1. 1. Paige Thompson April 6th, 2015 ASM 150 Week 2 Reflection Identify and list the skills required to communicate effectively with the elderly. When communicating with the elderly, it is important to employ several skills. You must listen, pay attention, maintain eye contact, and display an active posture. You have to find a reason for listening, so you naturally show a real interest in what they are saying. It is not enough for them to speak; they need to be heard. It is also incredibly important to show respect through maintaining personal space, and getting on eye level with the person youre speaking with. Be aware of your own non-verbal communication and body language, as well as keeping an eye on the other persons nonverbal communication to see that they understand you and are comfortable communicating with you. Give them plenty of time to process what you are saying. Slow down your speaking pace, using a nice, relaxed tone. Many older adults have more difficulty understanding rapid speech, as well as higher pitches. Lower the tone of your voice, but dont necessarily raise your volume. Yelling into someones ear will only make communication more difficult. You also need to develop an ability to rephrase, act out, and simplify what youre trying to express, in order to help the older adult better understand you.
2. 2. Describe the barriers to effective communication with the elderly. Another important thing to keep in mind is to try to work around barriers that older adults may face. Excess noise, light, or distractions can make communication very difficult and ineffective. Make sure you are in a quiet and comfortable environment. As mentioned previously, many older adults have more difficulty understanding rapid speech, as well as higher pitches of voice, so you must slow down your rate of speaking. Messages can easily be lost in translation between the speaker/communicator and the older adult, and vice versa. A common age-related barrier is hearing loss (presbycusis), affecting how well older adults hear what youre saying and how youre saying it, and vision loss (presbyopia), affecting how they hear your nonverbal communicationgestures, facial expressions, and body language, as well as reading written messages and seeing signs and symbols. Many medical conditions can make it increasingly difficult to communicate effectively: aphasia, dysarthria, agnosia, apraxia, cognitive loss and dementia, and other conditions that affect speech, reading, writing, and comprehension. The message may arrive intact, but the receiver cannot comprehend what the message means, possibly due to physiological problems, or increasingly, due to a language barrier. Or, as in the case of dysarthria and other conditions affecting speech muscles and vocal cords, the message may be received and well understood, but the older adult may not be capable of responding.
3. 3. Possibly the most frustrating communication barrier occurs when the message is heard, understood, and simply ignored. Attitude issues due to a poor relationship between the two communicators can cause this. As caregivers, we must do our best to make the older adult feel comfortable and respected so as to avoid this issue. Examine issues of toxic talk and communication neglect. While not always intentional, communication neglect can be incredibly harmful to older adults. Socialization is incredibly important in every human being, and being denied that interaction can cause other health problems. Communication neglect can sometimes be used as a punishment (the silent treatment), but more frequently, it is done completely unintentionally. Busy work schedules and heavy patient loads can cause healthcare workers to simply avoid conversation with the elderly if they feel they dont have time for a full conversation. It can also occur when an older adult doesnt respond to attempts at conversation, and workers assume they dont want to talk, are unable to speak, or are too tired to visit. Unresponsiveness can be due to several other reasons, and attempts to socialize should not be neglected, as the older adult in turn becomes neglected. Another cause of unintentional communication neglect is treating elders as objects, referring to them by their condition or status, rather than by name or identity. This is often a result of the difficult balance between confidentiality and dehumanization. It is
4. 4. difficult to keep someones identity confidential in a public setting while still allowing those to keep their human characteristics. And while protecting someones humanity, its also important to avoid toxic talkcalling someone names, using baby talk or a frustrated tone, discussing the patient or family in a negative way, or generally speaking impolitely about the person, within hearing distance or not. List barriers you have experienced when communicating with the elderly. Share strategies you have implemented to overcome those barriers. Also, include an example of a personal situation where you and an older adult were faced with barriers in your communication and how you worked to overcome them to effectively communicate with each other. I have had several experiences with the elderly where communication was more difficult than usual. I have a client that has a lot of confusion and hearing loss. She hears better out of one ear than the other, so I make sure to speak on that side of her, to speak slowly and clearly, but not to raise my voice very much so as not to make my tone any harsher. I also make sure to repeat things in simple terms to ensure she understands me. Another of my clients often refuses to wear his hearing aids but then has difficulty hearing me at a normal speaking level. He has asked me to speak louder for him, but I also make sure to keep my words clear and simple. He has some anxiety issues due to confusion, so I always make sure my tone is relaxed and soothing as if I were talking to a friend, and while I prompt him with what to do next, I try my best to not make it sound as if Im telling him what to do, and
5. 5. I give him options so he feels hes still making his own decisions. A resident of the facility where I work seems to have some mild agnosia, though I dont know that its officially diagnosed. She used to attend many activities and was relatively social. Since moving to the health center, she is more withdrawn, not in a depressed way, but is just indifferent to group settings. I found recently that shell participate in a group setting, and if I make it clear to her that I am speaking directly to her, through eye contact, using her name, and sometimes touch, she will respond and actively participate. By putting forth a little more effort on my end, I can see that she enjoys the interactions, instead of passively observing others. I recently had an encounter with a man that has Parkinsons and his vocal volume and enunciation were obviously suffering to the point that he could not communicate with someone to fill out a form, and he wasnt able to hold the pen well to write for himself. Because of his symptoms, I was able to recognize that he needed a little help and offered to assist him. We worked together with him speaking a little more slowly and me sitting a little closer than usual to block out the environmental noise. We also discovered that for longer words that were difficult to hear, spelling them out was much more efficient and we quickly completed the form together.