Communication in dementia care

In January 2014 I completed an MSc dissertation on person-centred communication in dementia care. My motivation for choosing this topic was partly because I had seen a need for more research in this area which could inform practice, and partly because the method I had chosen to investigate, the SPECAL method, had not been researched since 2000.

A large home-care company and a national charity in the UK had adopted the SPECAL method with clients with dementia, which meant there was a growing number of professional carers who might want to be interviewed about their experiences. Seven brave careworkers consented to qualitative interviews with me, which I found very enjoyable and instructive.

The general level of client well-being the careworkers reported was above average, and in one case exceptionally good. In that case the client had been bedbound and showing many signs of distress before the careworker had arrived. After consistent application of the SPECAL method over several months, and with support from the family members, the client was now walking upstairs again, eating and sleeping well, and was much happier. Discovering the SPECAL method had been a revelation for that careworker, and she derived a lot of enjoyment from her work.

What most people remember about SPECAL is its three golden rules (don’t ask questions, don’t contradict, and listen), but there is much more to the method than this (such as the SPECAL Profile and the SPECAL Passport. As my study focused on communication, the three golden rules dominated the discussion with the careworkers.

SPECAL is a dementia care method that deserves more attention from health and care researchers and practitioners alike. I hope my small contribution to the field may encourage others to look more closely.

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The future is… open

This is a well-worn phrase, but it expresses the potential of the many free resources that are apparent in the world around us, especially in education. As the sixth Open Access Week gathers steam, highlighting the need for all research to be made available online, I wonder if the challenge now is not so much about getting people to “open up” and share useful and educational materials, but about encouraging people to use what is already there and making it easier for people to find the good stuff.

I sometimes contribute items to Wikipedia and have benefited from many articles written and edited by anonymous others, some of whom turn out to be students completing assignments for a global readership. Wikipedia is currently offered in 285 languages (Wikinews 2012) which is amazing for something which relies heavily on voluntary, unseen efforts. YouTube has also become a weird and wonderful repository of free information, placed there by people all around the world (like this video on how to remove the back wheel on a mountain bike). Who could have predicted this?

Open Educational Resources (OER) – i.e. free educational materials on the Internet – were given great publicity when MIT decided to start its OpenCourseWare project 11 years ago. OER are being developed and disseminated at great pace. The HEA and JISC OER infokit explains what they are and how to find them (because you won’t necessarily find them using a standard Google search). Now we have open (i.e. free) online courses provided by the likes of the University of the People and the Open University’s OpenLearn. You may also have heard of MOOCs – massive open online courses; Stephen Downes maintains a guide to open courses, including the Connectivist MOOCs he set up with George Siemens. I particularly like Stephen’s explanation of the learning model implicit in the MOOC design he helped to pioneer.

The key area in which sharing has been problematic is academic research, which Open Access Week seeks to change. These are gradually being made available online to the educational community and in some cases more widely, thanks to the pressure applied by people and organisations to make publicly-funded research available (my own introduction to this was the inspiring Dutch Cream of Science site in 2005). The impetus now is to make all research publicly-available (see Richard Poynder’s blog on the reaffirmation of the Budapest Open Access Initiative) which in my view cannot come soon enough. As Iain Chalmers of the Lind Alliance has made clear, failing to publish clinical trials has lethal consequences. On the other hand, making knowledge available for free and online can lead to surprising discoveries, such as the teenager Jack Andraka who devised a cheap solution to a range of medical tests. This is the kind of open future I want to see.

So far, so good. What concerns me now is that we need to have more efficient search tools to be able to uncover what we need, which in turn requires good metadata. (Have you tried a search using keywords on JORUM lately? Happy with your results?) Moreover, teachers have to be encouraged to use OER if the investment made by educators around the world is to yield results. Students already use OER (especially Wikipedia), and they need guidance on which sites are reliable and how to critically analyse the materials. Quality materials that are helpful to both teachers and learners, such as the Great Writers Inspire site (which includes ebooks, essays on literary themes by graduate students and podcasts by academics) are the exception, not the rule. We now need an easy way to link these materials so that access to them is not a matter of chance or word of mouth.

My plea to all teachers and learners out there is this: do share and do reuse shared materials, but ensure your materials are discoverable by those who need them most. That includes people like me and the children at this Armenian NGO, Future is Open. Free education for children everywhere? Now that is a future worth working towards.

PS: If you are interested in OER either as a user or a producer, do contribute to this very short (one-page) survey by TEPL.

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Open Educational Resources

In 2011 I evaluated a short project that was supporting the development of online resources to be shared with the rest of the educational community, known as Open Educational Resources (OER). The project, called Ripple, was led by Oxford University, supporting the development of resources at Oxford Brookes University and Harper Adams College. For some ideas of how you might benefit from OER see Oxford’s Advent Calendar.

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