Question

Discussion Board 3.1: Communicating with Patient's Records

11 unread reply.11 reply.

Discussion:

Communication is the key to a successful interaction with a patient. However, there can be challenges along the way. Age, culture, and education all play an important role in how people respond to your care.  

Objectives:

• To understand how to communicate with people in the medical environment under unusual circumstances.

Instructions:

Respond to the following: Choose one of the communication issues below and explain what issues you may have with communicating with this patient and how you can overcome these issues. Make sure you cite at least 2 outside sources for your solution to the issue

• You are working with a family of a young autistic child
• You are working with an elderly person who has comprehension issues/dementia
• You are working in the inner city with a person who has an 8th-grade education
• You are working with an Orthodox Jewish woman/man ( opposite sex)
• You have a 3-year-old child and both her parents
• You have a 16-year-old boy with his mother in the lab

Answer 1

Here I have selected a situation in which a nurse is working with an elderly person who has comprehension issues/dementia. Let us see what are the possible communication issues that may arise while caring for such a patient.

1. Working with a client with dementia would be difficult as they may have memory disorders, personality changes, and impaired reasoning.
2. Poor comprehension is one of the communication deficits that is seen in an individual with dementia. They may not be able to continue the flow of conversation and the thought process can also be incomplete. For better understanding the nurse may communicate withn short sentences using easy to understand words and avoid lengthy and complicated utterances.
3. Processing speed declines in dementia. So speak slowly and clearly without changing the normal rhythm of speech,it will help to improve understanding.
4. The technique of presenting the world to talk about before the nurse starts talking about it will help to improve the comprehension. For example instead of saying" Mrs. Victoria, its time for breakfast" you may take the client to the breakfast table, show her the items and tell "Mrs.Victoria, Your breakfast is ready,have it". By providing a proper contextual support, comprehension is benefited, and agitation from part of client could be avoided.
5. The client with dementia is at risk of cognitive overload that may occur as a result of an attempt to process an information, for example to perform the co-referencing of a pronoun to its referent. The nurse can avoid using pronouns like he or she. Instead can repeat the names to avoid strain on then client. For eg: "Mr.Graham is here. He has bought a bunch of fresh flowers for you" may be a confusing statement for a client with dementia whereas the statement "Mr.Graham is here. Mr.Graham has bought a bunch of fresh flowers for you" may be more comprehensible though it sounds strange.
6. For individuals with dementia passive voice is cognitively difficult to understand and should be avoided. For example a nurse to avoid staements like "These tablets are to be taken in at bed time", instead "take these tablets at bedtime" may help in comprehending.
7. The people with dementia are unlikely to respond to open ended questions like ,"how do you feel now" , "tell me about the status of your pain", instead the nurse could use statements like, "does it hurts here or here?", "did you fall down" etc.
8. Slowing up the interaction may lead to a better communication
9. Nurse can show patience and wait for the response from the client
10. Non verbal communication techniques like a relaxed posture,eye to eye contact and a pleasant look and smile could help in developing a therapeutic relationship with the client.
11. Inorder to aid in memorising things,nurse can help the client to maintain an activity dairy for reference to keep in pace with the daily targets.