1
Uncovering the Message ofUncovering the Message of
the Nonverbal Older Adultthe Nonverbal Older Adult
R. A. Weise, M.D.R...
2
The Nonverbal Older AdultThe Nonverbal Older Adult
A Man Called PeterA Man Called Peter
3
• What isWhat is nonverbalnonverbal communicationcommunication??
Nonverbal communication is the giving or sharingNonver...
4
The Purpose of Communication inThe Purpose of Communication in
Health CareHealth Care
• To “communicate”, inTo “communic...
5
• To “communicate”, inTo “communicate”, in HealthHealth CareCare, means:, means:
 to provide general health relatedto p...
6
The Purpose ofThe Purpose of
Communication inCommunication in
Health CareHealth Care
Is, ultimately, to promoteIs, ultim...
7
What is Healing?What is Healing?
8
What Healing is Not!What Healing is Not!
• HealingHealing isis notnot fixingfixing
““Fixing”, in Latin, means to “make ...
9
What Healing is Not!What Healing is Not!
• FixingFixing emphasizes:emphasizes:
ResultsResults overover relationshipsrel...
10
Healing is Not Fixing!Healing is Not Fixing!
• Today’s healthcare is, all to often, basedToday’s healthcare is, all to ...
11
Healing is Not Fixing!Healing is Not Fixing!
2.2. HealthcareHealthcare has become more and morehas become more and more...
12
Medical SpecialtiesMedical Specialties
Engeman, 1964Engeman, 1964
• PediatricsPediatrics
• OpthomologyOpthomology
• Neu...
13
Medical SpecialtiesMedical Specialties
ABIM, Maintenance of Certification, 2007
• Allergy/ImmunologyAllergy/Immunology
...
14
Healing vs. FixingHealing vs. Fixing
IfIf healinghealing isis notnot fixingfixing,,
thenthen whatwhat isis healingheali...
15
What isWhat is HealingHealing??
• HealingHealing is theis the dynamic,dynamic, creativecreative
processprocess of helpi...
16
What is Healing?What is Healing?
• HealingHealing Emphasizes:Emphasizes:
ConnectionConnection over outcomeover outcome...
17
• Health care communication must, not only,Health care communication must, not only,
supply competent fixing but, also,...
18
Uncovering the Message of theUncovering the Message of the
Nonverbal Older AdultNonverbal Older Adult
Barriers to Effec...
19
Barriers toBarriers to EffectiveEffective CommunicationCommunication inin thethe
Nonverbal Older AdultNonverbal Older A...
20
Barriers to Effective CommunicationBarriers to Effective Communication
inin thethe
Nonverbal Older AdultNonverbal Older...
21
DefinitionsDefinitions
• Aging: post maturational / intrinsicAging: post maturational / intrinsic
deteriorationdeterior...
22
DefinitionsDefinitions
• AgingAging:: ChangeChange over Timeover Time
• NormalNormal AgingAging:: BalancedBalanced chan...
23
NormalNormal AgingAging
• We age inWe age in fourfour domainsdomains::
 PhysicallyPhysically
 EmotionallyEmotionally
...
24
GeneralGeneral Principles ofPrinciples of Normal AgingNormal Aging
1.1. Aging isAging is gradualgradual
 large physiol...
25
GeneralGeneral Principles ofPrinciples of NormalNormal AgingAging
4.4. With old age comes aWith old age comes a diminis...
26
SpecificSpecific Changes Associated withChanges Associated with
NormalNormal AgingAging
• What can weWhat can we expect...
27
Normal Aging andNormal Aging and CNSCNS FunctionFunction
• MemoryMemory slowsslows downdown with age (age associated me...
28
CNSCNS FunctionFunction
• Visual-SpatialVisual-Spatial coordinationcoordination declinesdeclines with agewith age
 per...
29
Normal AgingNormal Aging of theof the SensorySensory SystemSystem
• HearingHearing
 High-pitched hearing loss (Presbyc...
30
SensorySensory SystemSystem
ello i Aleian Broerello i Aleian Broer
Medical enterMedical enter
31
SensorySensory SystemSystem
• VisionVision
 lens becomes thicker and more dense;lens becomes thicker and more dense;
...
