MASENO UNIVERSITY

SCHOOL OF NURSING
COMMUNICATION
SKILLS
NUR/00048/022
NUR/03011/022
NUR/00026/022
NUR/00011/022
NUR/00007/022
OBJECTIVES

▶ Define words such as aphasia, visual impairment, hearing impairment, angry

and depressed
▶ Explain ways to recognize patients with different kinds of vulnerability
▶ Describe ways of communicating with each vulnerable group
INTRODUCTION

▶ Vulnerable refers to a state or condition of being susceptible to harm, either

physically, emotionally, or in terms of security. It implies a lack of protection,
resilience, or ability to defend oneself against potential risks, threats, or
negative outcomes. Vulnerability can manifest in various contexts, such as
personal relationships, health, finance, or social situations. It is often
associated with feelings of fragility, weakness, or exposure to potential harm
or exploitation. Vulnerability can arise from factors like physical or emotional
limitations, lack of resources or support systems, or situations that increase
the likelihood of negative consequences.
COMMUNICATING WITH VULNERABLE
GROUPS:
1. THE APHASIC
Aphasia---.
▶ It is a language disorder that impairs the ability to communicate.
▶ It is caused by stroke related injuries to the areas of the brain that controls
speech and language.

What to do if you have aphasia;

▶ 1. Take your time ; it may take time to get the words out.
▶ 2. Use assistive devices.
 CONT;

▶ 3. Be patient and understanding. If a loved one has aphasia, empower them

by giving them timeto communicate. ...

▶ 4 Find ways to connect.

▶ 5 Make it easier for them to communicate. ...

▶ 6 Treat them with respect and dignity.

Ways of communicating with the aphasic
;
1. After speaking, allow the person plenty of time to respond. If a person with aphasia feels
rushed or pressured to speak, they may become anxious, which can affect their ability to
communicate.
2. Use short, uncomplicated sentences, and don't change the topic of conversation too
quickly.
3. Avoid asking open-ended questions. Closed questions that have a yes or no answer can be
better.
CONT;

4. Avoid finishing a person's sentences or correcting any errors in their language. This may cause
resentment and frustration for the person with aphasia.
5. Keep distractions to a minimum, such as background radio or TV noise.
6. Use paper and a pen to write down key words, or draw diagrams or pictures, to help
reinforce your message and support their understanding.
CONT;

7. If you don't understand something a person with aphasia is trying to

communicate, don't pretend you understand. The person may find this
patronising and upsetting.
8. Use visual references, such as pointing, gesturing and objects, to support their
understanding.
9. If they're having difficulty finding the right word, prompt them – ask them to
describe the word, think of a similar word, try to visualise it, think of the sound
the word starts with, try to write the word, use gestures, or point to an object.
2.HEARING IMPAIRMENT

▶ Hearing impairment refers to a partial or total inability to hear. It can range from mild to
profound and may be caused by various factors, including genetics, aging, exposure to loud
noise, infections, or injury. Individuals with hearing impairment may face challenges in
communication, social interactions, and accessing information. Assistive technologies, such as
hearing aids or cochlear implants, can often help mitigate these challenges
▶ The hearing impaired can face challenges in communication, accessing information, and
participating fully in various activities. These difficulties may lead to social isolation, limited
educational and employment opportunities, and reduced access to essential services, making
them a vulnerable group in certain contexts.
TYPES OF HEARING LOSS
There are three main types of hearing loss:
1. Conductive Hearing Loss:
-Caused by issues in the outer or middle ear, such as earwax, fluid, or problems with the
ear canal or eardrum.
- Often treatable through medical intervention or surgery.
2. Sensorineural Hearing Loss:
- Results from damage to the inner ear (cochlea) or the auditory nerve.
- Common causes include aging, exposure to loud noise, and certain medical conditions.
- Generally permanent, but hearing aids or cochlear implants can assist.
CONT
;
3. Mixed Hearing Loss:
- Combination of conductive and sensorineural hearing loss.
-Occurs when there are issues in both the outer/middle ear and the inner ear
or auditory nerve.
- Treatment depends on the specific causes affecting each part.
 HOW TO COMMUNICATE WITH THE HEARING IMPAIRED

