I remember reading in a nursing textbook many years ago that good communication is the bridge between confusion and clarity. Effective communication in healthcare, particularly in the aged care sector is vital to ensure our most vulnerable are not only kept safe but they are happy, comfortable and feel respected in the place they call home.
Each day within the aged care sector nurses and carers are presented with challenges preventing them from being able to effectively communicate with their residents. These include; limited time with each resident due to increased patient to staff ratios, inappropriate use or lack of communication aids such as glasses, hearing aids and other communication tools, language barriers and a lack of consistency in carers. Being an aged care staff member is complex, requiring patience, poise and a deep want to help others without seeking anything in return.
Throughout this post we will explore how aged care staff such as nurses and carers can best communicate with their residents to provide the ultimate, positive, patient centered care experience.
1. Address a person by their preferred name, not 'dear’, ‘mate’ or 'love'
Kickstart your interaction the right way by using names they are fond of. If you have never met a particular resident before, ask what they would like to be called. If you've been looking after the resident for some time it might be worth double checking what name they would like to go by instead of assuming you have been right the entire time. If you're not sure, ask. For clients who are non-verbal, don’t be afraid to call the family and ask for advice.
2. Use aids where appropriate
To effectively communicate, some residents require the use of reading glasses, hearing aids, dentures, contact lenses, a tracheostomy filter and even writing boards. Without these special and often unique pieces of equipment patients can feel detached and isolated, limiting their ability to effectively communicate.
Furthermore, along with communication aids, some residents don’t feel comfortable communicating without a specific piece of clothing or jewellery on them at all times.
The challenge for aged care staff is that often residents cannot voice their need for such aids or demands and hence require sound documentation and handover between staff to ensure appropriate and timely fitting, removal and cleaning of such aids. If you are new to a facility or a new resident has been admitted, ensure you have a good understanding of their likes and dislikes and importantly what they require to communicate effectively.
3. Show clear intentions
Tell (and show if necessary) what you are doing or going to do. Avoid surprising the person with an unexpected behaviour as this could seem intimidating and even frightening. Move slowly with purpose and in a predictable manner, explaining what you are doing at the time. Though you may think you sound silly and repetitive, you are in their safe space and they need to feel respected and know exactly what’s going on. Consistency is key so avoid making abrupt changes to their routines.
If possible, get the resident involved in their care. Give them choices where appropriate such as the soap to use, do they want to help wash themselves, what would they like to wear? Enable them to feel empowered.
4. Build Trust
Residents in the aged care setting have likely moved out of their family home and into a new place that is unfamiliar for a magnitude of reasons. This can be frightening and unsettling requiring staff and also their families to go that extra mile establishing a new normal in which they feel safe.
Building trust can be quickly established through the use of family photos, personal belongings and caring about them on a personal level. Staff need to identify what items, hobbies and even things they liked to do prior to arrival and start to incorporate these into daily life. Once the residents start to feel comfortable, communication channels will likely open.
5. Pay attention to non-verbal cues
Eye contact, posture, tone of voice, body movements, breathing and even simple gestures can tell another person how you’re feeling significantly more than words can alone.
When engaging with aged care residents try and focus on using open body language. For example, sitting or moving to a position where you are level with the person instead of standing over them. Uncross your arms and try to maintain good eye contact. For patients with dementia, simply touching their arm or holding their hand can assure them you are not a threat and they are in a safe space.
6. Use words of encouragement
Try and approach each resident with a positive and open demeanour. Remember you, and potentially a small handful of other staff, may be the only person who that resident has contact with for the entire day. Make it count. Knock before entering their space and smile as you make eye contact despite how many jobs you know you need to complete. These few seconds make an excellent and safe first impression potentially opening up previously closed communication paths. Avoid mumbling, speak slowly but with purpose and ask direct questions where appropriate. Dodge using words and phrases of reassurance and encouragement if you believe they will be insulting and instead stick to talking about tasks for the day and stories of the past to fill the silence.
7. Cultural considerations
The beautiful thing about working in aged care within Australia is that we are a multicultural society. Our residents can come from all over the world bringing with them often new languages, different sets of values and cultural beliefs. So in order to effectively communicate with every resident fairly, aged care facilities must create an environment where residents not only feel they can express themselves but where they are being heard. For example, staff could be given the tools to learn some basic language such as “pain”, “toilet” and “hungry” and also be given an opportunity to learn some key cultural differences to make those residences feel safe and heard.
8. Take care when multitasking
Residents know when you are not giving them your undivided attention. They can feel when you are rushing and are so stretched for time you are trying to balance their needs with that of others. Even if they do partially understand your workload it doesn’t make them feel good as they feel more like a number than a person.
Though difficult, try where possible to fully engage with a resident before moving onto the next task. Make the residence feel valued even if it takes you a few minutes longer.
In summary, to effectively communicate within the aged care system it takes just more than a single staff member. It takes an entire team to create a space which is safe, welcoming and allows the resident to speak and act with the intention of being heard.
Emma Smith
Registered Nurse
Co-founder of The Other Shift
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