32
SensorySensory SystemSystem
• TasteTaste
 decreases in acuity with old agedecreases in acuity with old age
 saliva pr...
33
NormalNormal AgingAging andand MovementMovement
• MusclesMuscles
decrease in size and strength with age (50 %)decrease...
34
MovementMovement
• BalanceBalance
-- complexcomplex mechanismmechanism involving brain,involving brain,
vessels, skin, ...
35
SexualitySexuality andand NormalNormal AgingAging
• DesireDesire persistspersists into advanced ageinto advanced age in...
36
SexualitySexuality andand Normal AgingNormal Aging
• The frequency of sexual intercourse amongThe frequency of sexual i...
37
EmotionalEmotional AgingAging
• LossLoss is the hallmark of emotional agingis the hallmark of emotional aging
• With ag...
38
SocialSocial AgingAging
• Can promoteCan promote isolationisolation
• With advancing age:With advancing age:
OurOur on...
39
• Physical Aging can lead toAging can lead to DependencyDependency
• EmotionalEmotional Aging can lead to toAging can l...
40
41
TheThe AgingAging SpiritSpirit
• TheThe MostMost ImportantImportant Domain of AgingDomain of Aging
Operates onOperates...
42
43
44
• PhysicalPhysical AgingAging can lead tocan lead to DependencyDependency
• EmotionalEmotional Aging can lead toAging c...
45
TheThe AgingAging SpiritSpirit
• Provides theProvides the powerpower toto transformtransform::
- DependencyDependency i...
46
Barriers toBarriers to EffectiveEffective CommunicationCommunication inin thethe
Nonverbal Older AdultNonverbal Older A...
47
• DiseaseDisease creates significant barriers to optimumcreates significant barriers to optimum
communication with nonv...
48
Barriers toBarriers to EffectiveEffective CommunicationCommunication inin thethe
Nonverbal Older AdultNonverbal Older A...
49
• EnvironmentalEnvironmental pressures can significantly reducepressures can significantly reduce
communication with th...
50
How toHow to ImproveImprove CommunicationCommunication
with thewith the Nonverbal Older AdultNonverbal Older Adult
Unco...
51
I.I. GeneralGeneral principlesprinciples of nonverbalof nonverbal
communication in older adults:communication in older ...
52
II.II. SpecificSpecific strategiesstrategies to enhanceto enhance
communication with the nonverbal oldercommunication w...
53
How to Improve Communication with theHow to Improve Communication with the
Nonverbal Older AdultNonverbal Older Adult
I...
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1.1. OverOver comingcoming the barriers ofthe barriers of NormalNormal AgingAging
a)a) Slow down all interactionsSlow d...
55
2.2. OverOver comingcoming the barriers ofthe barriers of EmotionalEmotional AgingAging
a)a) Identify the feelings/emot...
56
3.3. OverOver comingcoming the barriers ofthe barriers of SocialSocial AgingAging
a)a) Determine to connect to them and...
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4.4. OverOver comingcoming the barrier of anthe barrier of an ApatheticApathetic SpiritSpirit
a)a) The most difficult o...
58
2.2. OverOver comingcoming the barriers caused bythe barriers caused by DiseaseDisease
a)a) Comprehensive Geriatric Ass...
59
c)c) Over coming barriers caused by theOver coming barriers caused by the
EnvironmentEnvironment
a)a) Mobilize the pati...
60
Uncovering the Message of the the NonverbalUncovering the Message of the the Nonverbal
Older AdultOlder Adult
• Underst...
