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Communication - A Vital Role in Home Health

Communication is the vital link between you, the client and the agency. You communicate to help keep people safe, to respect their privacy, to give them dignity, to promote their independence and to help maintain infection control. You ability to send and receive messages helps other people understand you and makes it possible for you to understand others.

Communication Process - The process of communication involves five parts: a sender and a receiver, the channel, the message, and feedback. The sender is the person who begins the communication - the first speaker. The receiver is the person to whom the message is sent. The message is the actual expression of the thought, information, or opinion. The channel is the way the message is sent (verbal, non-verbal, written). Feedback is the return of information from the receiver to the sender. Feedback is used to tell whether or not the communication was successful.

Communicating With Your Client and Family Members

Effective communication starts with following basic principle - respect for the client and family as human beings. Listen to what they have to say. Listening is an essential part of the communication process. Good listening involves the use of eyes, ears, and feelings. It takes energy, concentration, and effort to be a good listener. Some suggestions to improve listening skills are:

  • Concentrate - LISTENING is HARD WORK
  • Take time to listen
  • Be patient and let the sender complete the message, even if it takes a lot of time.
  • Do not interrupt, let the speaker finish
  • Get feedback and give feedback
  • If you don't understand, do not let the person continue; say, “Would you please tell me again? I do not understand what you just said.”
  • Observe body language and facial expression
  • Listen to the tone of the sender's voice.
  • Do not think about how you will respond before the person has finished talking; use quiet time to mentally summarize main ideas.
  • Focus your attention on what is being said, not on what you will say later.
  • Show interest, use nonverbal communication to demonstrate your interest.
  • Give speaker your full attention
  • Listen for feelings
  • Ask questions that will encourage the speaker to continue
  • Do not be afraid of silence, observe, ask the client to tell you more and ask them how they feel about what they are discussing.
  • Do not finish sentences that the speaker begins.
  • Do not jump to conclusions by assuming that you know exactly what your client means.
  • Be aware of your own feelings and point of view.

Verbal Communication

  • Get the receiver's attention before you start talking
  • Use words that the receiver understands
  • Choose the right volume of your voice
  • Speak slowly and clearly
  • Smile as you speak, use your sense of humor
  • Give the client time to respond
  • Be aware of your tone of voice
  • Listen to the receiver

A Learned Skill - Communication is a skill that improves with practice. As your skill increases, you will be able to speak more clearly and send and receive more accurate messages. You will also be more sensitive to the nonverbal messages you are sending and receiving from your client and family. While there are many verbal communication techniques, you will find that a few will be used more often than others. Five examples follow:

  1. Use open-ended questions that may be answered with an explanation instead of closed question that can only be answered by a yes or no response. Example:
    Closed question: Open - ended question:
    a. Aide: “Did you eat all of your breakfast?” a. Aide “What did you eat for breakfast?”
    b. Client: “No” b. Client: “Nothing, I was too sick to eat.”
  2. Restate the message to let the client know you heard what is being said. This encourages further communication. For example:
    1. Aide: “You were sick this morning and didn't eat any breakfast.”
    2. Client: “That's right. After I took my pain pill, I felt like I was going to throw up, so I didn't have anything to eat.”
  3. Ask for clarification so the message may be clearly understood.
    1. Aide: “I am not sure I understand. You say that after you took your pain medicine you were too sick to eat breakfast and you felt like you were going to throw up.”
    2. Client: “Yes. Every time I take that darned medicine it makes me feel like throwing up. That's why I hate to take it, even though it eases the pain.”
  4. Summarize what you have been hearing.
    1. Aide: “This sounds like a problem to me.”
    2. Client: “It sure is. I've been putting up with this for a few weeks.”
  5. Share information with the client.
    1. Aide: “I'm going to call my supervisor about this. Maybe there is something that can be done to take care of this problem. What do you think about that?”
    2. Client: “Sounds good to me. I hope I don't have to put up with this much longer.”

The Hearing Impaired - they may or may not be deaf. Some with hearing impairments may have a problem hearing certain sounds. Here are some tips when communicating with the hearing impaired.

  • Learn what the client can and cannot hear
  • Encourage the wearing of their hearing aid
  • Approach from the front.
  • Get their attention before speaking
  • If one ear has better hearing speak into this ear
  • Use your hands, face, body and words to help them hear
  • Reduce background noise
  • Speak in short sentences
  • Write messages on paper

Caring for those with Dementia - They may have a head injury, Alzheimer's disease, dementia or merely be temporarily confused. It can be stressful and challenging to care for patients with behaviors you may not understand. Remember you must celebrate the person's life by looking beyond the disease and seeing the person inside. Here are some tips toward being successful in providing care to these individuals: They still need joy and pleasure in their life. Simple pleasures such as a warm comfortable bed, gentle massage, soft music, sweet smells and bright colors can add to the quality of their life. Compassionate care helps them feel secure.

Tips for Successful Communication -

  • Stand directly in front of them, maintain eye contact
  • Touch there arm or shoulder to keep their attention
  • Speak softly, slowly and clearly
  • Use simple words and sentences, repeat the same words
  • Use direct statements when you want them to do something. For example: “It's time to eat breakfast now.”
  • Allow extra time for them to understand and answer.
  • Use humor when possible and appropriate
  • Don't argue or confront them. Respond to the emotions they express
  • Remind them of their name, year, day.
  • Follow a simple set routine each day.
  • Do activities in small steps.
  • Avoid situations that call for the person to make choices or have to explain why.
  • Keep the environment calm and organized.
  • Talk about pleasant past events.

Communicating With Agency Personnel

As the eyes and ears of the team, you will be expected to report any problems or changes to your supervisor. You are to report what you observe with your senses:

Eyes - what you see Ears - what you hear Nose - what you smell Touch - what you feel

Report to Supervisor
  • A change in the physical condition of your client
  • A change in the client's emotional or mental condition
  • Signs of injury, neglect or abuse
  • A change in the home environment that may be hazardous for client and family
  • You do not understand a procedure or task
  • Problems with medications
  • You are unsure of how to proceed with your assignment
  • If the client/family ask you to do something that is not your responsibility
  • If you fee unsafe in the client's home
  • Document your observations
  • Document your conversations with your supervisor and with family members when appropriate.
  • Send documentation into the office at the end of each week.



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