3 M-CARE: Communication skills

Mobile Training for Home and Health
Caregiver For People with Disabilities and
Older People
539913-LLP-1-2013-1-TR-LEONARDO-LMP
Module:
Communication Skills

Unit 1
• Introduction and general principles
– The role of PCG
• Acts, talks and reacts when asked
• Providing opinion when asked
• When participating in meeting
• Communication
• Ways to interact
• Attitude

PCG should be non-intrusive and
should only act, talk or react when
s/he is asked.
Photo by:http://seniorcarepartners.wordpress.com/our-caregivers/

• The role of PCG is like an interpreter/ translator,
without providing personal point of view, unless
explicitly asked.

• The PCG cannot be involved or intervene when
s/he participates in a meeting of his/her client
(unless asked).

• Communication with people with disabilities can
be challenging and demanding.
Photo owned by: Interprojects

• However, you as a PCG may overcome the
difficulties if you know some basic principles.

Remember!
• Effective communication
contributes to the
successful provision of
services but it is also a
source of adequate
personal self-confidence.
Photo by Stuart Miles,
http://www.freedigitalphotos.net/

• Feedback on communication is continually given
and received both by a PCG and a disabled
person.

• If people want to change their experiences in
a positive direction then they should change
the ways they interact with and influence each
other.

• You as a PCG should demonstrate a helpful,
compassionate attitude towards your clients
with disabilities.

When communication with a visually
impaired person
• When addressing visually impaired people, a
good way of communicating for certain
activities is through the “clock method”:
– “The photographer is at 12 o' clock”, indicating in
what direction they should look.

Unit 2
• Empathy
– What?
– Requirements

• Empathy is the ability to understand the world
from the perspective of others - to adopt the
others’ point of view.

• Empathy is not doing something for others,
but to be with the other.
• Empathy requires commitment and
understanding of what is happening to the
other person.

Unit 3
• Disability etiquette
– What?
– Every client is unique
– Adjustments
– Differences
– Acceptable words
– Words to avoid

• Each person is unique.
• Even though someone else
may have the same
disability, this does not
mean that they have the
same difficulties.

• The sort of adjustments that suit one person
may not be at all suitable for another.

• This is why the PCG should always discuss
his/her ideas about adjustments with the
client with disability.

• Everyone has different ways of thinking and
communicating.

• Some people may have difficulties getting
around and use a wheelchair or crutches, but
this has no impact at all on their ability to read
or to communicate.

• Others may have no trouble at all getting
around but may have real difficulty with
reading.

Use terms such as
• People with disabilities
• Blind
• Partially sighted
• Deaf or hard of hearing
• Intellectual (learning) difficulties
• Mental health difficulties
• Wheelchair users
• Stick to correct terms in daily
speech, but also when preparing
official documents, individual
plans or while addressing the
client in public places

Avoid using terms such as
• handicapped people
• any description ending in
"...ic" which replaces the
identity of the individual e.g.
the epileptic
• a victim of... or suffering
from...
• spastic
• deformed or invalid
• retarded or dumb
• crippled or wheelchair bound

Unit 4
• Respect
– Communication with the client
– Speak directly

• Communication between you and your client
should be always based on mutual respect, trust
and tolerance. It makes communication easier
and prevents conflicts.
Photo by: http://www.co.rock.wi.us/Dept/Aging/CaregiverBooks.htm

• When talking with a person with a disability, speak
directly to that person rather than through a
companion or relative/family member.

Unit 5
• Communicate to know personal needs and
desires
– Unique personality
– Observing the client
– Things to consider
– Talk with your client
– Ask questions
– Client in the center of the service
– Stable client-PCG relationship

• You need to bear in mind that your client has
unique personality traits that remain consistent
throughout their life.
Photo owned by Interprojects

• One of the ways you
can understand your
client is by observing
him/her as they sleep,
eat, communicate with
you and other people.