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Uncovering the Message from the Non-Verbal Older Adult

  1. 1. 1 Uncovering the Message ofUncovering the Message of the Nonverbal Older Adultthe Nonverbal Older Adult R. A. Weise, M.D.R. A. Weise, M.D. Medical DirectorMedical Director Alexian Older Adult Health CareAlexian Older Adult Health Care
  2. 2. 2 The Nonverbal Older AdultThe Nonverbal Older Adult A Man Called PeterA Man Called Peter
  3. 3. 3 • What isWhat is nonverbalnonverbal communicationcommunication?? Nonverbal communication is the giving or sharingNonverbal communication is the giving or sharing of information or knowledge, in the context ofof information or knowledge, in the context of feelings/emotions, without using wordsfeelings/emotions, without using words Nonverbal communication usually consists of:Nonverbal communication usually consists of: Facial expressionsFacial expressions Body language/posturesBody language/postures Information conveyed through touch, taste, smell, sight,Information conveyed through touch, taste, smell, sight, and hearingand hearing Emotional behaviorsEmotional behaviors Uncovering the Message of the NonverbalUncovering the Message of the Nonverbal Older AdultOlder Adult
  4. 4. 4 The Purpose of Communication inThe Purpose of Communication in Health CareHealth Care • To “communicate”, inTo “communicate”, in LatinLatin, means :, means :  to impartto impart  to participateto participate • To “communicate”, inTo “communicate”, in EnglishEnglish, means:, means:  to convey knowledge or informationto convey knowledge or information  to make knownto make known  to shareto share
  5. 5. 5 • To “communicate”, inTo “communicate”, in HealthHealth CareCare, means:, means:  to provide general health relatedto provide general health related informationinformation  to giveto give counselcounsel for specific personal illnessfor specific personal illness  to applyto apply technologytechnology for disease managementfor disease management  to promote anto promote an understandingunderstanding of health care costsof health care costs  to extendto extend compassioncompassion  toto carecare about the patient/client/residentabout the patient/client/resident The Purpose of Communication inThe Purpose of Communication in Health CareHealth Care
  6. 6. 6 The Purpose ofThe Purpose of Communication inCommunication in Health CareHealth Care Is, ultimately, to promoteIs, ultimately, to promote healinghealing notnot justjust fixingfixing
  7. 7. 7 What is Healing?What is Healing?
  8. 8. 8 What Healing is Not!What Healing is Not! • HealingHealing isis notnot fixingfixing ““Fixing”, in Latin, means to “make firmFixing”, in Latin, means to “make firm or to fasten”, i.e. to tighten somethingor to fasten”, i.e. to tighten something that is loosethat is loose In English, “to fix” means “toIn English, “to fix” means “to repairrepair ””
  9. 9. 9 What Healing is Not!What Healing is Not! • FixingFixing emphasizes:emphasizes: ResultsResults overover relationshipsrelationships PartsParts over theover the wholewhole ProductsProducts overover personspersons RepairRepair overover renewalrenewal
  10. 10. 10 Healing is Not Fixing!Healing is Not Fixing! • Today’s healthcare is, all to often, basedToday’s healthcare is, all to often, based upon “upon “fixingfixing”” 1. We have improved our “1. We have improved our “outcomesoutcomes” (results) in” (results) in reducing the impact of cardiovascular disease;reducing the impact of cardiovascular disease; cancer, infection, etc..cancer, infection, etc.. While, at the same time,While, at the same time, reducingreducing patientpatient // professionalprofessional caregivercaregiver relationshipsrelationships, i.e. acute care, i.e. acute care nurse to patient ratios (in reality) are risingnurse to patient ratios (in reality) are rising (1:4 in 1991, and now 1:6 ?).(1:4 in 1991, and now 1:6 ?).
  11. 11. 11 Healing is Not Fixing!Healing is Not Fixing! 2.2. HealthcareHealthcare has become more and morehas become more and more fragmentedfragmented, placing the responsibility for, placing the responsibility for patient care in the hands of thepatient care in the hands of the consultantconsultant rather than in the hands of therather than in the hands of the primaryprimary carecare physicianphysician.. This diffusion of careThis diffusion of care dilutesdilutes responsiblyresponsibly for thefor the whole (total) patient.whole (total) patient. The technological repair of the “part” becomes moreThe technological repair of the “part” becomes more important than the renewal of the “whole”(person).important than the renewal of the “whole”(person).
