Communication with and treating the older person

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Communication with and treating the older person

Dissatisfaction that clients/patients have with healthcare providers often result from communication problems between them and the health care professional. Effective communication techniques can help improve patient outcomes and improve compliance. Health professionals need to have understanding of some of the issues that may facing the older person (eg reduced income, increased expenditure, fear of abandonment, loneliness, poor health, pain etc) and need to be aware that most generalisations held about the older person do not stand up to scrutiny (ageism).

Greene (1994) showed that older patient’s satisfaction of medical encounters is improved when:
1) The practitioner shows a warm, supportive interpersonal style and provides information
2) The client is given the opportunity to explain his/her concerns and is an active participant in making decisions
3) The interaction is client centred and addresses the client’s needs

Basic communication strategies that apply to everyday communication are also applicable to communication with the older patient:
• listening, clarifying, giving information, seeking validation of understanding, keeping focus
Many of these may be impaired due to cognitive problems and communication disorders in the older person.

Practical tips for communication:
• sitting down  shows you are listening
• give them time to get to the point (word retrieval may be slower)
• show respect
• be careful of ageism
• do not shout or yell (not all older persons have hearing problems; shouting raises frequency of the voice  can reduce what is heard)
• be careful not to misinterpret behaviour
• be aware of nonverbal clues as checks of understanding
• many will be anxious or worried
• use a few minutes of ‘small talk’/chatting prior to commencement of consultation
• be sensitive to their needs
• respect their pride (eg be careful with offers of assistance – may resent the implication that they need help)
• many may live alone  be aware of the ‘social event’ of the clinic visit
• have the patient participate in decisions

Practically:
difficulty bending  will need help removing footwear
use of written instruction sheets
involvement of family members and/or caregivers

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