Getting people talking and socialising is central to Sarah’s work in the Cwm Taf Morgannwg memory service. She’s boosted the motivation of the people living with dementia she works with by adapting a standard programme designed to build confidence to consider local circumstances and individual needs. She’s made a significant impact on the lives of their loved ones, too.
Sarah organises and runs an 8-week group programme in which participants undertake 2 conversation activities a week. This stimulates the brain, lifts an individual’s mood, and helps to improve memory.
People living with dementia are often expected to attend multiple clinical appointments, and while these are essential, this often means they’re asked the same questions repeatedly.
“No wonder some get fed up,” Sarah says. “There are only so many times anyone can tolerate being asked, ‘Who’s the prime minister?’. This puts some people off chatting to others and this is something I’m addressing in our group work.”
There are only so many times anyone can tolerate being asked, ‘Who’s the prime minister?
Sarah sticks to topics people know, understand, and want to talk about.
“We focus on conversations meaningful to individuals to raise a person’s confidence gradually,” she explains. “We talk about workplaces as we know a lot of our group participants worked in the same local factories. Or we might ask, ‘Who remembers the cinema at the top of town?’. It’s about taking away the fear of failure and making it a conversation you want to be part of.”
Getting started
You don’t have to work in the field to help. Here are Sarah’s tips on how to start a conversation and help people build their confidence when you're talking to someone with mild to moderate dementia.
- Engage with kindness – make it their conversation, not what’s easy for you.
- Stick to questions people can answer. They may not know what the weather is like today, but they likely know what school they went to.
- Be wary of asking too many questions. No one likes to feel constantly quizzed or tested.
- Use photographs and other props such as newspapers to engage interest.
- Consider a person’s lifestyle to help you personalise the conversation.
Making it relevant
“We write down questions and dot them around the room before asking everyone to try answering them. For example, we ask, 'Where were you born?' or 'What job did you have?'. We ease into the introductions naturally, without putting anyone on the spot. This isn’t a clinical appointment. We want people to have fun, and I’m happy to answer the questions too,” Sarah says.
During the programme, there’s a reminiscence week specific to the local area and a session on childhood memories, where Sarah uses photos to start conversations.
“We’re sensitive to any childhood trauma in individuals’ lives, but the aim is to bring back joy. We ask people to talk about their childhood bedrooms and the sweets they enjoyed all those years ago. Where I can, I buy some of the sweets and we all enjoy tasting them again,” she explains.
“Music bingo” is another conversation starter Sarah uses. She plays music from the fifties and sixties to spark memories about the impact music had on people’s lives.
“This can often take people back to their teenage years or when they met their partners. We encourage participants to share memories of local traditions that can often spark more conversation between them.
"Many have told me about a regular event from times gone by that they refer to as the “monkey parade”, where they’d walk up and down the high street eyeing each other up!” Sarah says.
Identifying what’s important to individuals is central to the programme’s success. “When we’re talking about people’s childhood homes, we use street-view pictures of the local terraced houses, focusing in on the streets and back lanes these individuals played in when they were younger. It’s great for triggering memories,” she adds.
Extended benefits
Sarah’s been working in her post-diagnosis support role for 3 years. Her success was recently recognised when she won the nursing support worker award at the 2024 RCN Wales Nurse of the Year awards.
She works in a multidisciplinary team but it’s Sarah who makes sure the group happens and leads the sessions.
Participants attend each session for 2 hours. That’s an adaptation from the original recommendation of 1 hour a week over a longer period, because it became clear it was hard for families to commit to a long-term programme.
The 2-hour slot also gives carers the added advantage of a little time to themselves for a coffee, an uninterrupted shopping trip or whatever they want to do. The verbal feedback has been overwhelmingly positive and has demonstrated the importance of peer support.
- Watch now: How to use music in dementia care
On completing the programme, one participant described it as a “lifeline”. Others have told Sarah they now have more understanding about how many others are living with the condition and how they are managing, and feel less alone.
We encourage participants to share memories of local traditions that can often spark more conversation between them
One attendee was initially sceptical about the programme. But he gained confidence after coming along to the groups where he was given the opportunity not just to talk, but also to demonstrate his personal strengths. He’s now back socialising in his local club, which is something he wouldn’t have considered before. Others report returning to their hobbies which they previously thought were beyond them.
Family and friends also see it as a way for them and those they care for to get out, see people, and establish a routine in their lives. Not only do they get 2 hours for themselves, but they’ve also said that their loved one functions better after the session and has something to talk about at home. As a result, they all often sleep better the night afterwards.
“In Merthyr [Tydfil] alone, we have hundreds of people living with dementia. My work is all about person-centred care because I want people to relate to and benefit from what I do,” Sarah concludes.