  12. 12. 12 Medical SpecialtiesMedical Specialties Engeman, 1964Engeman, 1964 • PediatricsPediatrics • OpthomologyOpthomology • NeurologyNeurology • OrthopedicsOrthopedics • DermatologyDermatology • PathologyPathology • Public HealthPublic Health • PsychiatryPsychiatry • SurgerySurgery
  13. 13. 13 Medical SpecialtiesMedical Specialties ABIM, Maintenance of Certification, 2007 • Allergy/ImmunologyAllergy/Immunology • AnesthesiologyAnesthesiology • Colon/Rectal SurgeryColon/Rectal Surgery • DermatologyDermatology • Emergency MedicineEmergency Medicine • Family PracticeFamily Practice • GeneticsGenetics • NeurosurgeryNeurosurgery • NeurologyNeurology • PsychiatryPsychiatry • Nuclear MedicineNuclear Medicine • Internal MedicineInternal Medicine • UrologyUrology • Nuclear MedicineNuclear Medicine • RadiologyRadiology • OB/GYNOB/GYN • OpthomologyOpthomology • OrthopedicsOrthopedics • ENTENT • PathologyPathology • PediatricsPediatrics • Physical Medicine/RehabPhysical Medicine/Rehab • Plastic SurgeryPlastic Surgery • Preventative MedicinePreventative Medicine • General SurgeryGeneral Surgery • Thoracic SurgeryThoracic Surgery
  14. 14. 14 Healing vs. FixingHealing vs. Fixing IfIf healinghealing isis notnot fixingfixing,, thenthen whatwhat isis healinghealing ??
  15. 15. 15 What isWhat is HealingHealing?? • HealingHealing is theis the dynamic,dynamic, creativecreative processprocess of helping an individualof helping an individual changechange illnessillness intointo wellnesswellness byby thethe transformationtransformation of:of: DependencyDependency intointo Inter-dependencyInter-dependency DisconnectionDisconnection intointo IntimacyIntimacy DiscouragementDiscouragement intointo HopeHope
  16. 16. 16 What is Healing?What is Healing? • HealingHealing Emphasizes:Emphasizes: ConnectionConnection over outcomeover outcome TheThe wholewhole personperson over the individualover the individual organ systemorgan system RevitalizationRevitalization over preservationover preservation Becoming a “Becoming a “servantservant partnerpartner ” rather” rather than, merely, a “than, merely, a “serviceservice providerprovider ””
  17. 17. 17 • Health care communication must, not only,Health care communication must, not only, supply competent fixing but, also, securesupply competent fixing but, also, secure healinghealing in our patients, clients, andin our patients, clients, and residentsresidents • CompassionateCompassionate communicationcommunication thatthat promotespromotes healinghealing is especiallyis especially difficultdifficult inin thethe nonverbalnonverbal older adultolder adult The Purpose of Communication inThe Purpose of Communication in Health CareHealth Care
  18. 18. 18 Uncovering the Message of theUncovering the Message of the Nonverbal Older AdultNonverbal Older Adult Barriers to Effective CommunicationBarriers to Effective Communication in thein the Nonverbal Older AdultNonverbal Older Adult
  19. 19. 19 Barriers toBarriers to EffectiveEffective CommunicationCommunication inin thethe Nonverbal Older AdultNonverbal Older Adult • Occur in, predominantly, threeOccur in, predominantly, three areas:areas: 1.1. Normal AgingNormal Aging 2.2. DiseaseDisease 3.3. TheThe EnvironmentEnvironment
  20. 20. 20 Barriers to Effective CommunicationBarriers to Effective Communication inin thethe Nonverbal Older AdultNonverbal Older Adult Normal AgingNormal Aging
  21. 21. 21 DefinitionsDefinitions • Aging: post maturational / intrinsicAging: post maturational / intrinsic deteriorationdeterioration  decline in reproductive capacitydecline in reproductive capacity  increasing vulnerabilityincreasing vulnerability  increasing likelihood of deathincreasing likelihood of death  70% environmental / 30% genetic70% environmental / 30% genetic
  22. 22. 22 DefinitionsDefinitions • AgingAging:: ChangeChange over Timeover Time • NormalNormal AgingAging:: BalancedBalanced changechange over timeover time  positivespositives >> negativesnegatives
