Coming Home Carer Skills
Module 6: Communicating well
Topics follow the 16 Care Certificate standards (2025). This module maps to standard 6, "Communication".
Coming Home Carer Skills is our own free course for family carers. Its topics follow the 16 Care Certificate standards (2025) from Skills for Care, NHS England and Skills for Health. It is not the Care Certificate, it is not a qualification, and those organisations have not endorsed it.
This guide to Communicating well is correct at October 2026. We've written it in good faith as general information to help family carers. It isn't legal, financial or medical advice, and it can't teach practical skills such as moving someone or first aid. For those, ask the person's nurse or therapist, or find an in-person course. To the extent the law allows, we can't accept liability for any errors or omissions, or for decisions made on the strength of this guide. In a medical emergency call 999. If you need advice quickly, call NHS 111. In Northern Ireland, contact your GP out of hours service.
Read the video transcript
Module 6: Communicating well. Video transcript
Full narration with what is on screen, for learners who prefer to read or cannot hear the video.
[00:00] Module 6: Communicating well
On screen: Coming Home Carer Skills; About 5 minutes. Picture: Fiona and Ian sit face to face at their kitchen table in good light, mid-conversation, both laughing. Their hands are drawn mid-movement, not making any specific sign.
Welcome to Module 6 of Coming Home Carer Skills: Communicating well. On screen are Fiona and her husband Ian, at home in Dundee. Ian is Deaf. His first language is British Sign Language, or BSL. Fiona signs too.
[00:19] Before we start
On screen: Our own free course for family carers.; Topics follow the 16 Care Certificate standards (2025).; Not the Care Certificate. Not a qualification.; Not endorsed by Skills for Care, NHS England or Skills for Health..
First, a short note. Coming Home Carer Skills is our own free course for family carers. Its topics follow the 16 Care Certificate standards (2025) from Skills for Care, NHS England and Skills for Health. It is not the Care Certificate, it is not a qualification, and those organisations have not endorsed it.
[00:43] In this module
On screen: Good talking basics; Hearing and sight loss; When memory or speech changes; Talking with professionals; Keeping simple notes.
By the end, you should know some simple ways to help the person understand you, and to help you understand them.
[00:51] A missed message
On screen: Back turned.; Bright window behind.; The message was missed.. Picture: Fiona stands at the kitchen sink with her back half turned, talking over her shoulder. Ian sits at the table behind her reading a newspaper (blank pages), not looking up. Bright window behind Fiona.
One busy morning, Fiona told Ian that his GP appointment had moved to 10 o'clock. But she was at the sink, with her back to him, and a bright window behind her. Ian could not see her face or her hands. He missed the message. The next day, he was ready at the wrong time. Nobody was to blame. Small changes would have made the difference.
[01:17] Good talking basics
On screen: Get their attention first.; Face them, with light on your face.; One idea at a time.; Ask what helps.. Picture: Fiona sits down facing Ian at the table and gives a small wave to catch his eye. A lamp lights her face. Ian looks up and smiles.
Get the person's attention first. Say their name, wave, or touch their arm gently. Face them, at the same level, with the light on your face, not behind you. Turn off the radio or TV. Use short sentences, one idea at a time, and give them time to answer. If they do not understand, say it a different way. Most of all, ask the person what helps them.
[01:46] Hearing aids and hearing loss
On screen: Hearing aids in and switched on.; Do not shout.; Say it a different way.; Sudden change: see a GP straight away.. Picture: Samuel sits in his armchair touching his hearing aid; Grace sits beside him, turned to face him, smiling, the TV remote in her hand and the TV off (blank screen).
Grace's dad, Samuel, wears hearing aids. Grace makes sure his hearing aids are in and switched on, and she turns off the TV. Speak clearly, but do not shout. Shouting can be uncomfortable for a hearing aid user, and it can look angry. If hearing seems to be getting worse, ask the GP about a hearing test. If hearing gets worse suddenly, see a GP straight away or call NHS 111. In Northern Ireland, contact your GP out of hours service.
[02:21] Sight loss
On screen: Say who you are, and when you leave.; Say where things are.; Ask before moving things.. Picture: Bilal puts a mug of tea down on a small table near Nasreen's right hand and tells her where it is. Nasreen smiles and reaches for it. Her white cane rests against her chair.
Bilal's mum, Nasreen, is partly sighted. When he comes into the room, Bilal says who he is. When he leaves, he says so. He says where things are, rather than pointing. "Your tea is on your right." He asks before moving anything. NHS sight tests are free for people aged 60 or over in England, Wales and Northern Ireland, and free for everyone in Scotland.
