Communication with the Elderly

1. Communication with the Elderly Presented by Dr. Soad H. Abd El Hamid El Tantawy Lecturer of Gerontological Nursing Faculty of Nursing Mansoura University Dr. Soad Hassan

2. Communication with Elderly Outline: • Definition of communication • Types of communication • Ways of communication • Factors affecting communication • Barriers of communication • How to communicate with elderly person • How to communicate with elderly person with sensory deficit • Communication with Alzheimer patient Dr. Soad Hassan

3. Introduction The communication process in general is complex and can be further complicated by age. One of the biggest problems when dealing with older patients is that they are actually more heterogeneous than younger people. Communication can also be hindered by the normal aging process, which may involve sensory loss, decline in memory, slower processing of information, lessening of power and influence over their own lives, retirement from work, and separation from family and friends. Dr. Soad Hassan

4. Definition: Is the activity of conveying meaningful information. Communication requires a sender, a message, and an intended recipient, although the receiver need not be present or aware of the sender's intent to communicate at the time of communication. The communication process is complete once the receiver has understood the message of the sender. Dr. Soad Hassan

5. Elements of communication process • Sender : Is the communicator who has the responsibility to convey actions , words and feeling. Facial expression and body language convey the same message . • Massage : The information conveyed by the sender . the receiver change the massage back into feeling and mental image , massage should be clear and in familiar terms to the receiver and being understood . Dr. Soad Hassan

6. Receiver : Is the individual who listen and interpret the massage. The receiver understanding is depend on mental function and interpretation ability . • Feedback : Enable the sender to determine whether the massage was correctly interpreted simply by the receiver. Restate the massage is a type of feedback, sender ask question that allow the receiver for clarification . Dr. Soad Hassan

7. Ways of Communications • Two way communication : Is a dynamic process in which exchange ideas and thoughts occurs as a continuous process, require actively involved of receiver and provide feedback . • One way communication : Allows the sender to remains in control situation and the receiver remains passive. Is not the most effective type of communication . Dr. Soad Hassan

8. Factors influencing communication Personal factors: • Perception : A person perception is essential element in communication. People can see the same object and see different things. • Values : values influence the process of communication because people values , like their perception . • Culture : Each culture provide its member notion about how the world is structured and teach people how to use language , space to communicate certain massage and technique that differ from culture to culture. Dr. Soad Hassan

9. Attitude : A nurse attitude toward the elderly play a major role as elderly need to be respected and feeling valued so the nurse should convey trust and empathy through verbal and non verbal communication . • Trust : Trust is central to a therapeutic nurse – relationship . without a sense of trust the interaction is superficial , trust implies confidence , dependability and credibility in a relationship . Environmental factors : Seating arrangement , room comfort , movement of chairs ,object that facilitate or distract , noise , lack of privacy. Dr. Soad Hassan

10. Types of communication The two type of communication are verbal and non verbal. 10% of all communication is verbal and 90% is nonverbal . Verbal communication : It is the use of words to express thoughts , feeling , attitude. When communicating with older adult feedback is essential to explore thoughts of the older adults and ask for more explanations . Dr. Soad Hassan

11. Informing : Use direct statement regarding facts , a good information statement is clear , concise ,and expresses in words that elderly can understand. • Direct questioning : Are helpful when the nurse need to obtain specific information, is appropriate when information must obtained quickly . • Open ended technique : Allows the person to express more about their feeling and perception also allow the nurse to verify that the information exchanged is accurate • Active listening : The nurse pays attention to verbal and nonverbal communication using eye contact and facial expression Dr. Soad Hassan

12. Nonverbal communication : The most accurate form of communication , is the way of communication without the use of words people use their facial expression , eye contact , gesture and body language . Dr. Soad Hassan

13. Barriers of communications • Inappropriate reassurances. • Making judgments . • Giving advice, telling the person what should be avoided . • Challenging. • Improper questioning Dr. Soad Hassan

14. Effective communication • Be aware of the person's health issues. • Allow the elderly person to reminisce, and to grieve. • Respect the elderly person’s background, knowledge, and values. • Be attentive to the environment in which you are communicating • Speak clearly and articulately, and make eye contact. • Adjust your volume appropriately • Use clear and precise questions and sentences • Employ visual aids, if possible. • Take it slow, be patient, and smile. Dr. Soad Hassan

15. Communicating with the hearing impaired • Check to see if the hearing aid is in the person’s ear. Also check to see that it is turned on. • Wait until you are directly in front of the person, you have that individual’s attention and you are close enough to the person before you begin speaking. • Be sure that the individual sees you approach • Face the hard-of-hearing person directly and be on the same level with him/her whenever possible. • Keep your hands away from your face while talking. Dr. Soad Hassan

16. Recognize that hard-of-hearing people hear and understand less well when they are tired or ill. • Reduce or eliminate background noise as much as possible . • Speak in a normal fashion without shouting. • If the person has difficulty understanding something, find a different way of saying the same thing, rather than repeating the original words. • Use simple, short sentences to make your conversation easier to understand. • Write messages if necessary. • Allow time to converse with a hearing impaired person. Dr. Soad Hassan

17. Communicating with the deaf. • Write messages if the person can read. • Use a pictogram grid or other device with illustrations to facilitate communication. • Be concise with your statements and questions. • Utilize as many other methods of communication as possible to convey your message (i.e. body language). • Spend time with the person, so you are not rushed or under pressure. Dr. Soad Hassan

18. Communicating with the visually impaired. • Describe the room layout, other people who are in the room, and what is happening. • Tell the person if you are leaving. Let him/her know if others will remain in the room or if he/she will be alone. • Allow the person to take your arm for guidance. • Ask how you may help: increasing the light, reading the menu, describing where things are, or in some other way. • Call out the person’s name before touching. Touching lets a person know that you are listening. Dr. Soad Hassan

19. Allow the person to touch you. • Use the words "see" and "look" normally. • Use large movement, wide gestures and contrasting colors. • Explain what you are doing as you are doing it, for example, looking for something or putting the wheelchair away. • Describe walks in routine places. Use sound and smell clues. • Encourage familiarity and independence whenever possible. • Leave things where they are unless the person asks you to move something. Dr. Soad Hassan

20. Communicating with persons with Alzheimer’s Disease • Always approach the person from the front, or within his/her line of vision . • Speak in a normal tone of voice . • Face the person as you talk to him/her. • Avoid a setting with a lot of sensory stimulation, like a big room where many people may be sitting or talking, a high-traffic area or a very noisy place. Dr. Soad Hassan

21. Maintain eye contact and smile. • Be respectful of the person’s . • Use a low-pitched, slow speaking voice which older adults hear best. • Ask only one question at a time. More than one question will increase confusion. • Repeat key words if the person does not understand the first time around. • Nod and smile only if what the person said is understood. Dr. Soad Hassan

22. Thank you Dr. Soad Hassan