  23. 23. 23 NormalNormal AgingAging • We age inWe age in fourfour domainsdomains::  PhysicallyPhysically  EmotionallyEmotionally  SociallySocially  SpirituallySpiritually
  24. 24. 24 GeneralGeneral Principles ofPrinciples of Normal AgingNormal Aging 1.1. Aging isAging is gradualgradual  large physiological reservelarge physiological reserve  loose 1% reserve/ yearloose 1% reserve/ year 2.2. TheThe moremore complexcomplex the function, thethe function, the greatergreater thethe declinedecline  balance vs. single nervebalance vs. single nerve 2.2. With advancing age comesWith advancing age comes increasedincreased variabilityvariability
  25. 25. 25 GeneralGeneral Principles ofPrinciples of NormalNormal AgingAging 4.4. With old age comes aWith old age comes a diminisheddiminished speedspeed ofof adaptationadaptation  adaptation occursadaptation occurs butbut the greater stress thethe greater stress the slowerslower the adjustmentthe adjustment  especially true inespecially true in frailfrail older adultsolder adults
  26. 26. 26 SpecificSpecific Changes Associated withChanges Associated with NormalNormal AgingAging • What can weWhat can we expectexpect in terms of organ systemin terms of organ system “specific” change, with advancing age, that“specific” change, with advancing age, that may negatively impact communication withmay negatively impact communication with the nonverbal older adultthe nonverbal older adult
  27. 27. 27 Normal Aging andNormal Aging and CNSCNS FunctionFunction • MemoryMemory slowsslows downdown with age (age associated memorywith age (age associated memory change)change)  delayed recall becomes sluggishdelayed recall becomes sluggish  attention span diminishesattention span diminishes • Executive function is less efficientExecutive function is less efficient  sequential reasoning slowssequential reasoning slows  new learning slowsnew learning slows  specialized knowledge maintainedspecialized knowledge maintained  judgment intactjudgment intact • Language & Communication skills mostlyLanguage & Communication skills mostly improveimprove with agewith age
  28. 28. 28 CNSCNS FunctionFunction • Visual-SpatialVisual-Spatial coordinationcoordination declinesdeclines with agewith age  perceptual speed diminishesperceptual speed diminishes • Personality becomesPersonality becomes moremore personalpersonal as we beas we be come an older adultcome an older adult • EmotionalEmotional identification and experienceidentification and experience remainsremains intactintact
  29. 29. 29 Normal AgingNormal Aging of theof the SensorySensory SystemSystem • HearingHearing  High-pitched hearing loss (Presbycusis)High-pitched hearing loss (Presbycusis)  looseloose consonantsconsonants in the Englishin the English language ( s; th; k; f ;etc.)language ( s; th; k; f ;etc.)  The most common type ofThe most common type of hearing loss inhearing loss in the elderlythe elderly
  30. 30. 30 SensorySensory SystemSystem ello i Aleian Broerello i Aleian Broer Medical enterMedical enter
  31. 31. 31 SensorySensory SystemSystem • VisionVision  lens becomes thicker and more dense;lens becomes thicker and more dense;  more light is needed (watts in bulb=age !)more light is needed (watts in bulb=age !)  slower accommodationslower accommodation  slower light/ dark adaptationslower light/ dark adaptation  need more contrastneed more contrast  reduced peripheral visionreduced peripheral vision  less tears (but watery eyes)less tears (but watery eyes)
  32. 32. 32 SensorySensory SystemSystem • TasteTaste  decreases in acuity with old agedecreases in acuity with old age  saliva production reducedsaliva production reduced  no decrease in # taste budsno decrease in # taste buds
  33. 33. 33 NormalNormal AgingAging andand MovementMovement • MusclesMuscles decrease in size and strength with age (50 %)decrease in size and strength with age (50 %) less elasticless elastic butbut trainabletrainable atat everyevery ageage (regular,(regular, consistentconsistent aerobicaerobic andand resistanceresistance exercise aexercise a must for optimal aging !)for optimal aging !)
