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Chapter 4: Therapeutic Communication with Older Adults, Families and Caregivers

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Chapter 4: Therapeutic Communication with Older Adults, Families and Caregivers Learning Objectives State the importance of communication with older adults. http ... – PowerPoint PPT presentation

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Title: Chapter 4: Therapeutic Communication with Older Adults, Families and Caregivers


1
Chapter 4 Therapeutic Communication with Older
Adults, Families and Caregivers
2
Learning Objectives
  • State the importance of communication with older
    adults.
  • http//www.jointcommission.org/multimedia/improvin
    g-patient-provider-communication---part-1-of-4/
  • Identify effective and ineffective communication
    strategies.
  • Understand how normal and pathological changes of
    aging affect communication.
  • Describe communication strategies for older
    adults with common normal and pathological
    changes of aging.
  • Describe person-centered communication.

3
Communication Basics
  • How we provide and receive information from
    others
  • Conveys a message between a sender and a receiver
  • Dynamic ongoing exchange of information with
    feedback
  • Relies on intact senses, physical and cognitive
    processes needed to send and receive messages,
    and a conducive environment.
  • Verbal relies on knowledge of a common language
    as well as the ability to produce words.
  • Nonverbal includes tone of voice and physical
    behaviors such as body language and eye contact.

4
Person-Centered Communication
  • Key characteristics of quality health care.
  • Focus on the patient and their unique perceptions
    and experiences with health and illness
  • Nursing interventions include providing
    information to promote health and healing and to
    engage patients in self-care
  • Confirms uniqueness of the patient and allows the
    patient to participate in his or her own care.

5
Person-Centered Communication
6
Communication Obstacles Facing Older Adults
  • Lack of opportunity for communication and
    declining social networks
  • Retirement
  • Spouses and friends die
  • Children move away
  • Physical or mental impairments interfere with
    ability to communicate

7
Strategies for Communication with Persons with
Dementia that Support Personhood (Table 4-1, page
100)
  • Recognition acknowledge uniqueness
  • Negotiation consult the person about
    preferences, desires, and needs.
  • Validation acknowledge the persons emotions/
    feelings and respond.
  • Facilitation/Collaboration work together,
    involve the person.

8
Intergenerational Communication
  • Elderspeak
  • Similar to babytalk
  • Simplification measurable reductions in
    complexity of grammar and vocabulary
  • Clarification strategies adding repetitions and
    stressing and altering the pitch of ones speech,
    resulting in speech that is overly caring and
    controlling and less respectful than normal
    adult-to-adult speech. figure 4-1, p. 101

9
Cultural Competence and Health Literacy
  • Teach-back method
  • patients repeat back the information they have
    received
  • easy and effective method to assess comprehension
    of health teaching
  • http//www.nchealthliteracy.org/teachingaids.html
  • Communication in end-of-life care
  • may be complicated by emotional distress and
    prior relationships with family and significant
    others
  • may be especially difficult when the news is bad
    or when patient's or families' listening skills
    are poor.

10
Changes Throughout the Typical Aging Process
  • There are numerous age-related factors that
    affect communication.
  • Vision changes presbyopia - aging-eye
  • Hearing changes presbycusis old mans
    hearing
  • Dual sensory impairment loss in both vision and
    hearing
  • Cognition changes
  • Short-term memory
  • Long-term memory

11
Pathological Changes Affecting Cognition, Speech,
Language
  • Dementia
  • Memory loss accompanied by speech and language
    impairments and/or decline in executive
    functioning
  • Alzheimers most common form of dementia
  • Speech and Language
  • rate of speech slows with declining cognition
    and/or lost teeth or ill-fitting dentures
  • comprehension may decline with hearing, vision,
    or sensory loss, cognitive changes, and emotional
    factors
  • Aphasia is an acquired language impairment and
    occurs when there is damage to language center in
    the brain.

12
Strategies to Aid Individuals with Communication
Impairments
  • Compensatory strategies technological devices-
    using hearing aids, eye glasses
  • Rehabilitative strategies practice repeatedly
    speech therapist
  • Effective communication strategies
  • (Table 4-2, P. 114-115)
  • Vision
  • Hearing
  • Cognition
  • Speech and language impairment

13
Communicating with Others
  • Families and significant others
  • Nurses can support family members, assist them to
    overcome communication barriers
  • Nurses must be aware of the need to include older
    adult in communication regarding health matters
    as much as possible.
  • Permission to communicate about health issues
    with others is a key privacy issue complicated by
    impairments
  • Professional and Nonprofessional Caregivers
  • Treat others with respect and be good role model
    for paraprofessionals

14
Summary
  • Many older adults may have significant sensory or
    cognitive impairments that affect their ability
    to communicate.
  • Nurses can use techniques to facilitate
    appropriate communication.
  • Health literacy should be considered when
    planning teaching or educational materials.
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