Book: Course Summary

In this last Unit, communication was the theme, in the context of extended family and professional carers. We emphasized the importance of family dynamics, and how each family's dynamics will have unique characteristics. Family dynamics are important as dementia can affect the wider family as well as immediate family members. Communication is therefore vital to bring families together so that they can deliver the best possible care to the person with dementia. 

This is easier said than done, as of course families are complex. While they are where we belong and feel comfortable, changes that accompany dementia will represent a profound challenge to how most families function. 

To combat tensions, we asked you to consider making a plan together with other family members. Family meetings can provide a purposeful method of identifying solutions to care issues. 

Try to make sure family members understand each other's needs, strengths and weaknesses, and indeed obligations to the care of the person with dementia. Note that family meetings may have to take place regularly to react to changes in circumstances. If possible, try to structure these so that tensions can be addressed and people's views expressed openly. 

We reiterated the importance of the 'comfort-care' palliative approach to ensure quality of later stage dementia care; we emphasized the importance of a human rights approach to decision making, for example in responding to a medical crisis, and that it is vital to make decisions in the best interests of the person with dementia; and we looked at Robert in the video telling us about how he made his decision to move his wife into long-term care. 

We moved on to look at communicating with professional staff, and the importance of open, honest dialogue in which both formal (health care professionals) and informal (family carers) have much to contribute. 

Transitioning to nursing home care was also explored, where we spoke about the need for you and the person you are caring for to feel comfortable with the new care environment. This may take some time to decide on a care location, but this time investment will be worthwhile. 

We mentioned that a gradual, gentle transition may be suitable, and that regular visits will help you become more comfortable and accepting of this significant change. 

Finally, we turned to end of life care and again we mentioned the importance of communicating through 'being with' rather than 'doing for'.

Full details are in the Book: Communication in Care.