Monday 21 October 2019

Being a good listener

With over 200 blogs on D4Dementia, some of them now 7 years old, I've decided to spend my 2019 year of blogging by re-visiting some of the topics I’ve covered previously, throwing fresh light on why they remain relevant and updating them with some of my more recent experiences. This month, I want to look at the communication skill of listening.

I’ve written about communication a lot on D4Dementia, most recently in my January 2019 post, 'Communication - It's more than just words'. In that blog I highlighted non-verbal communication skills and observation as two important facets of effective communication.

In this blog I want to build on those themes and look at listening as a vital communication skill. Listening as a skill runs throughout all of my training but particularly in my communication module which includes a learning point of ‘Talking and listening’.

Do you REALLY listen?

It’s always interesting to challenge learners by asking them how good they believe they are at listening. In my experience, most of us believe we are good listeners, when in actual fact we aren’t but fail to recognise this deficit in ourselves. This is partly because although listening is taken for granted, there is a stigma attached to not being a good listener, with poor listeners often considered to be disrespectful. Therefore most of us want to believe we are good listeners even if we aren’t.

But what is a ‘good listener’ exactly? To listen properly, you need to shut out all other thoughts and distractions and really concentrate on the person. That is easier said than done, however. Multitasking is considered a prized skill, but while there are many things you can do simultaneously, good quality listening requires more concentration than a multitasking person can provide. 

Once you’ve concentrated on the person, your listening is then about more than just being a listening ‘ear’. Whilst our ears take in the sound (or perhaps struggle with this if we have a hearing problem, as I wrote about in 'Missing the morning chorus - Life with hearing loss'), the interpretation happens in our brains - a busy head with numerous thoughts isn’t going to be a listening head. Our body language can also help or hinder our listening. If we are fidgeting, fiddling with our hands or glancing around we aren’t really concentrating on the person we should be listening to.

Listening in dementia care

When a person is struggling to communicate, you need to listen very carefully to pick up on any clues that can help you to understand what the person wants you to know. Communication can include sounds and noises that aren’t words and may not immediately resonate with you. This can result in the listener losing focus or interest pretty quickly, mostly because we are conditioned to wanting to understand things rapidly and easily.

Hence why, in dementia care in particular, high quality listening is so important. Appreciating that you’ve not immediately understood what you’re hearing but persevering regardless is vital to pick up clues that can help you to unravel what you are hearing. With time and patience you will often discover far more than you might originally have expected to.

So, that’s listening in a nutshell, but what about people who fall between being a ‘good listener’ and a ‘poor listener’? 'Partial listeners' are everywhere - those of us who concentrate to begin with before starting to formulate our answer and response, but in the process fail to listen to the rest of what is being communicated to us.

I saw this on social media recently, and for me it really sums up one of the biggest problems around listening.
Listening and responding as a care provider

The danger with being a poor or partial listener is that our response may end up being entirely inappropriate. Responsiveness is considered to be so important that it is one of the CQC Key Lines of Enquiry, so any care provider who isn’t creating a culture where they are really listening to the people they support and their staff isn’t likely to be one who is responding well either. As I said in my 2016 blog, 'Is your workforce person-centred?'
“My challenge to every social care provider reading this blog is embed observation and responsiveness into your leadership. If you think you already have, do it again, evaluate and keep evolving the leader you are, and the expectations you have of everyone in your team.”
Genuine listening isn’t something that many organisational structures support well, but I’ve seen a couple of examples that I’d like to share with you:

·        My first example comes from a care home, who wanted to ensure that they were really listening to their residents. They’d had suggestion boxes, feedback forms, resident meetings and a managerial ‘open door’ policy for many years, but they were concerned that these were piecemeal listening exercises. The suggestion box was rarely used, feedback forms often contained the same information (and weren’t always completed), the gaps in-between meetings didn’t reflect the need to listen on a daily basis, and only a few residents would regularly seek out the manager.

So, they implemented a new element into their working week where senior staff would, between them, visit 4 residents per day for protected time when they would just listen. As a result they discovered all kinds of information, including ideas for service improvements, dissatisfactions, information about people’s life stories, things they wanted to do, and even plans for their end of life. It was priceless information that they’d never discovered from any other ‘listening’ exercise.

·        My second example comes from a homecare agency, who were concerned that they weren’t listening to their staff enough simply because of the nature of their care workers’ remote working. When they had team meetings these were often jam packed with agenda items - staff attending were talked to a lot by managers, and it was assumed that they were listening, but there was sometimes precious little chance for each individual to have their say and be listened to.

So, they decided to implement a meet and listen with an external facilitator. Once a month they would have a meeting and managers wouldn’t say anything initially. Staff members would take it in turns to speak, and no one else could speak when that person was speaking. Managers would then be quizzed, randomly, at the end of the meeting by the facilitator, to ensure that they had been listening and to say how they would respond to what they’d heard.

For both of these services, the benefits of really listening became apparent very quickly. They also helped to bring home to frontline staff how vital a skill listening is, which of course had fantastic benefits for the people they were supporting too.

Until next time...
Beth x

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