  34. 34. 34 MovementMovement • BalanceBalance -- complexcomplex mechanismmechanism involving brain,involving brain, vessels, skin, senses, joints, muscles, etc.vessels, skin, senses, joints, muscles, etc. -- slowerslower toto respondrespond to sudden change withto sudden change with ageage - can be- can be improvedimproved in advanced agein advanced age
  35. 35. 35 SexualitySexuality andand NormalNormal AgingAging • DesireDesire persistspersists into advanced ageinto advanced age inin womenwomen (meno(menopausepause not menonot menostopstop)) ; but; but desiredesire decreasesdecreases inin menmen • Vagina shortens/ gets dryerVagina shortens/ gets dryer • Arousal takes longerArousal takes longer • Orgasms are fewer and further apartOrgasms are fewer and further apart (especially for men)(especially for men)
  36. 36. 36 SexualitySexuality andand Normal AgingNormal Aging • The frequency of sexual intercourse amongThe frequency of sexual intercourse among 85 y/o (who have opportunity), is about85 y/o (who have opportunity), is about the same frequency as a a Fortune 500the same frequency as a a Fortune 500 C.E.O.(2x month)C.E.O.(2x month) • SexualitySexuality infusesinfuses vibrantvibrant colorcolor intointo the,the, often, black and whiteoften, black and white relationshipsrelationships ofof agingaging
  37. 37. 37 EmotionalEmotional AgingAging • LossLoss is the hallmark of emotional agingis the hallmark of emotional aging • With age, we not only loose parts of our bodiesWith age, we not only loose parts of our bodies but also our:but also our:  work (retirement)work (retirement)  spouse (death)spouse (death)  Children (busyness)Children (busyness)  friendsfriends (immobility or death)(immobility or death) • Loss, in old age, can promote, in old age, can promote Self- centeredness
  38. 38. 38 SocialSocial AgingAging • Can promoteCan promote isolationisolation • With advancing age:With advancing age: OurOur once high position, becomesonce high position, becomes lowlow positionposition Being needed becomes being aBeing needed becomes being a burdenburden Once we controlled ourselves, now we areOnce we controlled ourselves, now we are controlledcontrolled byby othersothers
  39. 39. 39 • Physical Aging can lead toAging can lead to DependencyDependency • EmotionalEmotional Aging can lead to toAging can lead to to Self-Self- CenterednessCenteredness • SocialSocial Aging can lead toAging can lead to IsolationIsolation • Progressing toto SpiritualSpiritual ApathyApathy in old age
  40. 40. 40
  41. 41. 41 TheThe AgingAging SpiritSpirit • TheThe MostMost ImportantImportant Domain of AgingDomain of Aging Operates onOperates on FaithFaith >> FactsFacts FavorsFavors RelationshipsRelationships >> ResultsResults ProvidesProvides BalanceBalance ProvidesProvides EnergyEnergy ProvidesProvides MaturityMaturity,, Imagination,Imagination, andand WisdomWisdom
  42. 42. 42
  43. 43. 43
  44. 44. 44 • PhysicalPhysical AgingAging can lead tocan lead to DependencyDependency • EmotionalEmotional Aging can lead toAging can lead to SelfishnessSelfishness • SocialSocial AgingAging can lead tocan lead to IsolationIsolation BUTBUT ……
  45. 45. 45 TheThe AgingAging SpiritSpirit • Provides theProvides the powerpower toto transformtransform:: - DependencyDependency intointo ChosenChosen RelianceReliance - SelfishnessSelfishness intointo ServiceService - IsolationIsolation intointo CommunityCommunity -- ApathyApathy intointo HopeHope
  46. 46. 46 Barriers toBarriers to EffectiveEffective CommunicationCommunication inin thethe Nonverbal Older AdultNonverbal Older Adult • Occur in, predominantly, threeOccur in, predominantly, three areas:areas: 1.1. Normal AgingNormal Aging 2.2. DiseaseDisease 3.3. The EnvironmentThe Environment
  47. 47. 47 • DiseaseDisease creates significant barriers to optimumcreates significant barriers to optimum communication with nonverbal older adults:communication with nonverbal older adults:  Dementias ( A.D.; Lewy Body Dementia; etc.)Dementias ( A.D.; Lewy Body Dementia; etc.)  StrokeStroke  ImmobilityImmobility  CataractsCataracts  Hearing lossHearing loss  Depression/AnxietyDepression/Anxiety  Pain (Chronic and Acute)Pain (Chronic and Acute)  Loose dentures/ poor dentitionLoose dentures/ poor dentition  ArthritisArthritis Barriers to Effective CommunicationBarriers to Effective Communication inin thethe Nonverbal Older AdultNonverbal Older Adult
