Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Section 2: Overcoming Unique Communication Barriers Module 3: Overcoming Communication

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Section 2: Overcoming Unique Communication Barriers

Module 3: Overcoming Communication Barriers


Topic Overview: Unique BarriersTopic Overview: Unique Barriers

• How can we communicate better with:

– Children?

– Teens?

– The elderly?

– The blind?

– The hearing-impaired?

– The speech-impaired?


Age Barriers to CommunicationAge Barriers to Communication


Age BarriersAge Barriers

• Communication concerns:

– Young children

– Adolescents

– Geriatric

– Caregivers

How can you relate to their life experience?


Communicating with Young ChildrenCommunicating with Young Children

• Speak softly

• Sit at their level

• Treat them with respect

• Inform before you perform

• Talk throughout each step and give praise


Communicating with TeenagersCommunicating with Teenagers

• Speak as you would to an adult

• Respect their independence

• Obtain health information from them instead of a parent (they may be reluctant to be honest if a parent is present)

• Ask personal questions privately

• Allow silence so they can express opinions


Communicating with Older AdultsCommunicating with Older Adults

• Reduce background noise

• Begin conversation with casual topics

• Keep sentences and questions short

• Allow them to answer at their own pace

• Explain findings in simple language

• Observe body language for understanding

• Speak plainly and have them repeat instructions


Vision and Hearing Barriers to Communication

Vision and Hearing Barriers to Communication


Visually ImpairedVisually Impaired

There are approximately 10 million blind and visually impaired persons in the United States.

• 1.3 million Americans are legally blind

• 5.5 million elderly are blind or visually impaired

• 55,200 children are legally blind


Communicating with the Visually ImpairedCommunicating with the Visually Impaired

• Greet them by name as soon as you enter the room

• Speak directly to them in a natural tone and speed

• Explain ahead of time the reason for touching

• Give clues that you are listening

• Explain and demonstrate sounds


Communicating with the Visually Impaired (cont.)Communicating with the Visually Impaired (cont.)

• Make sure explanations are precise and thorough

• Notify them when you leave the room and when you return

• Feel free to use words that refer to vision

• Indicate the end of the conversation

• Ask if they need assistance before trying to help them


Seating Patients with Visual ImpairmentSeating Patients with Visual Impairment

• Ask if they would like assistance

• Offer them your arm by tapping the back of your hand against the palm of their hand

• Relax and walk at a comfortable pace

• Pause when you change direction

• Once in the operatory, place the patient’s hand on the seat of the patient chair


Hearing ImpairedHearing Impaired

1 of every 10 persons has significant hearing loss

Presbycusis

• Everyone who lives long enough will develop some hearing loss

• 45% to 50% of persons 75 and older have some hearing loss


Communicating with the Hearing ImpairedCommunicating with the Hearing Impaired

• Move closer to the person

• Never shout

• Reduce background noise

• Talk face to face and at eye level

• Do not wear a mask when explaining or asking questions

• Use a notepad to write out words

• Make sure the person understands you


Speech Barriers to CommunicationSpeech Barriers to Communication


Speech ImpairmentSpeech Impairment

Difficulty with speech does not have anything to do with intelligence.


Common Forms of Speech or Voice ImpairmentCommon Forms of Speech or Voice Impairment• Dysarthria

• Aphasia

• Laryngectomy


DysarthriaDysarthria

• Speech problems caused by muscles involved with speaking or nerves controlling them

• Difficulty expressing certain words

• Slurred speech

• Speaking at a slow or rapid rate

• Drooling

• Limited tongue movement


Dysarthria (cont.)Dysarthria (cont.)

• Mumbling

• Abnormal rhythm

• Nasal or stuffy sound

• Chewing and swallowing difficulty


Causes of DysarthriaCauses of Dysarthria

• Poorly fitting dentures

• Stroke

• Brain injury

• Severe alcoholism


AphasiaAphasia

• Disorder from damage to language centers of the brain

• Trouble putting words in proper order in a sentence

• Diminished ability to understand oral directions, read, or write; or no ability to speak at all


Causes of AphasiaCauses of Aphasia

• Stroke

• Gunshot

• Severe blow to the head

• Traumatic brain injury

• Brain tumor

• Alzheimer’s disease

• Transient ischemic attack


Voice ImpairedVoice Impaired

• Laryngectomy is the surgical removal of the voice box because of cancer

• Artificial larynx held against the neck transmits an electronic sound

• Esophageal voice is achieved by pumping air into the upper esophagus and releasing it

• Surgical voice restoration fits a prosthesis between the trachea and esophagus

• Silent mouthing of words


Communicating with Patients Who Have a Speech ImpairmentCommunicating with Patients Who Have a Speech Impairment

• Book longer appointment times

• Speak directly to the patient

• Develop a tolerance for silence

• Do not talk while the patient is formulating a response

• Do not finish the patient’s sentences

• Establish a code for yes and no

• Use visual aids for explanations


Communicating with the Voice ImpairedCommunicating with the Voice Impaired

• Give the patient plenty of time to speak

• Do not hurry the patient

• Ask the patient to repeat if you do not understand

• Watch the patient’s lips

• Never assume that the patient is playing a joke if you hear an electronic-sounding voice


Recap: Unique Barriers to CommunicationRecap: Unique Barriers to Communication

• Providing patient-centered care involves learning to

communicate effectively with patients even when unique

barriers to communication are present.

• Unique communication concerns include:

– Age barriers

– Vision and hearing barriers

– Speech barriers

Documents

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Section 2: Overcoming Unique Communication Barriers Module 3: Overcoming Communication