[02:50] When memory or speech changes
On screen: Simple choices: tea or coffee?; Give time. Do not rush.; Use pictures and gestures.; Do not argue about facts.. Picture: Abdi holds up two different mugs, one in each hand. Amina, seated, points at one and smiles. Her walking stick leans on the table.
Amina had a stroke last year. She has aphasia. This means problems with language, so finding and saying words can be hard. Her son Abdi gives simple choices. "Tea or coffee?" is easier than "What would you like?" He waits, because a word can take 30 seconds or more to find. He does not finish her sentences. Pictures, objects and gestures help too. If someone has memory problems, try not to argue about facts. Listen to the feeling behind the words. A speech and language therapist can help. Ask the GP.
[03:31] A good GP appointment
On screen: Write down 2 or 3 questions.; Ask for communication support.; Ask for plain words.; Say it back to make sure.. Picture: In a GP consulting room, Ian sits facing Dr Marin and signs. A BSL interpreter (unnamed extra, a woman in her 40s) sits beside Dr Marin so Ian can see them both. Dr Marin looks at Ian and listens. Hands drawn mid-movement, no specific sign.
For the new appointment, Fiona and Ian wrote down their 3 most important questions. When Fiona booked, she asked for a BSL interpreter. In Scotland, NHS staff can arrange an interpreter if you tell them beforehand. England has the Accessible Information Standard, Wales has its own NHS standards, and Northern Ireland has a free communication support service. On screen, Doctor Marin talks to Ian, not about him. Ian asks for plain words, and says it back to make sure he has it right. This time, Fiona could just be his wife.
[04:11] Keep a simple notebook
On screen: Date and what changed.; Appointments and what was said.; Questions for next time.; Agree it with the person.. Picture: Fiona and Ian sit side by side at the kitchen table. Fiona writes in a small notebook (blank pages) while Ian points to a line and adds something.
Back home, Fiona and Ian started a simple notebook. They write the date and anything that has changed, appointments and what was said, and questions for next time. A few words is enough. Write it together where you can, and keep it somewhere safe. These are the person's private details.
[04:33] When to get help fast
On screen: Sudden problems speaking, understanding or seeing: call 999.; Sudden confusion: call 999 or go to A&E.; Hearing gets worse suddenly: see a GP straight away or call NHS 111. In Northern Ireland, contact your GP out of hours service.; If you need advice quickly, call NHS 111. In Northern Ireland, contact your GP out of hours service.; BSL users can use the free 999 BSL video service..
If someone suddenly has problems speaking, understanding or seeing, it can be a sign of a stroke. Call 999 straight away. If someone suddenly becomes confused, call 999 or go to A&E. For anything less serious, contact their GP. If you need advice quickly, call NHS 111. In Northern Ireland, contact your GP out of hours service. BSL users can contact 999 through the free 999 BSL video service.
[05:10] Get help
On screen: The GP practice and an optician; RNID and RNIB; Stroke Association and Alzheimer's Society; Carers UK helpline: 0808 808 7777 (free).
For help, start with the person's GP practice, or an optician for eyes. RNID helps people who are deaf or have hearing loss, and RNIB helps blind and partially sighted people. The Stroke Association and Alzheimer's Society have helplines too. The numbers are in the Get help box. For advice about caring, Carers UK runs a free helpline on 0808 808 7777.
[05:40] To sum up
On screen: Face the person, in good light.; One idea at a time.; Ask what helps.; Plan appointments. Keep notes.; Next: read the pages, then try the quiz.. Picture: Evening. Fiona and Ian sit together on the sofa under a warm lamp, facing each other and laughing, mid-conversation. The notebook lies closed on the coffee table.
To sum up. Get the person's attention, face them, and make sure they can see your face. Keep it simple, one idea at a time, and give them time. Ask the person what helps, and ask services for the support they need. Plan appointments, and keep a simple notebook. Now read the pages below, then try the quiz. You can take it as many times as you like.
Page 1: Good talking basics
Good talking is about more than words. Small changes can make a big difference, whoever you care for.
Ask what helps. Everyone is different. Ask the person how they like you to talk to them. Write it down, so other people can do the same.
Get ready to talk.
- Get the person's attention first. Say their name, wave, or touch their arm gently if they are happy with that.
- Face them, at the same level. Sit down if they are sitting.
- Make sure the light is on your face, not behind you.
- Turn off the TV or radio, or move somewhere quieter. Ask first.
While you talk.
- Speak clearly, at your usual pace or a little slower. Do not shout.
- Use short sentences, with one idea at a time.
- Give the person time to answer.
- If they do not understand, say it a different way.
- Talk to the person, not about them.
Listen too. Good talking goes both ways. Stop what you are doing, look at the person, and let them finish. Faces, hands and body language help you understand each other.
