Person-Centered Communication with Older Adults

The Professional Provider's Guide

Timothy A. Storlie

• Éditeur: Academic Press
• Année: 2015
• ISBN:
  9780128004333
• Sujet: Social Sciences
• Sous-sujet: Gerontology

Providers serving older adults face a growing problem. Older adults are becoming increasingly dissatisfied with service quality citing deficits in provider communication and relationship skills. The author argues this dissatisfaction is largely related to three widespread issues: ageism, use of professional jargon, and age-related changes in the older adult. To address these concerns, Dr. Storlie advocates adoption of an evidence-based, person-centered approach to communication.

The benefits of person-centered communication are many. They can increase older adult satisfaction with provider services, enhance mutual respect and understanding, improve accuracy of information exchanged, positively impact service outcomes, increase compliance with provider recommendations, and reduce the frustration and stress often experienced by both provider and older adult.

Rare to this genre, readers are introduced to several under-explored topics within the field of communication, along with methods for applying concepts from research findings into these topics to enhance the quality of interpersonal communication. Topics include the role of mental imagery in the communication process, the influence of neurocardiology on relationships, and controversial findings from research into quantum physics. The book concludes by highlighting progress made in narrowing the interpersonal communication gap and forecasts how communications-oriented technological advances might improve quality of life for 21st century older adults and the providers who serve them.

Utilizing interdisciplinary case studies to illustrate common problematic situations, this book provides detailed exercises that explain how providers can integrate person-centered communication into their practices to improve provider-older adult interactions. Written in a style designed to maximize learning, it helps providers find the information they need, understand what they read, and apply what they've learned to improve professional communication.

Person-Centered Communication with Older Adults is an essential guide for today's healthcare professionals and other aging-services providers, and also for the educators who help to prepare the providers of tomorrow.

• Presents a conceptual framework for understanding respect-based, person-centered communication
• Teaches specific communication skills to aging services providers and educators to assist in effectively communicating with older adults
• Includes numerous case studies to help in identifying common problematic situations and describing practical ways to integrate positive communication
• One of the first books to integrate scientific, evidence-based findings with a personal approach that includes important new information on neurocardiology

Chapter 1

Providers, Older Adults, and Communication

Abstract

Adults age 65 and older are the fastest growing population segment in the United States and globally. Growing numbers of older adults are voicing dissatisfaction with providers, citing poor-quality relationships and unsatisfactory interpersonal communication. Unsatisfactory communication impacts the quality of services and outcomes. Five causes of ineffective communication are the following: underdeveloped communication skills; lack of commitment to a person-centered approach; use of jargon; ageism; cultural differences; and age-related changes in the older adult. Providers adopting a person-centered approach can expect to improve overall communication, increase mutual respect and understanding, enhance accurate exchange of information, positively impact outcomes, and save time while lowering stress. The provider's task is to make the older adult's needs the central focus. Older adults want to be seen, heard, respected, and appreciated. Each wants to feel as if she or he matters enough for the provider to offer a few minutes of undivided attention.

Keywords

Ageism; Baby boomer; Communication; Older adult; Person centered; Plain Language; Professional jargon; Respect

I ka olelo ke ola, ika olelo ka make.

In the word there is life; in the word there is death.

Ancient Hawaiian Saying (Charcot, 1983)

Core Question: Why do so many older adults feel dissatisfied with the quality of their provider relationships, and how can providers reduce this dissatisfaction?

Keywords: Ageism; Baby boomer; Communication; Older adult; Personcentered; Plain language; Professional jargon; Respect.

Introduction

Words are potent. Within the sprawling aging services network, millions of providers interact with millions of older adults on a regular basis. During these professional interactions, each enters into a dance of words and gestures—a dance that conveys information (Dossey, 2011). This dance transmits meaning—meaning that can encourage or discourage, reassure or frighten. The purpose of this book is to encourage providers to use words purposefully—mindful of their power to help or harm the older adult.