  48. 48. 48 Barriers toBarriers to EffectiveEffective CommunicationCommunication inin thethe Nonverbal Older AdultNonverbal Older Adult • Occur in, predominantly, threeOccur in, predominantly, three areas:areas: 1.1. Normal AgingNormal Aging 2.2. DiseaseDisease 3.3. The EnvironmentThe Environment
  49. 49. 49 • EnvironmentalEnvironmental pressures can significantly reducepressures can significantly reduce communication with the nonverbal older adult:communication with the nonverbal older adult:  Always in a bed or chairAlways in a bed or chair  IsolationIsolation  CrowdingCrowding  Poor lightingPoor lighting  Too much or too little sensory stimulationToo much or too little sensory stimulation  HurriedHurried  Lack of privacyLack of privacy  AgeismAgeism Barriers to Effective CommunicationBarriers to Effective Communication inin thethe Nonverbal Older AdultNonverbal Older Adult
  50. 50. 50 How toHow to ImproveImprove CommunicationCommunication with thewith the Nonverbal Older AdultNonverbal Older Adult Uncovering the Message of theUncovering the Message of the Nonverbal Older AdultNonverbal Older Adult
  51. 51. 51 I.I. GeneralGeneral principlesprinciples of nonverbalof nonverbal communication in older adults:communication in older adults: A.A. It may involveIt may involve noisenoise without recognizablewithout recognizable languagelanguage B.B. It isIt is emotionallyemotionally basedbased C.C. It hasIt has purposepurpose andand meaningmeaning D.D. It isIt is accurateaccurate How to Improve Communication with theHow to Improve Communication with the Nonverbal Older AdultNonverbal Older Adult
  52. 52. 52 II.II. SpecificSpecific strategiesstrategies to enhanceto enhance communication with the nonverbal oldercommunication with the nonverbal older adultadult A.A. DemonstrateDemonstrate respectrespect and guaranteeand guarantee safetysafety withwith each interactioneach interaction B.B. DecideDecide to develop a caringto develop a caring relationshiprelationship with thewith the patient/resident/clientpatient/resident/client C.C. Determine to be a “Determine to be a “ServantServant PartnerPartner”, not”, not simply, a “simply, a “ServiceService ProviderProvider.”.” How to Improve Communication with theHow to Improve Communication with the Nonverbal Older AdultNonverbal Older Adult
  53. 53. 53 How to Improve Communication with theHow to Improve Communication with the Nonverbal Older AdultNonverbal Older Adult III.III. PracticalPractical actionsactions that will promote and enrichthat will promote and enrich communication with the nonverbal elderlycommunication with the nonverbal elderly A.A. Promote excellence in health and health care deliveryPromote excellence in health and health care delivery B.B. Prevent illnessPrevent illness C.C. Focus on FunctionFocus on Function D.D. Concentrate on Feelings (Emotions)Concentrate on Feelings (Emotions) E.E. Direct communicative efforts at the specific barriers that impairDirect communicative efforts at the specific barriers that impair understanding:understanding: 1.1. Normal AgingNormal Aging 2.2. DiseaseDisease 3.3. The EnvironmentThe Environment
  54. 54. 54 1.1. OverOver comingcoming the barriers ofthe barriers of NormalNormal AgingAging a)a) Slow down all interactionsSlow down all interactions b)b) Taylor the communication to the quality of the relationship,Taylor the communication to the quality of the relationship, in the moment!in the moment! c)c) Speak slowly, firmly, and rephrase rather than repeatSpeak slowly, firmly, and rephrase rather than repeat d)d) Maintain compassionate eye contact, in adequate light, at orMaintain compassionate eye contact, in adequate light, at or below their eye level (kneel or sit)below their eye level (kneel or sit) e)e) Honor their sexualityHonor their sexuality f)f) Respect their privacy and time (schedule)Respect their privacy and time (schedule) g)g) Make them physically safeMake them physically safe h)h) Know themKnow them How to Improve Communication with theHow to Improve Communication with the Nonverbal Older AdultNonverbal Older Adult