Sources (read 8 Oct 2026): NHS website, "Communicating with someone with dementia", https://www.nhs.uk/conditions/dementia/living-with-dementia/communication/ ; RNID, lipreading tips, https://rnid.org.uk/2024/09/lipreading-awareness-week/ ; Alzheimer's Society, "How to communicate with a person with dementia", https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/tips-for-communicating-dementia
Page 2: Hearing and sight loss
Hearing loss. Hearing loss is common as people get older. Signs can include having the TV very loud, asking people to repeat things, and finding it hard to follow a chat in a busy place.
- If the person has hearing aids, make sure they are in and switched on.
- Do not shout. It can be uncomfortable for a hearing aid user, and it can look angry.
- If they miss something, say it in a different way.
- Write things down if it helps.
If hearing seems to be getting worse, ask the GP about a hearing test. NHS hearing aids are free. Ask the NHS hearing aid service that fitted them about batteries and repairs. Do not try to mend a hearing aid yourself, beyond what its user guide says. If hearing gets worse suddenly, see a GP straight away or call NHS 111. In Northern Ireland, contact your GP out of hours service.
Deaf people who sign. Some Deaf people use British Sign Language (BSL) as their first language. BSL is a full language, with its own grammar. It is different from English. Ask for a professional BSL interpreter at appointments. In an emergency, a BSL user can contact 999 through the free 999 BSL video service.
Sight loss.
- Say who you are when you come in, and say when you leave.
- Use the person's name, so they know you are talking to them.
- Say where things are. "Your tea is on your right" is better than pointing.
- Keep things where the person expects them. Ask before moving anything.
Eye tests. NHS sight tests are free for people aged 60 or over in England, Wales and Northern Ireland. In Scotland, NHS eye tests are free for everyone. If the person cannot leave home on their own because of illness or disability, they may be able to have an NHS eye test at home. Ask an optician.
Sources (read 8 Oct 2026): NHS website, "Hearing loss", https://www.nhs.uk/conditions/hearing-loss/ ; NHS website, "Hearing aids and implants", https://www.nhs.uk/tests-and-treatments/hearing-aids-and-implants/ ; RNID, communication tips, https://rnid.org.uk/wp-content/uploads/2020/05/Communication-tips-speaking-to-HL-screen-res-LP-2018.pdf ; nidirect, "Hearing aids" (Northern Ireland), https://www.nidirect.gov.uk/articles/hearing-aids ; NHS Swansea Bay (Wales), hearing services for adults, https://sbuhb.nhs.wales/hospitals/a-z-services/audiology-new/hearing-services-for-adults/ ; NHS Greater Glasgow and Clyde (Scotland), audiology, https://www.nhsggc.scot/hospitals-services/services-a-to-z/audiology/ ; British Sign Language Act 2022, section 1, https://www.legislation.gov.uk/ukpga/2022/34/section/1 ; GOV.UK, BSL user experience of health and social care, glossary, https://www.gov.uk/government/publications/bsl-user-experience-of-health-and-social-care-in-uk/glossary ; Ofcom, 999 BSL, https://www.ofcom.org.uk/phones-and-broadband/accessibility/new-999-video-call-service ; RNIB, "Sight loss: helping you to help others", https://www.rnib.org.uk/get-involved/volunteer/helping-you-help-others/ ; NHS website, "Free NHS eye tests and optical vouchers", https://www.nhs.uk/nhs-services/opticians/free-nhs-eye-tests-and-optical-vouchers/ ; GOV.WALES, "Get help with NHS eye care costs", https://www.gov.wales/get-help-nhs-eye-care-costs ; nidirect, "Health costs and free sight tests for over 60s", https://www.nidirect.gov.uk/articles/health-costs-and-free-sight-tests-over-60s ; mygov.scot, "Free NHS eye tests", https://www.mygov.scot/free-eye-tests ; eye tests at home: NHS Scotland, https://www.eyes.nhs.scot/media/1480/your-guide-to-free-nhs-eye-examinations-in-scotland.pdf ; NHS Wales, https://www.nhs.wales/sa/eye-care-wales/wgos/eye-health-professional/wgos-mobile-services/ ; nidirect, https://www.nidirect.gov.uk/articles/eye-care
Page 3: When memory or speech changes
Memory problems, dementia or a stroke can change how someone talks and understands. About 1 in 3 people have aphasia after a stroke. Aphasia means problems with language. Talking, understanding, reading, writing or using numbers can be hard.
Tips that help.
- Keep sentences short. Ask one question at a time.
- Give simple choices. "Tea or coffee?" is easier than "What would you like?"
- Give the person time. Finding a word can take 30 seconds or more.
- Try not to finish their sentences or guess, unless they want you to.
- Use pictures, objects, gestures and writing. Point to things together.
- If you have not understood, say so kindly. Say back what you think they meant.
