Dr Tony Young
Lecturer in Language & Communication

  • Email: tony.young@ncl.ac.uk
  • Telephone: +44 (0) 191 222 7515
  • Address: School of ECLS (Speech and language Sciences)
    King George VI Building
    University of Newcastle
    Queen Victoria Road
    Newcastle upon Tyne
    NE1 7RU

Background

Was involved in various capacities with language education in the UK, USA, Spain, Italy, Malaysia and Indonesia, 1984 - 2000, before lecturing in applied linguistics and the social psychology of communication at Birkbeck College, University of London. Joined Newcastle University in 2004.

Roles and Responsibilities

Head of the Applied Linguistics Section of the School of Education, Communication and Language Sciences.  Lecturer in language and communications. Director, MA Cross Cultural Communication (CCC) Programmes (Media and International Relations). Chair of Board of Studies, MACCC.

Qualifications

PhD University of London, January 2007

MA (with Distinction) in Applied Linguistics, Birkbeck, University of London, 1999

Diploma in English Language Teaching to Adults, Waltham Forest College, London, 1989

B.A.(Hons) English, University of Sussex, 1984

Memberships

International Association of Language and Social Psychology
International Communication Association
Society for Intercultural Education, Training and Research (Europe)
British Association for Applied Linguistics
European Second Language Association

Research Interests

Notions of culture, language and communication in applied contexts (educational, non-governmental organisations and health care)
Codification and dissemination of good communicative practice among professionals (teachers, health care providers)

Other Expertise

English language teaching and learning.
Curriculum design and implementation.
Adustment of international students.

Current Work

1. DEMTEC Project: I am leading a multiprofessional and lay team in the development of a conceptual framework and toolkit to optimise communication between professionals, carers and people living with dementia (with Cardiff and Vale NHS Trust and Alzheimer's Society, UK)
2. International students' transitions and adjustments to life and study in the UK. Project funded by the HASS Faculty development fund.
3. Chinese people's naming practices, particularly the motivation behind their adoption, or otherwise, of western-type names.
4. Investigating 'non native' speaking teachers' beliefs, attitudes and practices regarding appropriate models of English (English as a Lingua Franca, English as an International Language, 'Native speaker' varieties)

Future Research

1. Evaluation of DEMTEC as an intervention in hospitals, care homes and individuals' homes.
2. Evaluation of models of intercultural communicative competence to Languages of the Wider World (Collaborating with the Centre of Excellence in Teaching Languages, University College London, and the School of Oriental and African Studies, University of London.

Research Roles

Principal Investigator, Demtec project, co-investigator on transitions, Chinese naming and languages of the wider world projects.

Esteem Indicators

My work on communication and dementia won the James J Bradac Prize from the International Association of Language and Social Psychology for its outstanding contribution to the field of language and social psychology in June 2010.

I was founding convenor of the Special Interest Group in Intercultural communication for the British Association for Applied Linguistics.

 Impact Case Study

The Dementia Toolkit for Effective Communication

 

The challenge

Dementia is a growing worldwide epidemic with a profound impact on individuals and on societies.  The condition is likely to affect most people at some point of their lives, as sufferers or as family members.  At an individual level, people living with dementia (PLWD) typically face an inevitable and progressive (although rarely linear) loss of cognitive functionality. Depression and anxiety can also accompany the condition, particularly in the early stages. They may face social stigmatisation. Communication becomes increasingly more difficult for PLWD and for those around them at a time when the need for effective and sustaining communication is greater than ever.   Worldwide, the current number of PLWD is currently around 35 million - this will double by 2030 as life expectancy increases, placing a profound strain on health and care resources, particularly in low or middle income countries.  In the UK, which faces care challenges similar to most relatively prosperous countries, there are currently around 750,000 people with the condition – by 2030 this will have increased by around 50%.  Dementia and dementia care currently costs the country  around £20 billion annually, at a time when the parlous state of public finances ensures that pressure to find cost-effective means of care is ever more imperative. Key recent policy initiatives have highlighted quality of life and communication as target areas for improvement in dementia care.  However, research shows that the prevailing situation both in terms of support for PLWD and their family members in their homes, and in terms of the quality of formal care currently provided in care homes and hospitals, is considerably less than optimal, with poor communication practices the norm and appropriate, evidence-based carer communication training highly unusual (Young & Manthorp, 2009, Young, Manthorp & Howells, 2010). 