1.Face the Person: Ensure your face is visible, allowing them to lip-read
and observe facial
expressions.
2.Speak Clearly and at a Moderate Pace: Avoid mumbling and speak at a
pace that allows for
easy understanding.
3.Use Gestures and Facial Expressions: Supplement your speech with
appropriate gestures and
facial expressions to enhance communication.
CONT;

4.Get Their Attention Before Speaking: Tap gently on the shoulder or make
eye contact before
starting a conversation to avoid surprises.

5.Reduce Background Noise: Choose quiet environments to minimize

distractions and make
communication more accessible.
6.Rephrase Instead of Repeat: If misunderstood, try expressing the idea in
a different way
rather than repeating the same words.
CONT;
7. Provide Written Information: Use written notes or text messages to convey important details
or complex information.
8.Learn Basic Sign Language: Familiarize yourself with basic sign language to
bridge communication gaps effectively.
9. Use Assistive Technologies: If applicable, consider using hearing aids, cochlear
implants, or
other assistive devices to facilitate communication.
10.Be Patient and Empathetic:Recognize the challenges they may face and demonstrate
patience and understanding in your interactions.
SOCIAL AND EMOTIONAL SUPPORT FOR
THE HEARING IMPAIRED:
Social and emotional support for the hearing impaired during communication involves fostering
understanding and empathy. Here are some key aspects:
1.Inclusive Conversations:
- Ensure they are included in group conversations by making an effort to involve them.
2. Clear Communication Expectations:
- Set clear expectations for communication situations, helping reduce anxiety.
CONT;

3. Open Communication Channels:

- Encourage open dialogue about their communication preferences and any challenges
they
may be experiencing.
4. Educate Others:
- Promote awareness among peers, colleagues, and the community about effective
communication with the hearing impaired.
5. Support Groups:
- Connect individuals with hearing impairment to support groups where they can
share experiences and strategies.
CONT;

6. Active Listening:
- Demonstrate attentiveness and interest in what the person is saying.
- Use affirming gestures and expressions to convey understanding.
7. Patience:
- Allow extra time for communication, recognizing potential delays in processing
information.
8. Empathy:
- Acknowledge the challenges they may face and express empathy towards their
experiences.
CONT;

9. Professional Counseling:
- Provide access to counseling services to address emotional challenges
associated with
hearing loss.
10. Celebrate Achievements:
- Acknowledge and celebrate their accomplishments, fostering a positive and
supportive
environment.
Creating a socially and emotionally supportive space enhances the overall well-
being of individuals with hearing impairment.
 3.THE ANGRY

▶ An angry client is someone who is dissatisfied, upset, or frustrated with a product, service, or
experience provided by a company or individual. They often express their dissatisfaction through
strong emotions, complaints, or criticism due to unmet expectations, poor service, product
issues, or other grievances.
▶ Anger can make individuals vulnerable in certain situations due to factors such as impaired
judgment, susceptibility to emotional manipulation, health implications, social isolation, and
legal consequences. When people are angry, their decision-making abilities may be
compromised, and they may act impulsively or irrationally, leading to negative outcomes.
Additionally, anger can be exploited by others to manipulate or take advantage of individuals,
and chronic anger can have detrimental effects on physical and mental health.
HOW TO RECOGNIZE AN
ANGRY PATIENT
Recognizing an angry patient involves being attentive to their behavior, body
language, and verbal cues.
Here are some signs that may indicate a patient is angry:
1. Facial Expressions: Furrowed brows, clenched jaw, narrowed eyes, or an
intense, strained expression.
2. Body Language: Fidgeting, pacing, crossed arms, or tense posture can signal
agitation.
3. Verbal Cues: Raised voice, sharp tone, use of aggressive language, or direct
complaints about their experience or treatment.
CONT;
4. Physical Signs: Increased heart rate, heavy breathing, or signs of distress.
5. Restlessness: Difficulty sitting still, tapping feet, or restless movements could indicate their
discomfort or anger.
6. Direct Complaints: Patients might openly express dissatisfaction with their care, treatment, or
the service they've received
7. Increased Tension: Physical signs like muscle tension, increased heart rate, or heavy breathing
could indicate their rising anger.
8. Avoiding Eye Contact: Some angry patients might avoid eye contact, feeling too agitated or
uncomfortable to engage directly.
9. Interruptive Behavior: They might interrupt or talk over others, struggling to contain their
frustration or anger.
 WAYS OF COMMUNICATING WITH THE ANGRY CLIENTS

