way. Our perceptions of these conditions change fundamentally. This was the effect on the sixth form students who piloted the programme and who believe that everybody in society should learn this approach.

The training programme was successfully piloted over three months in the autumn of 2018. See participants in the pilot below.

What is Amelesia Training For?

This training programme changes attitudes towards people living with dementia and alters our very perception of dementia.

It was piloted during the months of September, October and November 2018 in a residential care home in Great Dunmow, Essex. By the end of this programme participants felt much more comfortable with, and less frightened by, this condition. They no longer view it as madness (the meaning of the word ‘dementia’), but as ‘unmindfulness’ (the meaning of the word Amelesia): the lack of ability to focus and pay attention at a particular moment to a well-defined mental event. The disabled mind is overcrowded with and confused by too many events happening at the same time in their mind, vying for attention and verbal expression. What comes out of their mouths are seemingly irrelevant and unrelated strings of words.

By the end of this programme, the participant students had made several visits to residents with mild dementia in a care home. By adopting the conversational gambits they learned in the face-to-face training they concluded that people living with dementia do know what they are saying (as opposed to the established view that they do not know what they are talking about) and that inside that apparently chaotic mind there is still the person that they always were. It’s up to us to find that person, by the way we talk to them.

DBS (Disclosure and Barring Service)

It was not necessary to obtain a DBS certificate for students who participated in the pilot. I carried out email enquiries from the DBS Services office in October 2018, specifically asking the following question

Do students below the age of 18 need to obtain a DBS certificate in order to visit residents in residential care homes?

I am doing a project with a small number of sixth formers. All between 16 and 17 years old. They are making accompanied visits to residents. The visits take place in a communal area; they are not alone at any time with the residents.

 The response from Customer Services at DBS stated that:

 ‘Just having contact with a vulnerable group is not enough to apply for an Enhanced check’

Regulated activities are explained in the document Regulated activity (adults) published by The Department of Health in 2011 (www.dh.gov.uk/publications). It can be accessed directly through this link.

The definition of regulated activity in the above document is as defined by the Safeguarding Vulnerable Groups Act of 2006:

‘Anyone providing personal care to an adult is in regulated activity’ (Regulated Activity (adults) p 5)

‘Regulated activity continues to exclude any activity carried out in the course of family relationships, and personal, non-commercial relationships’ (Regulated Activity (adults) p 5).

In April 2022 I asked for updated advice from the DBS. I was told that care home managers should check with the Care and Quality Commission at the time of receiving student visitors. 

The participants were: Redbond Care Home in Dunmow, eight Year 13 students from Felsted School ¹, one community visitor, nine residents at Redbond Lodge. All visitors were volunteers ² to the programme and therefore self-selected. Residents were selected by the Care Home Manager on the basis of their low-to-medium dependency needs and on levels of their mental ability to make their own decisions, as assessed by their key-carer on arrival at Redbond Lodge.  On this basis they were asked if they wanted to have a visit by a visitor and some of their families were also asked if it was okay with them, for their relative resident to be visited. All visits took place in communal areas, sitting rooms or dining room. At no time were the visitors alone with the residents.

¹ Felsted School, Felsted Dunmow, Essex CM6 3JL

² All visitors were checked for a DBS (Disclosure and Barring Service) clearance. However it has been since ascertained with the DBS Office that 16-18 year old students do not need to have a DBS check for the purpose of visiting residents in communal areas. DBS certificates are necessary only if visitors enter into regulated activities in care homes (www.crbdirect.org.uk)

Pilot Summary Results

The pilot was evaluated verbally and with a written questionnaire. Please see the full evaluation paper  for detailed results.

With both evaluation methods answers were sought to the following questions:

1. Could this programme have wider applicability?
2. How beneficial was it to all participants?
3. Is the design appropriate?
4. How onerous and disruptive was it to the normal routine of students, school and care home?
5. Does it change attitudes towards people living with dementia and towards the disease itself?

1. Yes, said all the participants (100%):

It makes you aware of the different challenges dementia brings and teaches you how to bypass them and also understand the resident as a person…. (it) teaches you how to communicate with a person with dementia without being derogatory or insensitive while giving them control over the conversation. (said one student)

2. This training programme was very beneficial to all (100%) the participants, in many ways, including to residents in Redbond Lodge Care Home according to its home manager who qualified this statement by adding that ‘it has made a visible difference to the residents’ lives bringing the generations closer together and help build up outside relationships; it has also emphasised the importance of the feel-good moment enhancing residents’ well-being’.

3. The design incorporated content and structure. The content of the programme was deemed appropriate: all (100%) participants would not change any of it. Changes were suggested to the order of the programme and the time allocated to the face-to-face training session. These have been fully implemented in the programme available on this site.

4. The students in this pilot found it difficult to fit in the number of visits that had been envisaged. Seven of them made three visits and one made four visits. The actual programme was not onerous in the sense of burdensome, only in terms of time, fitting it in with their studies, half term falling in the middle of the programme and applications to universities. They all enjoyed the experience and think that other students would benefit. For their deputy head-teacher fitting it in with everything else students and she were involved with was the most challenging as well as arranging transportation from the school to the care home. She suggested that this programme should be formalised in a community experience programme or any such programmes that individual schools offer as extra curriculum activities. As for the care home in Dunmow, the care manager said that it was only a little bit onerous but that it was very beneficial to the residents.

5. Yes, by the end of the programme all participants changed their mind on a number of levels:

• seeing people affected as disabled and not as mad;
• it is possible to identify the core personality of the person obscured by the disabled mind;
• they witnessed how people with memory and cognitive impairment live in a sort of continuous present because past events come into their minds, often, as if they are happening now, a sort of fusion of time and space;
• it is possible to have meaningful and sustained conversation by adapting the way we use our language.