Special care dentistry - role of the carer AND PT'S PERSPECTIVES (2 lectures) Flashcards
List the forms of support
Advocacy services
Paid formal carers
Paid informal carers
Volunteers
Define communication
A continuous transactional process involving participants operating within specific contexts whereby they create a relationship by sending and receiving messages via channels, many of which are distorted by noise
What are the models of communication?
Linear - uni-directional transfer of a message. No feedback.
Interactive - 2 way exchange of information includes feedback, context and noise
Transactional - simultaneous communication whereby a message is created between 2 or more people
What are the misconceptions of communication?
Meanings are in words More communication is better Communication solves all problems Communication is simple Effective communication is a natural ability
Communication context?
Psychological Relational Environmental Situational Cultural
Implications for decision making?
Difficult to achieve because of poor communication skills
Lack of opportunities for decision making
Society displays incompetence in lacking the requisite communication skills to interact meaningfully with people with communication impairments
Reasons for limited communication opportunities?
Limited range of interactions, lack of communication partners
Oral/muscular impairments, sensory impairment, memory deficit or language delay
Delays in speech, language, communication performance
Illness
Limited language use and speech intelligibility
Difficulty establishing rapport
Overestimation of individual understanding of verbal language or failure to interpret non-verbal behaviour
Reliance on others = impoverished communication
What are healthcare workers lacking?
They lack the requisite communication skills to meaningfully interact with people with communication impairments = reduces opportunities for decision making
How do healthcare professionals display competence?
Possess or employ the requisite communication skills to ensure meaningful transactions with people with communication impairments = enhances their opportunities for decision making
How to support someone to make a decision?
Explain the consequences or outcomes of a particular choice or decision
Increasing the existing knowledge of a person to facilitate a choice or decision
Examples of communication aids?
Information sheets or DVDs explaining - pt can review before making a decision Picture banks Photosymbols Picture exchange communication systems Address your own communication skills
What is makaton?
Helps children and adults with a broad range of communication needs
Interactors of all kinds
Educational and service providers
Advantages of photos, pictures and symbols?
Understand info - for those who do not read or find it hard to understand when you explain things Help get message across Some people do not communicate verbally Speech can be hard to understand Pictures are permanent
Can help people:
- Get their message across
- Make choices - especially if find it hard to make in head
Advantages of symbols?
Communication -
making a symbol communication book can help people make
choices.
• Independence and participation -
symbols aid understanding which can increase involvement,
choice and confidence.
• Literacy and learning -
symbol software encourage users to “write” by selecting symbols
from a predetermined set in a grid.
• Creativity and self expression -
writing letters and stories and expressing your own opinions.
• Access to information -
all of us need accessible information and this should be presented
in such a way that the reader can understand and use.
People who regularly use symbols?
People learning English as their 2nd language
People with memory difficulties, dementia or cognitive impairments
People with dyslexia, dyspraxia or spatial/time/organisational difficulties
Deaf or hearing impaired
Young children who don’t read yet
Autism
Learning difficulties/difficulties
Limitations of photos, pictures and symbols?
2D image representation of an object or idea
Profound communication impairments - do not use pictures or symbols. Use an object to help explain what you’re saying
May not be able to tell what a picture represents
Some may not be able to read word underneath
What do carers do?
Onus on the supporter of individuals who are
facilitated on a daily basis by support services
to enable the individual to play an active part
in health care decision – making. Enablement
can take many forms but it is only in forming
partnerships between services, supporters,
and individuals in receipt of support that
successful healthcare decision making can
occur.
Carer needs?
• May be unable to work, work less, and have to give up work, or take early retirement
• May be under a high level of stress: carer burn- out
• May feel under or devalued
• May have to delay or avoid marriage or having children
• Social life may change and they may be isolated
• May have a profound effect in terms of personal,
financial and social consequences for the supporter
Professional-carer partnerships requires sensitive listening and enabling questions - define both
Sensitive listening – listening to supporter
needs and using advanced empathy without
imposing a point of view can identify where you
may be helpful and attending to the needs of
the supporter may have a direct impact on how
the patient is enabled
• Enabling questions – using probing questions
that are non-confrontational prompts care
givers to talk about their needs, clarify their
meanings, and come up with solutions to care
rather than have a practitioner suggest them.
What are the learning points when working with carers?
Carer’s own agendas
• Frustrating for supported person
• Inaccuracies
• Presumptions about carer competence and
understanding
• Multiple carer roles leads to role conflict
How to work with pts with a carer?
Talk to carers about any likely reactions the
patient may have to the examination (the carer
will usually know)
• Get to know the patient and how they like things
to be done
• Be prepared for (un)likely reactions
• Don’t be in a hurry to see the next patient – allow
more time
• Discuss any treatment and procedures thoroughly
with carers before embarking on them including a
plan of action for if things don’t go as expected.
• Allow the carer to be present if necessary – it
might avoid any bad reactions if the patient is
stressed by what is happening