• Which activities does s/he likes
best?
• Is adjusting to changes easy for
him/her?
Photo by stockimages,

• Does s/he need time to
become familiar with these
things?
• Does s/he use the disability as
an excuse to withdraw
himself/herself from daily
activities?
Photo by stockimages,

• As much as possible, have time to talk
to your client as this is crucial to
gaining information and
understanding.
• Ask him/her questions which will
allow him/her to share feelings and
thoughts to you.
• Remember that it is the client that is
the centre of your service rather than
the process itself.
• Open communication can bring to
both of you to a stable relationship
based on trustworthiness and
honesty. The easiest way to
communicate is to tell the truth.
• Good communication is an important
caregiver’s skill which allows you to
know your client better and support
him/her to identify his/her needs and
likes.

Unit 6
• Communication hints
– Shake hands
– Identify yourself
– Speaking in group
– Listen for clarifications
– Treat adults as adults
– Listen carefully
– Be patient
– Ask short questions
– Repetition
– Eye level
– Look directly
– Lip read
– Common expressions

• When introduced to a person with a disability, it
is appropriate to offer to shake hands.
– People with limited hand use or who wear an
artificial limb can usually shake hands.
– Shaking hands with the left hand is an acceptable greeting.

• When meeting a person who is visually
impaired, always identify yourself and others
who may be with you (e.g. doctors, nurses,
educators).

• When speaking in a group, remember to
identify the person to whom you are speaking
in case people with visual impairments are
present.

• If you offer assistance, wait until the offer is
accepted. Then ask for additional clarifications.

• Treat adults as adults.
– Address people who have disabilities by their first
names only when extending the same familiarity to
all others.

• Listen attentively when you're talking with a
client who has difficulty speaking.

• Be patient and wait for the person to finish,
rather than correcting or speaking for the
person.
Photo by: http://www.caregivingcafe.com/top-20-websites-for-caregivers/

• If necessary, ask short questions that require
short answers, a nod or shake of the head.

• Never pretend to understand if you are having
difficulty doing so. Instead, repeat what you
have understood and allow the person to
respond.

• Always while speaking with a client with
mobility impairment, place yourself at eye
level in front of that person to make the
conversation easier.

• When speaking with a person with a hearing
impairment:
– Make a sign to start a conversation.
– Not all people who are deaf can read lips.
• Look directly at the person and speak clearly, slowly, and
expressively to ensure the person can read your lips.
• Keep hands away from your mouth when speaking.

• Don't be embarrassed if you happen to use
accepted, common expressions such as "See
you later," or "Did you hear about that?" that
seems to relate to a person's disability. These
are common and accepted expressions.

Unit 7
• Active listening
– What?
– How?

• Remember that active listening is your fast track
to understand your clients’ needs.
• PCG should listen more than talk.

• Active listening means that you as a PCG should
be:
– Concentrated
– Focused when your client is talking to you
• Being good listeners is a sign of respect for
those that we care for.

Unit 8
• Communication with People with hearing impairments
– Who?
• Speech with or without a hearing aid,
• Lip-reading
• Sign language
• Written communication
– Moderate hearing impairments
– Hearing aids
– Video calls
– Text phone
– Facebook, Instagram, Whatsapp, Viber
– “Safe” areas of touching
• Client’s shoulder
• The elbow
• The hand

People who are hard of hearing or deaf use:
• speech with or without a hearing aid
• lip-reading
• Sign language or
• written communication

In case of mild to moderate hearing impairment,
face-to-face communication can be effective .

A large proportion of those with a mild/moderate
hearing impairment would not be able to rely
solely on speech but would have to use lip-
reading and writing to communicate.

• Ample use of visual aids can improve
accessibility of the communication.
• Telephone amplifiers make incoming speech
about two to four times louder.

Video calls
• Video calls are a good alternative for the
communication with hearing impaired clients

• People who cannot use voice telephones might
use text phones.
• Text messages can also be sent from computers
to mobile phones and vice versa.

• People with hearing impairments also use social
media such as Facebook, Instagram, etc.
• Don’t be afraid to use these channels to send
messages or to make an appointment.

• Other alternatives for communication might be
Skype, Viber, WhatsApp, Tango etc., depending
on the preference of the client.
• Some of them are also accessible for people
with hearing and/or visual impairments.