Older adults (individuals age 65 or older) are the fastest growing segment of the population in the United States and globally (U.S. Bureau of the Census, 2011). This increase—due in part to the generation of baby boomers born between 1946 and 1964—is expected to continue until 2030 and significantly impact most aspects of society and the related network of service providers.

Growing numbers of older adults are voicing dissatisfaction with service providers (Greene & Burleson, 2003). The main reasons cited are the poor quality of the provider/older adult relationships and unsatisfactory interpersonal communication. Unsatisfactory communication can impact the quality of services rendered as well as service outcomes.

Ineffective, unsatisfactory communication has many causes. This chapter introduces five major causes that will be the focus of much discussion throughout this book:

1. Underdeveloped provider communication skills.

2. Lack of provider commitment to a person-centered service delivery approach.

3. Inappropriate use of professional jargon by providers.

4. Ageist attitudes and language by the provider.

5. Impediments to effective communication stemming from cultural differences and from age-related physical, social, and psychological changes in the older adult.

This book argues for a person-centered, respect-based, Plain Language approach to communicating with older adults. It explains how providers can communicate more effectively, more respectfully, and less stressfully.

Providing services to older adults can be rewarding, yet stressful (Tamparo & Lindh, 2008). Communication between providers and older adults is often perceived as demanding and challenging (Hart, 2010). Improved communication can deepen rapport, increase mutual respect and understanding, enhance accurate exchange of information, improve compliance with provider recommendations, positively impact outcomes, and often save time while lowering frustration and stress for the provider and the older adult.

A Message to Service Providers

Do older adults (individuals aged 65 or older) comprise a significant percentage of your patient, client, or customer base? Is communicating with older adults a regular and frequent part of your work? Are older adults one of the target groups for your practice, agency, or program?

Are you an educator helping students to prepare for a career that includes working with older adults? If you answered “yes” to any of the preceding questions, this book was written for you.

Every Older Adult Has a History and a Story—Here Is Frances’s

The medication aide at the assisted living facility—a thirty-something woman with two years of professional experience—glared at Frances and impatiently demanded she sit down and take her to prescribed medications. Eighty-eight-year-old Frances, a relatively new resident at the facility, complied and choked back her tears just long enough to return to the privacy of her apartment where she sat and cried off and on for the next hour.

As a pioneering nurse practitioner with a Ph.D., Frances had served thousands of patients during her long medical career. She helped establish intensive care units around the United States, taught in university nursing programs, served as keynote speaker for several national professional association meetings, and was the recipient of various prestigious professional awards.

A published poet and author of seven nursing-related text books and 112 professional journal articles, Frances completed over 45 medical mission trips to Central and South America since she retired. Today, she was being ordered where to sit and told what to do by a near-total stranger who was young enough to be her granddaughter—a stranger who knew next to nothing of her lifetime of professional achievements.

Frances finished describing her many accomplishments. She wiped away her tears, looked directly into my eyes and said, “Tim, I’d trade it all—all of it—for some old-fashioned human kindness, a little courtesy and respect” (personal conversation, 2013).

Unfortunately, Frances’s experience is not atypical. Her example showcases a major problem in the United States—the problem of disrespect often shown to older adults in a service-delivery system that is more frequently provider centered than person centered. During my experience as a home health and hospice medical social worker, I observed dozens of similar cases and situations where a patient, client, or resident was treated disrespectfully, interactions where each individual wanted only what Frances had wanted—a precious minute or two of another’s attention, given with kindness and respect.

The Older Adult Wants What Every Person Wants

Ideally—in an atmosphere of person-centered services—the older adult’s interests and needs remain central. Whether the older adults served by providers are called patients, clients, residents, customers, or consumers, they are—underneath all labels—unique individuals, each with a special story, a specific past, current conditions, and future aspirations.

The provider’s task is simple (yet frequently challenging): Keep the needs of the older adult as the central focus of service and see, hear, and interact with the individual as a unique person and not as a “patient,” “client,” or “customer.” Drench, Noonan, Sharby, and Ventura (2012) suggest that before taking action, the provider ask, “What are the client’s needs and how will this help him or her?” (p. 5).

In every encounter, olde...