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thelinguist.uberflip.com AUGUST/SEPTEMBER The Linguist 27 FEATURES constituted care for people with dementia, particularly if the staff member's home culture believed that such care was the exclusive business of family and that dementia was a normal stage in the ageing process. Creating materials For formal training of multilingual aides, we created online materials to support training modules and mounted them inside the college's two-year course management package. We later converted many of them, particularly those which were brief vignettes illustrating cultural issues or colloquial language, to PowerPoint slides to be shared in the care home setting. For example, we illustrated how to signal active listening by changing what we informally call 'go-aheads', such as 'mmm' or 'hmm' into two-syllable 'mmm-hmms', since many older persons with dementia are hard of hearing. We talked about what not to say when it is bath time, such as "Well, are you finally ready to be clean?", and why the omission of a 'please' in the phrase "take these towels to 33" was not rude in a healthcare work context, but an ordinary direction from a supervisor. For technical vocabulary, we scanned key chapters, identified the frequency and usual contexts of key words, and used them in vignettes as vocabulary reinforcement. We also created a miniature phrasebook, similar to many foreign-language phrasebooks, that presented a range of greetings, conversation starters and closings or leave-takings. But whatever we did, from vignettes to role-play dialogues using technical language or holiday customs, we placed an emphasis on the story. Making stories Everybody has a story, and most caregivers we have met have stories about their experiences with older people. In our initial 'Stories' workshop for aides who spoke English or multiple languages, we told each other those stories and worked to extrapolate those features they could use as they communicated during their usual caring. The second session did not go as well, however, as we confused our audience with the printed materials we circulated. They were short but too academic in flavour, their vocabulary was too advanced and not everyone could read English well enough to understand them. The international aides, by and large, had studied some English in a grammar- or reading-based curriculum and could read the materials, but they didn't particularly like them. Most of the local aides, many of whom were older minorities, had received poor education as children and the written materials were over their heads. We changed everything for the third session and subsequent workshops, and kept to a predominantly oral format with small-group skits about key themes. We set up a parallel two-part session for the international aides. Here, they could ask more culture-based questions about, for example, the use of colours for holidays and special occasions: white for weddings instead of funerals, red for Valentine's Day, orange and black for Halloween (whatever that was). They could practise ways to use the little phrasebook and increase both fluency and confidence in communicating with the residents and supervisory staff. Assuming that multilingual international caregivers will learn something on the fly about the language of the country, the technical language of the job, and the colloquial language of the supervisors is not helpful to them, to the staff and, most of all, to the residents with dementia, whose language and cognitive status need greater communication support, not less. For further details, see 'Challenges and Experiences in Training Multilingual, International Direct Care Workers in Dementia Care in the United States' by Boyd Davis and Margaret Maclagan in Multilingual Interaction and Dementia (2017). Notes 1 US Census (2013); bit.ly/2tFDSze 2 Prince M et al (2015) 'World Alzheimer Report: The global impact of dementia, an analysis of prevalence, incidence, cost and trends'; www.alz.co.uk/research/WorldAlzheimerReport2015.pdf 3 Nielsen T et al (2011) 'Assessment of Dementia in Ethnic Minority Patients in Europe: A European Alzheimer's Disease Consortium survey'. In International Psychogeriatrics 23, 86-95 4 Plejert C, Lindholm C, Schrauf R (2017) Multilingual Interaction and Dementia. Bristol: Multilingual Matters COPING STRATEGIES People with dementia suffer from confusion (above); and strategies to improve communication across the language barrier can help (above right) For writers' biographies for all feature articles, see page 34. IMAGES © SHUTTERSTOCK