“Safe” areas for touching the client if
you want to make a sign?
• Touching the client’s shoulder

• Touching the elbow

• Touching the hand

Unit 9
• Socio-haptic signs
– What?
– Haptic signs
– Obstacles

Socio-haptic signs
• Refers to the ways in which people
communicate and interact via the sense of
touch.

Socio-haptic signs
• You may choose together with your client your
haptic signs to communicate

Socio-haptic signs
• Also you may use them to notify the client
when there are obstacles (e.g. object on the
walking pathway, steps, etc.)

Unit 10
• Communication with people with speech
impairments
– Unaided communication methods
– Written words
– Communication aids
– Reduced manual dexterity

People with severe speech impairments may use
communication methods such as body language,
sign language and gestural strategies.

They may also use written words as an alternative
to speech.

• Some people with speech impairments use
communication aids such as objects, photos or
symbols organised in charts or books and VOCA.
– VOCAs are hardware units or laptops installed with
communication software, using symbols and/or text that
produce speech with either digitised voice recordings or a
synthesised voice.

• A person who has speech impairment should
have no difficulty to understand spoken
language.
• If the cause of the speech impairment is
cerebral palsy or brain damage, clients may
have reduced manual dexterity, making it e.g.
impossible or very difficult to make written
answers.

Unit 11
• Communication with people with visual
impairments
– Written words
– Telephone communication

• Most blind and partially sighted people rely
heavily on speech communication.
Communication based on written words is
problematic, unless they use supporting
assistive technologies.
The photo is owned by http://www.nfcacares.org/who_are_family_caregivers/

• A telephone communication is an accessible
way to communicate with blind and partially
sighted clients.

Unit 12
• Communication with people with limited manual
dexterity
– Speech and written means
– Writing speed and legibility
– Writing aids
– Keyboards

• People with limited manual dexterity can
communicate using speech and written means,
unless they have an additional impairment such
as aphasia, dysarthria, or a visual impairment.

• Manual dexterity impairments result in the
loss of fine control of movement, which can
affect writing speed and legibility.

• Some people may use writing aids such as
pencil grips and wrist supports.
• Some people with limited manual dexterity
may find typing easier than hand writing.
Photos by: Colorgear

• Keyboards can be altered to make typing with
the fingers easier, or they can be adapted to be
used by another part of the body, e.g. a head
pointer.
The photos are owned by http://www.nfcacares.org/who_are_family_caregivers/

Unit 13
• Communication with people with learning
difficulties
– Levels of support
– Clearly presented and straightforward to understand
– Grasping complicated sentences
– Repetition
– Severe to profound learning difficulties

• People with learning difficulties can have
– problems with communication, and might need
high levels of support.
– additional sensory or physical impairments.
Photo owned by PhoenixKM

• Information should be clearly presented and
straightforward to understand e.g. short
sentences, clear wording without comparisons
and metaphors.
• Speech is a suitable communication method
for most people with moderate learning
difficulties or disabilities

• Some people may have problems grasping
complicated sentences and may not be able to
absorb a lot of information at one time.

• Repetition may be important to help people
remember what is being said.

• Speech is unlikely to
be an effective
means of
communication for
most people with
severe to profound
learning difficulties.

• Don’t use long sentences
• Include one main point, and
only 1-2 clauses in a sentence
• Communicate in the active
voice, rather than the passive
• Avoid abstract concepts
• Use simple words, without
being patronising
General guidelines when
communicating with people who have
learning difficulties

• Repeat difficult or unfamiliar words
• Don’t use jargon
• Avoid abbreviations and acronyms
• Avoid using the third person
• When you give instructions split them into simple
steps
• Remember not to treat them as a child or as a less
capable person

Unit 14
• Tips “How to reduce tension in communication with your client?”
– Tips when client is annoying and the tension increases
– Paraphrase your statements
– Suggestions
– Volume of your voice
– Change the subject
– The velocity of your speech
– The time and the mood of your client
– Personal issues and confidentiality
– Personal problems
– Financial issues
– Adaptations
– Challenges
– Public places and events
– Disclosure
– Social integration and health care

When you feel that your client is getting annoying
and the tension increases you may use some tips
to reduce it
• Suggest discussing the disputable topic again at
a later stage when your client will be calmer.

