Effective communication skills, and how to avoid toxic talk and communication neglect

1. Paige Thompson
April 6th, 2015
ASM 150
Week 2 Reflection
Identify and list the skills required to communicate effectively with the
elderly.
When communicating with the elderly, it is important to employ
several skills. You must listen, pay attention, maintain eye contact, and
display an active posture. You have to find a reason for listening, so you
naturally show a real interest in what they are saying. It is not enough for
them to speak; they need to be heard. It is also incredibly important to show
respect through maintaining personal space, and getting on eye level with the
person you’re speaking with. Be aware of your own non-verbal
communication and body language, as well as keeping an eye on the other
person’s nonverbal communication to see that they understand you and are
comfortable communicating with you. Give them plenty of time to process
what you are saying. Slow down your speaking pace, using a nice, relaxed
tone. Many older adults have more difficulty understanding rapid speech, as
well as higher pitches. Lower the tone of your voice, but don’t necessarily
raise your volume. Yelling into someone’s ear will only make communication
more difficult. You also need to develop an ability to rephrase, act out, and
simplify what you’re trying to express, in order to help the older adult better
understand you.

2. Describe the barriers to effective communication with the elderly.
Another important thing to keep in mind is to try to work around
barriers that older adults may face. Excess noise, light, or distractions can
make communication very difficult and ineffective. Make sure you are in a
quiet and comfortable environment. As mentioned previously, many older
adults have more difficulty understanding rapid speech, as well as higher
pitches of voice, so you must slow down your rate of speaking. Messages can
easily be lost in translation between the speaker/communicator and the older
adult, and vice versa. A common age-related barrier is hearing loss
(presbycusis), affecting how well older adults hear what you’re saying and
how you’re saying it, and vision loss (presbyopia), affecting how they “hear”
your nonverbal communication—gestures, facial expressions, and body
language, as well as reading written messages and seeing signs and symbols.
Many medical conditions can make it increasingly difficult to communicate
effectively: aphasia, dysarthria, agnosia, apraxia, cognitive loss and dementia,
and other conditions that affect speech, reading, writing, and comprehension.
The message may arrive intact, but the receiver cannot comprehend what the
message means, possibly due to physiological problems, or increasingly, due
to a language barrier. Or, as in the case of dysarthria and other conditions
affecting speech muscles and vocal cords, the message may be received and
well understood, but the older adult may not be capable of responding.

3. Possibly the most frustrating communication barrier occurs when the
message is heard, understood, and simply ignored. Attitude issues due to a
poor relationship between the two communicators can cause this. As
caregivers, we must do our best to make the older adult feel comfortable and
respected so as to avoid this issue.
Examine issues of toxic talk and communication neglect.
While not always intentional, communication neglect can be incredibly
harmful to older adults. Socialization is incredibly important in every human
being, and being denied that interaction can cause other health problems.
Communication neglect can sometimes be used as a punishment (“the silent
treatment”), but more frequently, it is done completely unintentionally. Busy
work schedules and heavy patient loads can cause healthcare workers to
simply avoid conversation with the elderly if they feel they don’t have time
for a full conversation. It can also occur when an older adult doesn’t respond
to attempts at conversation, and workers assume they don’t want to talk, are
unable to speak, or are too tired to visit. Unresponsiveness can be due to
several other reasons, and attempts to socialize should not be neglected, as
the older adult in turn becomes neglected. Another cause of unintentional
communication neglect is treating elders as objects, referring to them by their
condition or status, rather than by name or identity. This is often a result of
the difficult balance between confidentiality and dehumanization. It is

4. difficult to keep someone’s identity confidential in a public setting while still
allowing those to keep their human characteristics. And while protecting
someone’s humanity, it’s also important to avoid toxic talk—calling someone
names, using baby talk or a frustrated tone, discussing the patient or family in
a negative way, or generally speaking impolitely about the person, within
hearing distance or not.
List barriers you have experienced when communicating with the
elderly. Share strategies you have implemented to overcome those
barriers. Also, include an example of a personal situation where you and
an older adult were faced with barriers in your communication and how
you worked to overcome them to effectively communicate with each
other.
I have had several experiences with the elderly where communication
was more difficult than usual. I have a client that has a lot of confusion and
hearing loss. She hears better out of one ear than the other, so I make sure to
speak on that side of her, to speak slowly and clearly, but not to raise my
voice very much so as not to make my tone any harsher. I also make sure to
repeat things in simple terms to ensure she understands me. Another of my
clients often refuses to wear his hearing aids but then has difficulty hearing
me at a normal speaking level. He has asked me to speak louder for him, but I
also make sure to keep my words clear and simple. He has some anxiety
issues due to confusion, so I always make sure my tone is relaxed and
soothing as if I were talking to a friend, and while I prompt him with what to
do next, I try my best to not make it sound as if I’m telling him what to do, and

5. I give him options so he feels he’s still making his own decisions. A resident of
the facility where I work seems to have some mild agnosia, though I don’t
know that it’s officially diagnosed. She used to attend many activities and was
relatively social. Since moving to the health center, she is more withdrawn,
not in a depressed way, but is just indifferent to group settings. I found
recently that she’ll participate in a group setting, and if I make it clear to her
that I am speaking directly to her, through eye contact, using her name, and
sometimes touch, she will respond and actively participate. By putting forth a
little more effort on my end, I can see that she enjoys the interactions, instead
of passively observing others. I recently had an encounter with a man that has
Parkinson’s and his vocal volume and enunciation were obviously suffering to
the point that he could not communicate with someone to fill out a form, and
he wasn’t able to hold the pen well to write for himself. Because of his
symptoms, I was able to recognize that he needed a little help and offered to
assist him. We worked together with him speaking a little more slowly and
me sitting a little closer than usual to block out the environmental noise. We
also discovered that for longer words that were difficult to hear, spelling
them out was much more efficient and we quickly completed the form
together.