Communication Strategies Flashcards
Dementia Pt: need to perform PROM exercise
- State the issue that limit communication:
- Incoherent Pt with dementia - Who will you be communicating with?
- Regardless of their communication limitation (incoherent), I would never exclude the Pt from the conversation
- I would communicate directly with the Pt - What strategies will I use to establish therapeutic communication
- Pt has severe dementia symptoms and is incoherent. She is also unable to follow cues and has difficulty communicating
Set the stage:
- Approach slowly, avoid startling the Pt
- Get eye level to greet the Pt
- Warm and friendly
Communication strategies:
- Speak slowly and use gestures
- Yes/No questions and allow enough time to respond
- Clear single-step instruction
- Hand over hand to assist with movement
- Ensure the task of PROM is done slowly to start
- Watch for Pt’s body language and watch for cues demonstrating discomfort or pain
Pt don’t speak English: mobilizing
- State the issue that limit communication:
- Pt don’t speak the same language as the PT - Who will you be communicating with?
- Regardless of their communication limitation (dun speak the sme language as the PT), I would never exclude the Pt from the conversation
- I would communicate directly with the Pt - What strategies will I use to establish therapeutic communication
- Language barrier can make it difficult for the Pt to understand the proposed treatment and its risks
Best to worst
- Translator (hosiptal in urban area)
- Co-worker/another health professional who speaks Punjabi (rural/private setting)
- If Pt family/friends arrive: use them but ensure accurate translation between family/frd and the Pt
–>Close attention to Pt: If they appear uncomfortable or unwilling to participate in te Ax/Rx plan–>wait and get an interpreter
- Use google translation
Dementia Pt become slight confused and do not respond when you ask if they want to participate in the exercise
- State the issue that limit communication:
- Dementia with verbral communication difficulties - Who will you be communicating with?
- Regardless of their communication limitation (as above), I would never exclude the Pt from the conversation
- I would communicate directly with the Pt - What strategies will I use to establish therapeutic communication
Basic understanding about dementia comm
-a range of dementia severit and that dementia symptoms can fluctuate significantly - even thoughout a day/PT session
- Treat the Pt as an individual and implement the appropriate communication strategies based on their dementia symptoms at that very moment
I am aware that Pts with dementia can feel confused and anxious and it’s important that I develop a level of trust with my Pt to involve them in care. In order to engage them in their exercises, I would want to do the following
- Gain their interest in participating by asking them what they would like to do first
- Act in a reassuring and encouraging manner
C4 SCI Intubated
Limitation
- Intubation preventing verbal speech
- C4 SCI prevent non-verbal language such as arm gesture
Strategies
- Incredibly vulnerable time for this Pt–>take extra time to communicate effectively
Incorporate blinking as a strategy to communicate
- set up a system: blink once=yes, twice=no
- Yes/No question, easier for the Pt to respond
Stroke: global aphasia come with son (SDM)
Limit
- Global aphasia= unable to understand/express language
Who will you communicate
- I can take the son’s word and do not require paperwork to confirm that they are SDM
- Althought the Pt has a SDM, I would work with my Pt and their son to establish a clear method of communicating.
- The son knows the Pt well and can provide benefit during the session
Strategies
- Use the son to help interpret their mothe’s wishes (based on know behaviours and actions) and do my best to gain consent from the Pt using other methods of communication other than verbal.
- ask the son to help me interpret his mother’s facial signs and actions as they know their loved one best
What facaial expression does your mom make when upset/pain/frustrated
Communicate with a Pt with Hx of sexual abuse and nervous to attend PT sessions
Issue
- Hx of sexual abuse and is nervous to partake in PT
**Strategies*
- Ask the Pt if they would prefer a private room for Rx
- Spend extra care gaining informed conset
- Continually explain what we are doing or plan to do and gain informed consent each step of the way
- Take extra time to hear the Pt’s story and understand why they are seeking my help
- Aim to build a rapport with them so we build our therapeutic alliance
- Demonstrate respect for the Pt’s boundaries and acknowledge that I understand recover from abuse is not linear and I would check in with them often and adjust care as needed
- I would encouraged the Pt to be an active participant in their own health care
Concussion Pt: Pt wife want Pt to return to work next week
Identify the issue
- The Pt’s wife has an unrealistic expectation of their spouse’s recovery
- No safety issue now but the situation can escalate to the point where the Pt feels pressure to return to work early–>important to manage both the Pt and their spouse’s expectations early
Create, communicate, and document a plan of action
- Discuss a more realistic plan for return to work
- Educate the Pt and their spouse about concussion recovery timelines, current issues affecting their recovery and an expected plan for return to work
- Document the discussion
Monitor the situation
- Make sure both of their questions around expected recovery are heard and responded to
Pt always on their phone, arriving late, acting bored during the sessions
Issue
Not actively participate in her own care
Create, communicate and document a plan of action
- Connect with the Pt about their goals
- Ensure the Pt understands their Rx options and care plan and make sure it aligns with their goals
- Empower the Pt to become involved in their own care so they can make informed decisions and take control of their back pain
Monitor
- Continually check in with my Pt to make sure we are working toward her goals and she is an active collaboratory in her own care plan
- If in later sessions the Pt seems uninterested and unwilling to particiapte–>might discontinue care even though the Pt still requires treatment.
Make sure I had exhausted all options of trying to involve the Pt in their care