 

The Response

Since 2009 a team of multidisciplinary researchers has addressed address issues of optimising communicative practices involving PLWD, family members, formal carers and care and health professionals.  This work has been carried out with the collaboration of the Alzheimer’s Society.  The core team has consisted of a language and communications scholar (Young), a social care specialist (Chris Manthorp), an old age psychiatrist (David Howells) and, latterly, a quality of life and dementia care expert, Toby Williamson, and Ellen Tullo, who has expertise in medical education. A cycle of Iterative research projects involved:

1.       Observation of communicative practice in hospitals and care homes in the UK

  1. Seeking the views of stakeholders into current communicative practices in contexts they are familiar with. 

Participants were spectrum of people involved in delivering  health and social care (speech and language therapists, psychiatrists, nurses, care home managers and care workers ), and (unusually)  lay stakeholders (PLWD and family members)  via focus group and individual interviews.

Findings indicated:

  1.  A lack of familiarity among a large majority of stakeholders with any available advice involving communication with PLWD. 
  2. Extant advice, where accessed, had been found by potential users to be either minimal, patronising, over-technical for application by non-experts, overly context-specific  and/or hard to apply to the specific needs of individuals, tending to a ‘one size fits all’ approach.  It was rarely theoretically-based or empirically supported.  It was rarely applied. 
  3. Communication by professionals , especially GPs, in interactions with PLWD and family members was inadequate for purpose, with key communicative episodes (such as notification of diagnosis and its implications) being handled particularly badly.

In response, with the cooperation of both professional and lay stakeholders we have developed a prototype Dementia Toolkit for Effective Communication (DEMTEC).  This is a free-to-users instrument that is empirically supported and adaptable to individual PLWD and to a range of health, care and sociocultural environments.   It is intended that will be the basis for online advice to PLWD and their family members, and that it will form a component in the training of care workers, nurses and medical undergraduates.  DEMTEC consists of three ‘levels’. The foundation Level 1 details beliefs about the psycho-social effects of dementia on communication, as well as empowering, person-centred  approaches to communication involving PLWD. Level 2 consists of practical considerations and advice in 8 key areas.  Level 3 uses case studies to show how the principles and advice in preceding levels are adaptable and applicable to individuals in different care contexts and at different stages of dementia (Young, Manthorp & Howells, 2011; Young, Manthorp, Howells and Tullo, 2011).  Applications are now pending  for proof of concept and evaluation projects in the UK in medical contexts (ESRC),  and in social care contexts (DMT).    An application for joint UK-Hong Kong international applicability study is also under preparation (ESRC- RCG).  DEMTEC has been translated into Spanish and Catalan (Young, Manthorp & Howells, 2010), and will be translated into Chinese for the HK-UK project.  Discussion are underway with both the Alzheimer’s Society and the Mental Health Foundation for free, web-based dissemination of DEMTEC. 

 

Impact

Impact as defined by the REF includes, but is not limited to, an effect on, change or benefit to  the activity, attitude, awareness, behaviour, capacity, opportunity, performance, policy, practice, process or understanding  of an audience, beneficiary, community, constituency, organisation or individuals  in any geographic location whether locally, regionally, nationally or internationally.

Impact includes the reduction or prevention of harm, risk, cost or other negative effects.   Other impacts within the higher education sector, including on teaching or students, are included where they extend significantly beyond the submitting HEI.   

 

Our project has multiple potential beneficiaries fitting these criteria:

