This assignment discusses barriers to, and methods of, effective communication with people who are confused by reflecting on my experience in communicating with an elderly confused patient. Specifically, and within the scope of this assignment, I reflect on two methods of effective communication with elderly confused patients; one verbal (reality orientation) and one non-verbal (touch).
During my first placement I was asked to assist in the care of Elsie (pseudonym), an 86 year old lady admitted to hospital with a fracture to her hip and a urinary tract infection (UTI). Elsie was suffering from frequent periodic episodes of confusion; however this was not due to a diagnosed cognitive disorder. Manos and Braun (2006) and Keenan (2011a) say that elderly patients with a bone fracture or a UTI often present with confusion; which is a disorder of brain function (Manos and Braun, 2006). The elderly are more prone to confusion when they are ill because, with increasing age, kidney size and renal blood flow decrease causing a reduction in renal threshold (Keenan, 2011b).
When Elsie was in a confused state I found it difficult to interpret what Elsie was trying to communicate to me because her responses to my questions did not make sense. When communicating with Elsie I consciously used the active listening SOLER (Sit square-on, Open posture, Lean forward, Eye contact, Relax) model (Egan, 2010) that I had been taught at University. I used this to show Elsie I was listening and to help me try to understand what Elsie was communicating. I felt frustrated because although I used SOLER, slowed down my normal pace of communication and repeated what I was saying, Elsie’s responses still did not make sense. The National Health Service (NHS, 2...
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...aching on a patient’s personal space. I should therefore use a calm reassuring voice with the use of touch. I find it comforting to know that Oliver and Redfern (1991) say that the use of touch is a skill that can be acquired and learnt.
Reflecting on my experience communicating with Elsie I have learnt about two communication techniques (reality orientation and the use of touch) that will help me communicate more effectively with an elderly confused patient. I have realised I need to find out more about using expressive touch in communication and the use of other verbal and non-verbal techniques that can help in communicating with elderly confused patients, such as effective use of paralinguistic communication. This will give me greater confidence in communicating with elderly confused patients because I will have additional strategies to bring to the situation.
She did not associate someone's ability or inability to speak with their current state of mental activity. I understand that her husband was having issues communicating which is probably why she felt so strongly about it, but infants do not speak because they do not know how to speak because they have not learned how to speak yet. An older adult at some point was capable of speaking so when they get to a point where they are unable to use language then there it is clearly linked to their mental activity. However, I do agree that touch is a well-known way to soothe someone. We soothe infants when they are sad by holding them. When an older adult has lost the ability to speak, they are vulnerable so if we carefully observe their body language rather than just give up on them and do nothing. If it seems appropriate a simple pat on the back or a hug may make this person easier to communicate with in another way.
The purpose of this paper is to explore why non-verbal communication is an important tool for professional practice. Some of the aspects of non-verbal communication are facial expression, eye contact, posture, orientation, proximity, touch, fine movement, gross movement, dress, setting and direct work (Egan 2002). [The Skilled Helper/ People Skills] In my opinion non-verbal communication is a very important tool when working with clients. For example, in a professional setting a client could be telling you they are fine and they aren’t afraid yet they could be shaking or looking around nervously. The non-verbal prompts that clients give out subconsciously or consciously give us, as professional workers clues to how the person is really feeling even if what they say using verbal communication isn’t the same as the non-verbal prompts. Thompson (2009) says that in addition to the words we speak, we give very powerful messages through non-verbal communication and our body language ...
Calvin’s abilities include uninhibited movement of his legs and left hand (H. MacDonald, B.S.C., P.T., personal communication, January 25, 2017; Brooklyn, M.S., Ph.D., personal communication, February 2, 2017; Hans, J.D., LL.M., personal communication, January 29, 2017; J. Bartholemeo L.P.N., personal communication, February 8, 2017; C. J. Cullinan, R.N., M.S., C.N.S., C.R.R.N., C.H.P.N., B.S.N., personal communication, January 29, 2017) and a well-developed sense of humor (H. MacDonald, B.S.C. P.T., personal communication, January 25, 2017; Brooklyn, M.S., Ph.D., personal communication, February 2, 2017; Hans, J.D., LL.M., personal communication, January 29, 2017; J. Bartholemeo, L.P.N., personal communication, February 8, 2017; C. J. Cullinan, R.N., M.S., C.N.S., C.R.R.N., C.H.P.N., B.S.N., personal communication, January 29, 2017). The system of communication developed for Calvin is based around his skills, so it may not apply to all nonverbal people with different abilities to communicate, and it is important to take each individual’s skills into account when developing a system of
There are different types of communication (verbal, nonverbal, paralinguistic). Verbal communication is communicating with words. For instance, an individual speaks to another at a business meeting regarding profit margins. Second, nonverbal communication is communicating without the use of words but through gesture, body language, facial expression and eye contact (Baron, Branscombe, Byrne). Also these physical expressions can provide powerful and valuable information about others’ current feelings and reactions without the need of words. Lastly paralinguistic is defined as the use of emotional expression, gestures, and the location of the body in relation to the other's body, eye contact, and level of voice instead of verbally expressing these cues (Triandis). Additionally, paralinguistic is also known as paralanguage as a way to modify or nuance meaning, or convey emotion, with the use of pitch, volume, and intonation (Triandis). For instance, as described by Triandis’ article Culture and Communication, “in Bulgaria and south India a nod means "no,” and a shake of the head, means "yes".” It’s interesting how Triandis describes the amount of difficulty it was to compre...
