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Picture This…..Communicate

This article discusses the importance of health literacy for older adults with communication difficulties and provides strategies for effective communication and teaching. It also highlights the prevalence of communication problems among older adults and the impact of health literacy on medication use.

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Picture This…..Communicate

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  1. Picture This…..Communicate Health Literacy for Aging Adults With Communication Difficulties April/May 2006 By: Kathy K. Wright

  2. Working with Older People With Communication Difficulties • Many employees of Health and Social Service agencies work with older adults • Health care and service settings include: • Hospitals/doctors offices • Nursing homes/residential care homes • Domiciliary and day care services * Significant numbers of older adults have some kind of communication problem.

  3. Effective Communication • Effective communication is an important factor in quality of life • Several authors have suggested that communication interventions are needed to arrest the decline of communication in residential care setting

  4. Care givers • Need to receive training to develop their own communication skills • This will in turn help them to communicate effectively with older people who may have a range of complex difficulties with communication

  5. Definitions • Literacy • National Literacy Act: Ability to read, write and speak English, compute and solve problems at level of proficiency necessary to function on job and society

  6. Health Literacy • Ability to read and comprehend prescription bottles, appointment slips and other essential health-related materials to successfully function as a patient • The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions

  7. Importance of Health Literacy • To assess patients’ ability to understand information • To identify literacy/knowledge deficits • To establish effective communication and teaching strategies that are specific to client’s needs

  8. Health Literacy in the United States • National Adult Literacy Study • Functionally illiterate reading level • 45-54 year olds: 16% • 55-64 year olds: 26% • > 65 year olds: 44% Kirsch I. Jungeblut A., Jenkins, L. et al. Adult Literacy in American: A first look at the results of the National Adult Literacy Survey. Washington DC: National Center for Education, US Department of Education. 1993

  9. Deafness – either pre-lingual (native speakers) or post lingual Non-English speaking Cognitive Impairment/Dementia Brain damage Stroke victims Mental health/depression Developmental Delay Low IQ Illiteracy Autism Declined physical health Non-English speaking caregivers Chronic diseases Older Adults with Communication Problems

  10. Functional Health Literacy & Medication Use • Health literacy affects a client’s ability to understand and adhere to medication directions/and to understand medical terminology • A social worker’s assessment of a client’s health literacy can be beneficial in: • Clarification of understanding of instructions • Tailoring medication counseling • Develop innovative communication using charts, calendars, pictures, and pictographs

  11. Examples of adaptation for better health literacy… language modification pill box modification

  12. Answers to Medication Challenges • Prepackaged in 30 day supply: like birth control pills • Pillboxes decorated with small pictures or emblems: sun (AM) moon (PM) • Calendars: for reminder emblems or to mark off as daily pills are taken

  13. Answers to Communication Challenges • Flashcards: pictures of simple words for communication of tasks (i.e. bathroom, brush teeth, food, etc.) • Books: simple sentences on each page or pictures, • Gestures: simple basic signs that are universal in meaning, ex: bringing right hand with palm toward chest for come here

  14. Vision Printed information may be enlarged to a higher font for low vision persons. Black print against yellow or orange paper is easier to read. The blind may handle many tasks independently with proper instruction. Hearing Impairment/Deafness Do not talk louder than normal range – it will further distort if they hear at all. Do stand/sit where they may see your face as they may pick up visual cues or be able to lip read to an extent. Use universal “sign language” gestures. Vision and/or Hearing Impairment

  15. Slowing of Speech • Speeding speech in addition to increasing the rate of flow of information also tends to degrade and/or distort the speech signal. • This is possibly the reason why older adults are more affected by speeding speech. Their auditory systems are unable to handle it.

  16. Patience • Most older adults or anyone with communication issues will be more than willing to work with someone who is making an effort to communicate with him or her. • Pay attention to non-verbal communication as well as what is being said. • The main ingredient is PATIENCE which along with EFFORT will ultimately lead to SUCCESS.

  17. RESOURCES Bialystok, E., Craik, F. I., Klein, R., & Viswanthan, M. (2004). Bilingualism, Aging, and Cognitive Control: Evidence from the Simon Task. Psychology and Aging,19(2), 290-303. Bryan, K., Axelrod, L., Maxim, J., Bell, L., & Jordan, L. (2002) Working with older people with communication difficulties: an evaluation of care worker training. Aging & Mental Health,6 (3), 248-254. Desselle, D. D. (2000). Advocating for the Elderly Hard-of- Hearing Population: The Deaf People We Ignore. SocialWork, 45(3). 277-281.

  18. Resources cont. Gutheil, I. A., & Heyman, J. C., (2005). Communication between older people and their health care agents: Results of an intervention. Health & Social Work, 30 (2). 107-116. Kirsch, I., Jungeblut, A., Jenkins, L. et al. (1993). Adult Literacy in America: A first look at the results of the National Adult Literary Survey. Washington DC: National Center for Education. US Department of Education, 1993. Miller, C. (2003). Visible Minorities: Deaf, blind, and special needs adult native literacy access. Canadian Journal of Native Education, 27 (1), 74-78.

  19. Resources cont. Sadler, et al. (2001). Brining health care information to the deaf community. Journal of Cancer Education,16 (2) 104-108. Senghas, R. J., & Monaghan, L. (2002). Signs of their times: Deaf communities and the culture of language. Annual. Rev. Anthropology. 31, 69-97. Schneider, B. A., Daneman, M., & Murphy, D. R. (2005). Speech Comprehension Difficulties in Older Adults: Cognitive slowing or age-related changes in hearing? Psychology & Aging, 20 (2), 261-271.

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