Download Communicating with the Visually Impaired

Module 3: Overcoming
Communication Barriers
Section 2: Overcoming Unique Communication Barriers
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Topic Overview: Unique Barriers
• How can we communicate better with:
– Children?
– Teens?
– The elderly?
– The blind?
– The hearing-impaired?
– The speech-impaired?
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Age Barriers to Communication
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Age Barriers
• Communication concerns:
– Young children
– Adolescents
– Geriatric
– Caregivers
How can you relate to their life experience?
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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
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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
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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
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Vision and Hearing Barriers
to Communication
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Visually 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
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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
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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
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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
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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
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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
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Speech Barriers to Communication
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Speech Impairment
Difficulty with speech does not have anything to do with
intelligence.
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Common Forms of Speech or Voice
Impairment
• Dysarthria
• Aphasia
• Laryngectomy
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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
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Dysarthria (cont.)
• Mumbling
• Abnormal rhythm
• Nasal or stuffy sound
• Chewing and swallowing difficulty
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Causes of Dysarthria
• Poorly fitting dentures
• Stroke
• Brain injury
• Severe alcoholism
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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
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Causes of Aphasia
• Stroke
• Gunshot
• Severe blow to the head
• Traumatic brain injury
• Brain tumor
• Alzheimer’s disease
• Transient ischemic attack
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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
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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
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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
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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