The elderly patients on the whole require more compassion, concentration and patience from the nursing staff to get their message across. There are many factors that increase the difficulty in communication between the nurses and the elderly. Patients perceive good communication as critical to the delivery of health care. (Adiar, 1994, Young, 1995) The common patient barriers to communication involve impaired hearing and vision, difference in the way of acting and verbal expression from the younger generation, cognitive and memory problems, physical problems, and environmental factors such as noise or poor lightening. (Park and Song, 2004) Whereas the common nurse related barriers have been assessed to be stereotyping, poor articulation, and excessive use of medical terminologies. (Lubinski and Wellan, 1997)
Many strategies have been described by nurses as being helpful in communication with patients who have verbal difficulties. The cases like of May usually require non verbal communication techniques along with verbal communication. Non verbal communication comprise mainly of seven indices. These are facial movements, gaze, touch, gesticulation, interpersonal spacing, posture and odor. (Barker, 1963, McBride, 1964, Scheflen, 1973, Henley, 1977, Argyle, 1994)
Nurses report looking at the patient and picking up clues such as facial expressions, eye gaze, and body language are extremely helpful. Another system is the yes and no system, where by the patient answers to the questions via head nods, eye blinks and foot taps etc. (Hemsley et al, 2001)
Watching for expressions on the face of patients such as relief expressions, repeating the questions to ascertain the yes or no response, rephrasing questions, adding animation or signs, and using pen and paper and pictures to communicate ideas have also been regarded as very helpful in achieving communication. (Hemsley et al, 2001)
Communication between the nurses and the patients can be improved significantly if nurses were trained to pick them in their surroundings. Nurses should develop an interest in caring for the elderly, since this will improve the overall attitude of the nurse towards providing care. Nurses should provide confidence to the patients so as to allow "disclosure" of patient's weaknesses. (Park and Song, 2005) The removal of physical environmental barriers will also help in better communication development. Many of the older patients do not respond well to the hospital environment. This problem can be alleviated if the nurses introduce and explain the hospital environment, so as to increase familiarity. (Park and Song, 2005)
The problem of generation gap can be minimized by educating the nurses of the perceptions of the patients and giving individual nurse care to the patients. (Park and Song, 2005)
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