When communicating with an angry client, it's important to employ effective

communication skills to de-escalate the situation and work towards a resolution.
Here are eight skills to use:
1. Active Listening:

Demonstrate that you are fully engaged and focused on what the client is saying.
Repeat back key points to show that you understand their concerns.
2. Empathy:
Put yourself in the client's shoes to understand their perspective and emotions.
Express genuine concern for their feelings and acknowledge their frustrations.
CONT;

3. Remaining Calm:
Maintain a calm and composed demeanor, even if the client's anger is escalating.
Avoid responding with anger or frustration, as it can further escalate the situation.
4. Open Communication:
Encourage the client to express their concerns and feelings openly.
Foster a two-way conversation, allowing them to share their perspective without
interruption.
5. Problem-Solving:
Focus on finding solutions rather than placing blame.
Collaborate with the client to identify practical and mutually agreeable
resolutions.
CONT;

6. Patience:
Stay patient, even if the client is expressing frustration or repeating concerns.
Rushing the conversation may escalate tensions, so allow them the time to voice
their grievances.
7. Positive Body Language:
Use open and non-threatening body language, such as maintaining eye contact
and uncrossed arms.
Avoid defensive postures, as this can make the client feel more confrontational.
8. Setting Boundaries:
Establish clear and respectful boundaries for the conversation.
Address inappropriate behavior while maintaining a professional and assertive
tone.
 VISUAL IMPAIREMENT

▶ Visual impairment refers to a significant loss of vision that cannot be corrected fully with
glasses, contact lenses, medication, or surgery. It can range from mild to severe, and individuals
with visual impairment may experience different levels of vision loss, including partial sight or
blindness.
CAUSES OF VISUAL IMPAIREMENT

Conditions leading to visual impairment can vary and might include:

▶ Refractive Errors: Such as myopia (nearsightedness), hyperopia
(farsightedness), astigmatism, or presbyopia, which can be corrected with
glasses or contact lenses.
▶ Eye Diseases: Conditions like cataracts, glaucoma, diabetic retinopathy,
macular degeneration, or retinal detachment can cause vision loss.
▶ Genetic Factors: Some visual impairments are congenital or hereditary,
leading to conditions like albinism or retinitis pigmentosa.
▶ Injuries or Trauma: Damage to the eyes or head injuries can result in vision
impairment.
WAYS OF COMMUNICATING TO VISUALLY
IMPAIRED
▶ Communicating effectively with visually impaired individuals involves using
techniques that cater to their specific needs. Here are eight ways to
communicate with someone who is visually impaired:
1. Introduce Yourself:
1. Always identify yourself when approaching or entering a conversation. This helps
them understand who they're speaking with.
2. Verbal Cues:
1. Use clear and descriptive language when communicating. For instance, provide
details about your surroundings or use vivid descriptions in your conversation.
CONT;

3. Ask for Preferences:

Inquire about their preferred mode of communication. Some might prefer verbal
descriptions, while others may use tactile or auditory methods.
4. Respect Personal Space:
Avoid sudden gestures or invading their personal space without warning. Inform them
before touching or guiding them, respecting their comfort zone.
5. Describe Actions:
Narrate actions or movements taking place, especially if they are relevant to the
conversation. For example, explain if someone enters or leaves the room.
CONT;