- Keep the person in the conversation. Do not talk as if they are not there.
Do not argue about facts. Someone with memory problems may say something you know is not right. Think about whether it matters. If it is not causing harm or worry, you may not need to correct them. Listen to the feeling behind the words.
Get expert help. A speech and language therapist can help the person, and show you ways to talk together. Ask the GP.
If it happens suddenly, get help straight away. Sudden problems speaking or understanding can be signs of a stroke: call 999. If someone suddenly becomes confused, call 999 or go to A&E. If changes come on slowly, over weeks or months, talk to the GP.
Sources (read 8 Oct 2026): Stroke Association, "Aphasia and communication", https://www.stroke.org.uk/stroke/effects/aphasia ; Stroke Association, "Supporting someone with communication difficulties", https://www.stroke.org.uk/stroke/support/materials/stroke-news/supporting-someone-communication-difficulties ; Stroke Association, "Tips for aiding communication", https://www.stroke.org.uk/stroke/effects/aphasia/communication-problems/tips ; Alzheimer's Society, "How to communicate with a person with dementia", https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/tips-for-communicating-dementia ; NHS website, "Symptoms of a stroke", https://www.nhs.uk/conditions/stroke/symptoms/ ; NHS website, "Sudden confusion", https://www.nhs.uk/symptoms/confusion/
Page 4: Talking with professionals
Appointments can feel rushed. A little planning helps the person get the most from them.
Before the appointment.
- Write down your 2 or 3 most important questions.
- Write down what has changed, and when it started.
- Take a list of all the person's medicines.
- Ask for communication support when you book. For example, a BSL interpreter, a longer appointment or letters in large print.
During the appointment.
- Let the person speak for themselves as much as they can. The professional should talk to them, not just to you.
- Ask for plain words: "Can you say that another way?"
- Say it back to make sure: "So the new tablets start on Monday. Is that right?"
- Write down what is said, or ask for it in writing.
Before you leave, make sure you know what happens next, and who to contact with questions.
Communication support in each nation.
- England: NHS and publicly funded adult social care services must take account of the Accessible Information Standard. It is about making sure disabled people, and people with sensory loss, can understand information and get the communication support they need.
- Wales: NHS Wales has its own standards for accessible communication and information (2025). Welsh Government guidance says interpreting should be free, and family and friends should not usually be asked to interpret.
- Scotland: the "Charter of Patient Rights and Responsibilities" sets out your rights when you use the NHS in Scotland. They include communication support, such as an interpreter or a sign language interpreter. Tell staff beforehand and they can arrange it.
- Northern Ireland: the free Regional Communication Support Service gives sign language interpreters and other support for health and social care. Staff book it.
Sources (read 8 Oct 2026): NHS website, "What to ask your doctor", https://www.nhs.uk/nhs-services/gps/what-to-ask-your-doctor/ ; NHS England, Accessible Information Standard, https://www.england.nhs.uk/about/equality/equality-hub/patient-equalities-programme/equality-frameworks-and-information-standards/accessibleinfo/ ; GOV.WALES, accessible communication and information standards in healthcare, https://www.gov.wales/accessible-communication-and-information-standards-healthcare-html ; Scottish Government, "Charter of Patient Rights and Responsibilities" (revised June 2022), https://www.gov.scot/publications/charter-patient-rights-responsibilities-revised-june-2022/pages/2/ ; Welsh Government, standard operating procedure for interpreting and translation in primary and emergency healthcare, https://www.gov.wales/standard-operating-procedure-commissioning-interpretation-and-translation-services-primary-and-html ; NHS inform, communication and involving you, https://www.nhsinform.scot/care-support-and-rights/health-rights/communication-and-consent/communication-and-involving-you/ ; nidirect, "Communication support for deaf people", https://www.nidirect.gov.uk/articles/communication-support-deaf-people
Page 5: Keeping notes
A simple notebook can help everyone. It helps you remember, and it helps professionals see what has changed.
What to write.
- The date, and anything you noticed. For example: "Dad seemed more muddled after tea."
- Appointments, and what was said.
- Questions to ask next time.
- Medicines, and any changes to them.
- What helps the person understand you best.
Keep it simple. A few words on the days something happens is enough. Take the notebook to appointments.
Write it with them. Where you can, write the notes together. The person may want to add their own words, or a drawing.
Respect their privacy. These notes are about another adult. Ask the person if they are happy for you to keep them, and what goes in. Keep the notebook somewhere safe. Module 7 says more about privacy.
Source (read 8 Oct 2026): NHS website, "What to ask your doctor" (write down what you discussed and what happens next, and keep your notes), https://www.nhs.uk/nhs-services/gps/what-to-ask-your-doctor/
The printable guide
32 pages, A4. Questions to write in, with answers at the back.