Bob Newhart, a phone, distance, dementia and communication

BBC Radio 4 have a series For One Night Only which looks back at classic concerts. These are not only music related as last Saturday attested featuring The Button-Down Mind of Bob Newhart. This is the title of Bob Newhart's award winning comedy album that topped the charts in 1960. When Bob Newhart first appeared his act was radically different from the usual comedy fare. In this edition presenter Paul Gambaccini interviews the now 81-year-old Newhart about the album, his success and approach: an individual on stage with a telephone.

In the discussion I was struck by the point that although it was just one man with a phone the audience acted as a proxy for the other party. Being socialised as we are the audience became the other party in Newhart's comical one-to-one conversations. We fill-in the missing details; what has most likely been said, what must have happened and what may happen next. Our humanity, experiences and imaginations fill the space making use of the redundancy that resides in context, language and the comedic.

As noted previously my colleagues and I have started giving some talks on communication to residential and nursing home staff. The focus in these sessions being person centered care and the challenges that residents living with dementia face together with their carers and families.

I don't want to worry senior managers - but in my sessions I try to convey to staff how everyone, whatever their experience, position and grade has a role to play in assuring high quality person centered care. Listening to For One Night Only you see the challenge writ large. Now a sense of humour in medicine and nursing is a great help, but this isn't the staff room and it's no comedy either.

Care staff must realise how important it is that they pick up and use the 'phone'. Their individual observations, patience and interpersonal efforts are vital. Even with some training in dementia care  staff may be surprised how the person with cognitive problems can fill in the spaces. Even if a resident cannot understand the words spoken to them, the tenor, tone, intent and attitude behind the words can be communicated and contribute greatly to supporting the care that follows. Especially when there is a need to deliver personal care.

In providing much needed personal care the technological marvel that is telephony may have its limits (even as telecare), but it can still teach us much about information and communication.

Most obviously when 'distance' remains.

Image source: http://www.pbs.org/weta/onstage/twain2002/bios/