  • People living with dementia (PLWD).  Enhancing the communication practices of those around them will help PLWD to retain agency and personal and social identity through increased control over their lives and circumstances. Better communication will reduce the use of anti-psychotic drugs to control behaviour in hospital and other care contexts and so prolong life and enhance its quality (National Audit Office, 2007). Use of the toolkit will help to alleviate anxiety, and will also help PLWD to retain and regain competences.  This will reinforce and support a sense of dignity and so enhance quality of life for this large, and growing, body of people. DEMTEC's flexible design means it will be adaptable over time, and to different sociocultural contexts, so these benefits are potentially long-lasting and international.  The contributions of individual PLWD and carers, and of self-help groups and NGOs such as the Alzheimer's Society in drawing up DEMTEC will be recognised and will serve as encouragement and as a model for the involvement of all stakeholder groups in developing psychosocial interventions in health and social care contexts.  Dissemination of DEMTEC as a free-to-all-users toolkit will allow an ongoing process of refinement and adaption of DEMTEC which will encourage research and reflection on communication practices and dementia which will extend beyond Linguistics to gerontology, psychiatry and speech and language therapy.
  • Family members and informal carers for PLWD will benefit from improved communication, and more effective interactions, lessening their own anxiety, mitigating stress and facilitating greater satisfaction with their roles with consequential quality of life and cost of care benefits.
  • Care home workers, hospital nursing staff and other care professionals will benefit from being introduced or reintroduced to a person-centred approach to relationships with PLWD. Recent reports, which have received much attention in the press and in Parliament, have shown poor understanding of dementia in significant numbers of health professionals and care workers, despite the prevalence of dementia in hospital and care home settings, and in the wider community. Manifestations of this lack of understanding are reductions in independence and choice, which may lead to perceived behavioural disturbance and an over-reliance on anti-psychotic drugs, with consequent detrimental results on the quality of life of PLWD, and a higher mortality rate (Department of Health and the Medical Research Council, 2009).  Professionals will also benefit from improved communication lessening their own anxiety and facilitating greater satisfaction with their roles. More positive and meaningful communication with PLWD will make for better relationships and for positive reinforcement of roles.
  • Wider society. Given the scale of the demographic challenge, it is clearly necessary to find means of improving the lives of people with dementia in ways that will not demand infinite resources, especially at a time when public finances are severely restricted.   Improvement in communication practices of the type promoted by training based on DEMTEC offer a highly cost effective and evidence-based means of improving quality of care and the quality of life of PLWD and their formal and informal carers.  The toolkit will also help to deliver goals specified in the National Dementia Strategy (Department of Health, 2009), including improving care in hospitals, creating an informed and effective workforce and living well with dementia in care homes.

Specific measures of impact might include:

  1. Number of hits on the DEMTEC website, which will be linked to the Alzheimer’s and Mental Health Foundation sites.
  2. Evaluative feedback from website users.
  3. Demonstrable improvements in quality of life of PLWD in contexts where DEMTEC has been a component of staff training (using the Dementia Quality of life – DEMQOL – questionnaire and the Quality of Interactions Survey – QUIS.  Measures here include daily activities and self-care; general health and wellbeing; cognitive functioning; social relationships; and self-concept.  They might also include the reduced use of antipsychotics.
  4. Evaluative feedback from PLWD, family members, staff members and others who have used or been exposed to DEMTEC in different care environments (people’s homes, care homes, day centres, hospitals). 
  5. Uptake of DEMTEC as a component of general medical training for medical undergraduates and for nursing staff, and changes in practice and in patient outcomes that accrue. 

 

References

Department of Health (2009). Living Well with Dementia: a National Dementia Strategy.www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_094058 .

Department of Health and Medical Research Council (2009). Report from the Ministerial Summit on Dementia Research. Medical Research Council, London.  Available online at http://www.mrc.ac.uk/consumption/idcplg?IdcService=GET_FILEanddID=24618anddDocName=MRC006472andallowInterrupt=1

Young, T.J.,&  Manthorp, C. (2009). Towards a code of practice for effective communication with people with dementing illnesses.  Journal of Language and Social Psychology, 28, 2, 174 -189. 

Young, T.J., Manthorp, C & Howells, D. (2010). Communication and dementia: New perspectives, new approaches.  Barcelona: Editorial Aresta, translated into Spanish (2010) as Comunicación y Demencia:  Nuevas Perspectivas, Nuevos Enfoques, and into Catalan (2011) as  Comunicació i Demència:  Noves Perspectives, Nous Enfocaments,.

Young, T.J., Manthorp, C.,  Howells, D. & Tullo, E. (2011).  Developing a carer communication intervention to support personhood and quality of life in dementia.  Ageing and Society, 31, 6, 1003 - 1025.

Young, T.J., Manthorp, C. Howells, D. & Tullo, E. (2011).   Optimising communication between medical professionals and people living with dementia, International Psychogeriatrics, 23, 7, 1078 – 1085.

 

Postgraduate Teaching

SPE815 Language in Society
SPE881/EDU255 Interpersonal Communication
CCC8077 Professional Communication

CCC8042 Culture and Intercultural Communication in English language Education
CCC8001 Social Psychology of Communication
CCC8026 Research methods