Transcript What to Say and How to Say it: Eradicating Communication

What to Say and How to Say It:
Eradicating Communication Barriers
A Presentation by:
Jennifer Birkas, OT Reg.(Ont.)
Audrey Brown, M.Sc., SLP(C), Reg. CASLPO
What Are the Barriers YOU Face
When Talking to an Elderly Client?
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Sensory loss - hearing, vision
Cognitive impairments - attention, memory, etc.
Language barriers
Well-meaning caregivers
Beliefs/expectations about health care
Fatigue, physical limitations
Voice/speech/language disabilities (stroke,
Parkinson’s)
– Challenging communication environments
What About Your Clients? What
Do They Experience with Us?
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Expectations of the elderly
Limited time
Lots of education - technical jargon
Generation gap/less life experience
Narrow focus
Conflict in agenda
The Challenges Associated with
Dementia
• Sensory Memory
– problems with registration, recognition and
identification
• Short Term Memory (Working)
– problems with encoding/decoding
• Long Term Semantic, Episodic and
Procedural Memory
– problems with retrieval
Strategies for Sensory Memory
Difficulties
• Be calm, slow and use deliberate
movements
• Get close (but not too close), eye level
• Ensure attention first
• Open position and posture
• Use glasses, hearing aids, dentures
Strategies for Short Term
Memory Difficulties
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Give extra time for responses
Use a variety of modalities and cues
One step instructions
Keep words consistent if repeating
Use an inviting tone
Memory book or card with information for
repetitive questioning behaviours
Strategies for Long Term Memory
Difficulties
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Guest books, memory books, pictures
Maintain environmental cues
Avoid yes/no questions, use 2 choice
Signs and photographs/pictures at eye level
– Be mindful of font, colour and size
Clear Verbal Communication
• Organize your information
• Use common words - not jargon
• Give clients a chance to express how they
feel and to tell their story
• Make direct eye contact
• Plan with your clients what they can do
• Let your client know what you are thinking
Clear Verbal Communication
• Explain procedures and ask permission
during examinations
• Focus on your client
• Check that your clients have understood
what you have said
• Use humour when appropriate
• Use written information as a back up
Literacy and Older Adults
• 80% of older adults are working with the
lowest levels of literacy
• 60% never completed high school, 37%
have less than Grade 9 education
• Well informed seniors are healthier - quality
of life is better
Use of Written Materials with
Older Learners
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Dark print on light background
14 point type size with serif (T versus T )
Non glare surface
Lots of white space to separate ideas
Include only essential information
Circle or highlight the most important parts
in brochures or written information
Think about the other 10%
• Posture
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Forward (the sprinter pose)
Watch your hands!
Use of touch, proximity
Gestures
• Facial Expression
– Eye contact, eye movement
– Non-verbal communication can contradict
verbal communication
Elderspeak
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Short sentences with simple grammar
Exaggerated intonation
Very LOUD, S-L-O-W talk
Simple vocabulary, tag questions (“You’re
hungry, right?”)
• Short directives (“Walk here”)