6. Be Clear and Direct:

Speak directly to the individual, avoiding speaking through intermediaries unless
requested. Maintain eye level when conversing, even if they can't see you.
7. Use of Signaling:
Use non-verbal cues or signals to indicate changes in topics, pauses in conversation, or
the need to take turns in dialogue.
8. Offer Assistance:
If they need help navigating, offer your arm for guidance, allowing them to hold your
elbow. Avoid pushing or pulling them abruptly.
 5.DEPRESSED
▶ A depressed client refers to an individual who is experiencing symptoms of depression, a
mental health condition characterized by persistent feelings of sadness, hopelessness, and a
lack of interest or pleasure in activities.
HOW TO RECOGNIZE A DEPRERESSED PATIENT

▶ Recognizing depression in a patient involves observing various behavioral,

emotional, and physical signs. Here are some common signs to look out for:
1. Persistent sadness: A depressed individual may exhibit a prolonged and intense
feeling of sadness, hopelessness, or emptiness.

2.Changes in sleep patterns: Depression can cause disruptions in sleep,

leading to insomnia (difficulty falling asleep or staying asleep) or hypersomnia
(excessive sleepiness).
▶
CONT;

3. Appetite changes: Depressed individuals may experience a significant

decrease or increase in appetite, resulting in weight loss or weight gain.

4. Lack of interest or pleasure: A loss of interest or pleasure in activities

that were once enjoyable is a common symptom of depression. Hobbies,
social interactions, and previously enjoyed activities may no longer hold
appeal.

5. Fatigue and low energy: Depression often leads to persistent feelings

of fatigue, low energy levels, and a general lack of motivation.
CONT;

▶ 6. Feelings of worthlessness or guilt: Depressed individuals may have a

distorted self-perception, feeling excessively guilty, worthless, or self-critical.
▶

▶ 7. Difficulty concentrating or making decisions: Depression can impair

cognitive function, making it challenging to concentrate, remember details,
or make decisions.
▶

▶ 8. Physical symptoms: Some individuals with depression may experience

physical symptoms such as headaches, stomachaches, or other unexplained
pains.
WAYS OF COMMUNICATING WITH DEPRESSED
PATIENTS

▶ When communicating with depressed patients, it is important to approach

them with empathy and understanding. Here are some tips for effective
communication:
▶ 1. Active Listening: Show genuine interest and attentiveness by actively
listening to what the patient is saying. Maintain eye contact, nod, and provide
verbal cues to indicate that you are engaged in the conversation.
▶

▶ 2. Validate Their Feelings: Acknowledge and validate the patient's emotions

and experiences. Let them know that their feelings are valid and
understandable given their circumstances
CONT;

▶ 3. Avoid Judgment: Refrain from making judgmental statements or offering

unsolicited advice. Instead, create a safe and non-judgmental space where
they can freely express themselves without fear of criticism.
▶

▶ 4. Offer Support: Express your willingness to support them through their

journey. Let them know that you are there for them and that they can rely on
you for emotional support.
▶

▶ 5. Encourage Sharing: Encourage the patient to share their thoughts and

feelings at their own pace. Avoid pressuring them to open up but let them
know that you are available to listen whenever they are ready.
CONT;

▶ 6. Be Patient: Understand that depression can affect a person's ability to

communicate effectively. Be patient and give them time to express
themselves. Avoid interrupting or rushing the conversation.
▶

▶ 7. Acknowledge Their Struggles: Show empathy by acknowledging the

challenges they are facing. Let them know that you understand their pain and
that you are there to support them through it.
▶

▶ 8. Encourage Professional Help: While your support is valuable, it is important

to encourage the patient to seek professional help. Let them know that
seeking therapy or counseling is a positive step towards managing their
depression effectively.