Some adults have communication difficulties and adaptations are necessary. It’s import to be sensitive with adults that have communication difficulties.
...using words your patient is used to and will understand. Clarify your message with body language, tone of voice, facial expression touch and gestures.
I quickly saw what I had been missing as the physician began to interact with her. He bent down by her chair and introduced himself as loudly as he could. He spoke slowly and calmly. Afterwards we had a discussion of what I could have done to improve and why my methods were not effective. I learned each patient is different, depending on his or her age, disabilities, background, and experiences. These differences require the physician to adapt and recognize how to more effectively communication to ultimately help the patient. It was frustrating to accept that a simple conversation was difficult, but this only
Additionally, other concepts of verbal communication skills such as questioning and probing, paraphrasing and understanding are used when talking to patients. Questioning and probing is where various types of questions and statements...
When looking back on the event, I can now acknowledge how unprepared, and unsupported, I was when first introduced to Mrs X. There are many barriers to communication that can lead to the message becoming distorted, and I feel my lack of knowledge and understanding, played a big part. Therefore, as mentioned by Lishman (2009) in order to achieve effective communication, it is important to be aware of the physical, psychological, and social barriers, that could affect the communication process. Being able to effectively communicate, is an essential skill in providing person-centred care. Therefore, it involves learning to communicate effectively even when various barriers to communication are
The verbal communication goal is to encourage the client to fully express the changes and wants of set outcomes established. Both verbal and non- communication can have an impact on the client once interaction is met. Non-verbal communication consists of body language, facial expressions, closeness, and eye contact (Schore, 2008). If a client senses the listener is uninterested or showing signs of discomfort due to their diagnosis or disability, it can cause one to be unengaged in the conversation. Verbal communication can also result in the same disengagement due to the social worker/ therapist tone of voice. Social workers are to be mindful and educated on the background of the client being served to be aware of the different approaches to take when engaging with the individual. The social work intern effective of non-verbal communication skills as the client continued to discuss her life before her recent hospitalization. The social work intern ensured to make steady eye contact, in which the client was receptive of. The social work intern also created a posture that created empathic body language, allowing the client to be more open during
The nurse who I assisted to ambulate this patient was much more knowledgeable about the strategies developed to communicate with this patient than I was. When the nurse communicated with this patient, she spoke directly to the patient where the patient was able to ...
In the provision of a high quality care, many factors influence the way it is provided; however, IC is crucial. A healthy work environment would result from open communication among the staff, it would increase the employees and patients’ level of satisfaction and sense of well-being. Good communication is the cornerstone for the IC, it is a complex process which requires to develop some skills to learn how to transmit some information. One of the most common factors leading to medical errors, are due to miscommunication, sometimes because the message is not clearly sent, and others because it is not clearly received or it is misunderstood (Danna, 2015). In terms of communication non-verbal communication must be taken into consideration as well; body language, facial expressions, use of space, and touch, entail conscious or unconscious movements and gestures, also impacts the communication among the staff and
Thesis statement: Non-verbal communication is as important as what people say; however, if not examined carefully can be misinterpret because of lack of awareness. This lack of knowledgecan cause misunderstandings in everyday life.
Some examples of the supportive communication includes smiling, leaning towards the patient (proxemics), making eye contact, and using a warmer tone of voice when speaking. The unsupportive nonverbal communication included no eye contact, minimal facial expression, and a cold tone of voice. This shows that nonverbal communication is not only a very important aspect of communication in general, but contributes to the overall well being, or discomfort of others as
There is expectation to demonstrate core communication skills and the capacity to develop them and ability to engage with people in order to build compassionate and effective relationships (The College of Social Work, 2014). Communication skills are fundamental in social work; every aspect of their role involves communication. In order to communicate effectively, social workers need to be aware of the forms of communication, i.e. non-verbal, verbal, body language and written and understand communication barriers. (Thompson, 2009). In light of this, when communication barriers occur, i.e. someone not understanding English or wanting to discuss their issues, having these skills allows social workers to overcome this, i.e. asking the right questions or putting in place an interpreter. Having effective communication within social work provides a strong base for good professional relationships. Trust is able to be built, providing confidence in both the social worker and service user in meeting, discussing and building upon solutions (Koprowska, 2005). I promoted such skill throughout the interview as I remained aware of my body language, ensuring I was open, faced the carer and remained good eye contact. I was also continuously aware of the carer’s body language, to inform me of how she was feeling. Being mindful of her eye contact, facial expressions and position of body enabled me to realise she was not being responsive in the conversation (Banks, 2006). Being able to identify this, allowed the barrier to be overcome by asking probing questions and engaging her back into the conversation. I provided active listening skills by summarising what the carer expressed, responded accordingly to what was being discussed and nodding to show ...