  55. 55. 55 2.2. OverOver comingcoming the barriers ofthe barriers of EmotionalEmotional AgingAging a)a) Identify the feelings/emotions they are expressingIdentify the feelings/emotions they are expressing b)b) Listen for understanding of the feelings/emotionsListen for understanding of the feelings/emotions c)c) Validate their feelingsValidate their feelings d)d) SmileSmile e)e) Use affirmative body language (head nodding)Use affirmative body language (head nodding) f)f) Redirect them towards service to othersRedirect them towards service to others How to Improve Communication with theHow to Improve Communication with the Nonverbal Older AdultNonverbal Older Adult
  56. 56. 56 3.3. OverOver comingcoming the barriers ofthe barriers of SocialSocial AgingAging a)a) Determine to connect to them and to limit their isolationDetermine to connect to them and to limit their isolation b)b) Use affirmative touch, when appropriateUse affirmative touch, when appropriate c)c) Help them connect to those around them, as well as, familyHelp them connect to those around them, as well as, family and friendsand friends d)d) Give the something that they can controlGive the something that they can control e)e) Give them choice and then honor their choicesGive them choice and then honor their choices How to Improve Communication with theHow to Improve Communication with the Nonverbal Older AdultNonverbal Older Adult
  57. 57. 57 4.4. OverOver comingcoming the barrier of anthe barrier of an ApatheticApathetic SpiritSpirit a)a) The most difficult of tasks in communicationThe most difficult of tasks in communication b)b) Help them cultivate a healthy spirit based upon truth, inHelp them cultivate a healthy spirit based upon truth, in the context of, their faiththe context of, their faith c)c) Help them make good choices, serve others, andHelp them make good choices, serve others, and connect with those around themconnect with those around them d)d) Encouragement and hope improve communicationEncouragement and hope improve communication How to Improve Communication with theHow to Improve Communication with the Nonverbal Older AdultNonverbal Older Adult
  58. 58. 58 2.2. OverOver comingcoming the barriers caused bythe barriers caused by DiseaseDisease a)a) Comprehensive Geriatric AssessmentComprehensive Geriatric Assessment b)b) Focus on improving or maintaining function (ADL’s)Focus on improving or maintaining function (ADL’s) c)c) Treat depressionTreat depression d)d) Get hearing aidsGet hearing aids e)e) Remove cataracts/ get glasses/ treat Macular DegenerationRemove cataracts/ get glasses/ treat Macular Degeneration f)f) Limit medicationLimit medication g)g) ExerciseExercise h)h) Relieve painRelieve pain i)i) See DentistSee Dentist j)j) Get physical/occupational/speech therapyGet physical/occupational/speech therapy How to Improve Communication with theHow to Improve Communication with the Nonverbal Older AdultNonverbal Older Adult
  59. 59. 59 c)c) Over coming barriers caused by theOver coming barriers caused by the EnvironmentEnvironment a)a) Mobilize the patient/client/residentMobilize the patient/client/resident b)b) Supply adequate light, space, and privacySupply adequate light, space, and privacy c)c) Provide appropriate sensory stimulationProvide appropriate sensory stimulation d)d) Compassionately balance safety with personalCompassionately balance safety with personal freedomfreedom How to Improve Communication with theHow to Improve Communication with the Nonverbal Older AdultNonverbal Older Adult
  60. 60. 60 Uncovering the Message of the the NonverbalUncovering the Message of the the Nonverbal Older AdultOlder Adult • Understanding and being understood by theUnderstanding and being understood by the nonverbal older adult is essential to providingnonverbal older adult is essential to providing them with adequate health carethem with adequate health care • Committing ourselves to establish and maintainCommitting ourselves to establish and maintain their personal safety and respect, will provide thetheir personal safety and respect, will provide the soil for our understanding of one another tosoil for our understanding of one another to grow and flourishgrow and flourish
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