Telephone 121 conversations and interviews

Pros and cons:

Useful for:

Disadvantages: 

• May exclude some people with speech, hearing and some other information processing difficulties who may not feel able to use telephone.
• Corporate or withheld phone numbers may not be picked up by vulnerable people who only take calls from familiar numbers.
• Many people find telephone interviews can be especially challenging because they usually built rapport through seeing each other's body language - which is not possible in phone calls.
• Can be difficult to do if you are working in a noisy environment, such as an open plan office or ward with lots of noise. Some people with dementia, and other people too, have difficulties with auditory processing so may not be able to filter to separate your voice from background noise.

Cost: relatively low cost as no travel or accommodation involved.

Timing:  if possible find out preferred time of call for the person with dementia.

• Some people may have disability needs that make it more difficult at various times of the day, or may experience 'sundowning' making calls less possible as it gets darker outside. 
• Some people may need support during the telephone conversation from people only with them at certain dates and times.

Number of people: usually 1-2-1, though depending on personal circumstances perhaps two or more people might take part with the phone on loudspeaker, such as where a carer may support a person with dementia to participate in the conversation. 

Preparation

If possible, send some introductory information about yourself by post or email, so that you are not a complete stranger during the call. Perhaps share your one page profile.

Find out about the person you will be speaking with - such as check if they have a one page profile or have ‘this is me’ information they would like you to look at before your phone call. 

Plan your interview framework – have questions you want to ask with you in written form, or for less structured interviews have an outline in front of you to remind yourself of key points to cover with the interviewer

Practise before the interview: ask a colleague, or if possible one or two people with dementia and/or carers, to help. They’ll be able to give you feedback on how you come across by phone. You could also record yourself so that you can listen back and identify any problems, such as speaking too quietly, quickly or using acronyms and jargon.

How to conduct your interview

Control your phone call environment.

• Minimise background noises such as televisions or noisy office environments (including typing sounds that the phone might pick up).
• Don't take other calls or respond to texts or emails – focus on the person with dementia and having a great conversation with them.
• Don't eat or drink - munching, slurping and swallowing sound horrid and may be amplified through the phone - and definitely don't talk while eating as it will distort the sound of your voice.
• Only use speakerphone if you're sure there is enough privacy, that there will be no interruptions and you are comfortable with this way of using a phone.
• Get yourself positioned so you can take any notes easily during the call.

Prepare yourself to communicate really clearly.

• Sit upright to help you project your voice clearly.
• Stay calm
• Before you dial, take a couple of deep breaths... and smile! It will show in your voice. 
• Speak clearly and at a reasonable pace.
• Don’t slouch on the couch – it will reduce your ability to project well and might make it harder for the person to understand what you are saying.
• Remember, if you don’t hear or can’t understand something a person with dementia says, it's fine to ask for clarification.

Be professional

• It may well be that someone else answers the phone, not the person with dementia. Plan what you will say 'Good morning, please may I speak to Mr Brown I have a telephone interview with him this morning.'
• First impressions are important – the first 30 seconds are crucial. Your voice must express interest, enthusiasm, and confidence.
• Introduce yourself professionally: 'Hello, this is Pat calling from Alzheimer’s Society,
• Ask who you are talking with and how they would like to be addressed - for example as Mr or Mrs or by their first name.
• You may find the carer is present, to support the person with dementia to take part in the phone call. It can be helpful to know they are there. For some activities, you may want to involve the carer too. For others you may need to thank the carer for providing support and be clear that you are only looking for responses from the person with dementia.

Use an interview framework. It should include:

• Check you have consent: introduce yourself, the purpose of the interview, an outline what will happen in the interview, and what will happen afterwards about what the person tells you (such as reporting and anonymity). 
  • Remember to apply process consent: if at any point the person you are interviewing is unable or unwilling to continue, allow them to withdraw and stop the interview.
• Build rapport so that the person feels able to be open with you: avoid being judgemental, focus on being in the moment and show empathy. 
• Use a range of question types to gather information
  • Ask follow on questions 
  • Adapt the types of question you ask to  the needs of the person you are interviewing. 
    • closed questions can be useful to check your understanding. Asking too many closed questions can make it feel like an interrogation.
    • asking too complicated questions may be confusing 
    • asking leading questions may skew your answers (many people like to please so may seek to give the answer they think you want rather than what they might have said otherwise)

Listen carefully.

Take notes.

After the interview, before you end the phone call

Thank the interviewee for taking part in the interview.

Tell the interviewee what will happen about what they have shared. Let the person know how they can find out more or get an update, if they want.

Offer the person the draft version of your notes so that they can check they are happy with them before you share them in reports etc. If the person is unable to read them for themselves, check they have help, if they want it, to review the notes.

Real-life examples featured in this resource

Making Evaluation Count: Alzheimer's Society's services overall nationally

Turning up the Volume on living with dementia: large scale, national activity