Thursday 13 September 2012

Care and language - More than Words

As we all grow older and more frail, language and the ability to communicate become even more important, especially when we lose the ability to do many of the things which we used to take for granted. As we get older, our worlds grow smaller, and the world can come to seem a frightening and lonely place.

Dementia, severe strokes and other medical conditions such as Parkinson's all affect our ability to use language and communicate, and the numbers of people with dementia in its various forms are rising fast.

Recently Beti George, a broadcaster who is best known to Welsh-speaking audiences, has made a number of radio and television programmes about different aspects of dementia, and has been campaigning to raise public awareness of the illness for some time. Her partner is one of those affected.

By coincidence the broadcast of one of Beti's programmes on S4C (Un o bob tri - One in three) came a few days after I had got back from visiting some residential homes in England. Two of the homes had a high proportion of dementia sufferers, and some were in the advanced stages of the disease, unable to move, feed themselves or communicate. Others were much more responsive.

I was visiting these homes as part of a project which is, at its heart, about communicating with older people, whether they have dementia or not, and it was a very rewarding experience. Making someone laugh, or even just getting a smile from someone who is otherwise not responsive is beautiful. Sometimes people will respond with memories; they might sing along to a song, join in reciting a short poem or talk about things they like or remember. A picture of a robin was probably the single most popular thing I had in my bag of tricks.

For people whose first language is Welsh, dementia can mean that as the disease progresses, they lose their ability to speak and understand English first. If your carers don't speak Welsh, the world can suddenly become a very lonely and frightening place.

Severe strokes can also affect language, and people who were otherwise bilingual can lose the ability to communicate in their second language. I know a young woman who is a speech therapist. She had been learning Welsh for a few months, and told me about one of her patients from a small village in the north of Pembrokeshire. This elderly lady had suffered a severe stroke and was slowly recovering. Being greeted in Welsh meant the world to that old lady.

Parkinson's does not rob people of their memories or reasoning abilities, but it can affect people's speech. My Dad, now 82, was diagnosed with Parkinson's 20 years ago, and his voice is sometimes extremely weak. But he loves to talk, and it is often very difficult or even impossible to understand what he is saying. It can be very frustrating for him, and requires a lot of patience from the people around him.

Of course, it is not just old people for whom language is important. We all of us, especially children, will feel more secure and less vulnerable if we can speak to people in the language of our homes and families when we are ill. Imagine a child with leukaemia who comes from a Welsh-speaking family ending up in a big city hospital where nobody or hardly anybody speaks Welsh.

Yesterday I went to observe a meeting at County Hall in Carmarthen. Part of that involved a fairly lengthy discussion about the annual report of the Director of Social Care. The report is very long, and if truth be told, not the most inspiring document you have ever read. The discussion largely reflected that, but one of the councillors, Alun Lenny, asked about Welsh language provision for dementia patients.

The councillor responsible for social care services on the ruling Executive Board, Jane Tremlett, responded that steps were being taken to provide non-Welsh speaking care staff with basic language skills.

At least that's something, because Carmarthenshire as a local authority has a pretty poor record when it comes to the language. Like all other local authorities in Wales, it has adopted a formal language plan, and is supposed to produce an annual report to show what progress if any is being made. Currently those reports on the council website are unavailable, but reports from previous years show that only a tiny proportion of the council's staff receive any training in the language (we're talking about 1-2%).

So we should welcome the initiative to provide at least some basic Welsh training for carers, although how adequate that training will be and whether the staff who have received it will actually put it to use is another matter. The truth is that being able to communicate with a sick child or an elderly person with dementia, Parkinson's or the after-effects of a stroke requires much more than being able to say Bore da.

The Welsh Government launched an initiative called Mwy na geiriau - More than words to raise awareness of this problem and to try to improve Welsh language provision, but we clearly still have a long way to go, even in places with high proportions of Welsh speakers, such as Carmarthenshire.

My reason for writing about this in English is partly to try to raise awareness a little, but also to show non-Welsh speaking readers, including those who are downright hostile to the language, why language matters and why language campaigners should not be dismissed as unreasonable fanatics.

20 years ago my wife, who is German, went to hospital to give birth to our youngest daughter. By a pure stroke of chance, the midwife just happened to be German also. It was a slightly surreal experience for me in an NHS hospital being bossed about by a midwife in German, but it made a huge difference to my wife in what was a fairly difficult delivery.

Here's a short film with English subtitles to end with.

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