Module 3 Overcoming Communication Barriers Section 2 Overcoming

Topic Overview: Unique Barriers • How can we communicate better with: – Children? – Teens? – The elderly? – The blind? – The hearing-impaired? – The speech-impaired? Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Age Barriers to Communication Copyright © 2010 Wolters Kluwer Health | Lippincott Williams &

Age Barriers • Communication concerns: – Young children – Adolescents – Geriatric – Caregivers How can you relate to their life experience? Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Communicating with Young Children • Speak softly • Sit at their level • Treat them with respect • Inform before you perform • Talk throughout each step and give praise Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Communicating 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Communicating 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Vision and Hearing Barriers to Communication Copyright © 2010 Wolters Kluwer Health | Lippincott

Visually Impaired There 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Communicating 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Seating 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Hearing 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Communicating 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Speech Barriers to Communication Copyright © 2010 Wolters Kluwer Health | Lippincott Williams &

Speech Impairment Difficulty with speech does not have anything to do with intelligence. Copyright

Common Forms of Speech or Voice Impairment • Dysarthria • Aphasia • Laryngectomy Copyright

Dysarthria • 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Dysarthria (cont. ) • Mumbling • Abnormal rhythm • Nasal or stuffy sound •

Causes of Dysarthria • Poorly fitting dentures • Stroke • Brain injury • Severe

Aphasia • 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Causes of Aphasia • Stroke • Gunshot • Severe blow to the head • Traumatic brain injury • Brain tumor • Alzheimer’s disease • Transient ischemic attack Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Voice 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Communicating 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Communicating 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Recap: 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 Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins