Learning Objectives

By the end of the presentation , students should be able to:

1. Define the 4 barriers domains to communication(Physical , cognitive, psychological

and sociocultural)
IL Acknowledge Techniques to break those barriers
111. Know how to Communicate with caregivers

Why do we need communication?

•To strengthens patient provider relationship

•To Increases adherence to recommendations (therapeutic partnership)
•For Betters health outcomes

Miscommunication impact on healthcare

•Diagnosis error
•treatment error
•poor patient education
•poor quality healthcare

Fundamentals of good communication

•Two way activity

Receptive and expressive component but not always in working order in old people

•Comfort

It is critical because it creates trust and trust is vital to adherence

•Active listening

It is a vital component to clinical encounter Components of communication

•Content-10%
•Vocal tone quality-30%
•Body language-60%

Barriers to good communication Physical barriers

Which includes hearing, vision, speech, movement

1. Hearing loss caused by High frequency tone, etc

Effects of hearing loss on communication

 • Miscomprehension of speech
• Difficult telephone use
• Difficult face to face interaction
• Selective hearing
• Social isolation
2. Vison loss caused by decreased pupil size and accommodation, glaucoma, cataract etc.

Effect of vision loss on communication

• Inability to identify doors, stair edges and light switches

• Avoidance of light source which causes glare
• Inability to talk about what one is viewing.
• Appears inattentive
3. Speech loss caused by dental difficulties, xerostomia etc
Effects of speech loss on communication

• Loss of self esteem

• Embarrassment
• Isolation
• Frustration
4. Movement loss caused by fear of falling, neurons die, osteoporosis etc
Effects of movement loss on communication

• Body language may appear inappropriate and may be misinterpreted

• Limited stamina may lead to loss of initiative and cooperation with caregivers

Physical barrier breakers

• Recognize and validate sensory loss

• Optimize function use of sensory aid
• Utilize the best senses
• Avoid sensory distractions
• Don't shout, lower pitch of voice
• Read body language but recognize altered presentation
• Large print and dark print materials
• Portable amplifiers
• Do not appear hurry
• Do an environmental audit including access, signage, temperature, lighting, noise level

Cognitive and psychological barriers slower cognitive processing, dementia.. anxiety,

depression, etc

Effects of cognitive and psychological barriers on communication

• Frustration leading to irritability
• Withdrawal
• Aggression "acting out" behaviors
• Anxiety great concerns obsessions

Breaking cognitive and psychological barriers

• Use short sentences avoid and

• Use close ended sentences
• Repeat and restate your messages
• Look for meaning behind actions
• Go slowly
• See resistance as a source of information

Sociocultural barriers

Understanding another persons perspective( Beliefs, attitude and behaviors) so that we can work
together as cultural competence is one of the basic issue of effective communication.

Breaking sociocultural barriers

• Develop trust understand that

• Ask questions about relevant beliefs, other healers, other remedies

Language reflects and creates reality, translate and interpretation Breaking Language

barriers

• Speak slowly and distinctly

• Avoid ambiguous statement
• Ascertain literacy level in naitive language
• Work with translator if necessary

Caregivers and communication

• Issue of balancing caregiver involvement and patient privacy disability level and cognitive
capacity
• Know the responsibility level of the caregiver
• Don't ignore either patient or caregiver
• Separate agendas of patient and caregivers

Tips for good listening

• Be patient
• Listen attentively Don't
• interrupt
• Listen for understanding
• Listen for cues
• Read body languages (postures, eyes, gesture, facial expressions)
• Use verbal cues that you are listening

Note; In assessing for the elderly person's understanding, Do not count

on; smiles, nods, agreement, absence of questions Instead look for:

• Note taking or request for additional info

• Relevant questions
• Ability to repeat what you've said.