• Paraphrase your
statements without using
words such as
–“no way”, “impossible”,
“never”, “forget about it”,
“you don’t need it”.

Instead of these you may use the following:
“I will see what I can do.”, “Maybe there is
another way”, “Let’s see the other possibilities”,
“Maybe we will try”, “Let’s think for a while” etc.

• Always mind the volume of your voice#.
Sometimes people speak loud but it doesn’t
mean that they shout.

• If the discussed topic creates tension you may
change the subject with a theme that is more
relaxing for the client

• Mind the velocity of your speech.
• Very slow and very fast talking usually creates
tension.

• Be aware of the time and the mood of your
client when you discuss with him/her
exhausting topics.

• Do not discuss personal issues that concern
your client when other people are present.
• Always respect confidentiality.

• Avoid sharing your personal problems as this
frequently cause additional tension or negative
emotions.
Photo by: http://seniorcarepartners.wordpress.com/our-caregivers

• Avoid discussing the financial status of your
client (unless specifically asked) as this might
lead to undesirable disputes.

• Do not plan adaptations without coordinating
them in advance with your client.

• When the client has to
perform an activity,
which you think could
be challenging for the
client due to his/her
specific condition, you
should not give up
before discussing it
with the person and
then decide what to
do.

• When accompanying your client to public places
or special events such as a concert, wedding,
baptism, funeral, hospital, concert, bank, etc.
ensure that you and your client are properly
dressed.

• The personal caregiver should do his/her best
to support the client to disclose in front of
public bodies any information that concerns
his/her disability.

• Make sure that your client is aware of all
available and applicable to him/her
(financial/non-financial) benefits in terms of
social integration, rehabilitation and health
care.

Important!
• If you don't treat your client like you would
anyone else, and start giving them extra
attention or behave in an over-motherly way,
your client may misunderstand your intentions
and think that you imply more.
• It's a common thing, clients wanting to be
romantically involved with their PCG. Watch
out and don't exaggerate!

Unit 15
• Tips “How to act with elderly people?”
– What to consider?
– Way of expressing
– Notes about daily activities
– Reduce tension

• They compare the
information with their
previous experience and
they might be less
enthusiastic towards
innovative content.

• You as a personal caregiver should carefully
select your way of expressing, because older
people might not always accept that someone
who is younger is providing guidance.

• You as a caregiver could encourage your elderly
client to take notes about daily activities (taking
pills, using home equipment, etc.)

• Sometimes older people may oppose the
personal caregiver’s ideas and guidance.
• Try to reduce the tension and give more
clarification and positive examples.

References:
• Aging families and caregiving / Sarah Honn Qualls; Steven H Zarit 2009, English Book
xiii, 338 p. : ill. ; 25 cm. Hoboken, N.J. : John Wiley & Sons, ; ISBN: 9780470008553
• The real truth about aging : a survival guide for older adults and caregivers / Neil
Shulman; Michael A Silverman; Adam G Golden2009 ,English Book p. cm. Amherst, N.Y.
: Prometheus Books, ; ISBN: 9781591027195
• Aging Families and Caregiving by Sara Honn Quall, Steven H. Zant, Eds. 2009, English
Book , (338 p.) Wiley: (January 27, 2009) ISBN: 10: 0470008555
• Photos are owned by Interprojects’ team and provided without copyrights by:
– http://www.nfcacares.org/who_are_family_caregivers/
– http://www.nfcacares.org/pdfs/AARPSurveyFinal.pdf
– http://www.womenshealth.gov/faq/caregiver-stress.cfm#a
– http://aspe.hhs.gov/daltcp/reports/ltcwork.htm
– http://www.healthcalculators.org/calculators/caregiver.asp
– http://www.co.rock.wi.us/Dept/Aging/CaregiverBooks.htm
– http://seniorliving.about.com/od/lifetransitionsaging/a/agingwellbooks.htm
– http://www.caregivingcafe.com/blog/wp-content/uploads
– http://seniorcarepartners.wordpress.com/our-caregivers/

3 M-CARE: Communication skills

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