Communicating With Our Caregivers

by Paulina Perez

We often have to learn the art of working together and often must teach it to our caregivers too. This type of relationship is built on mutual trust, respect, valuing the contributions and knowledge of others and working toward common goals. This requires a balance of power and understanding of roles.

Mutual and Professional Trust

Medical professionals rely on each other's observations, assessments, diagnoses and abilities. All of these people must work interdependently toward the common goal of obtaining the best outcome for us as a client/patient.

Human communication is messages between two people in face to face communication. It is important to remember that which has been communicated cannot be uncommunicated. It can only be built upon. Clients/patients and their caregivers must have not only effective but exemplary communication skills to make health care work more effectively.

All of our communication takes place within the context of time, place and history. Our conversation involves both verbal and non-verbal communication . Sometimes our non-verbal communication contradicts what is being said verbally(ie: when saying "Do you have any more concerns" while reaching for the door knob).

Communication requires adaptability on everyone's part. When we are communicating with health professionals we are interacting on two levels- content which is objective and relationships which are subjective.

Managed care has taken a toll on our ability to communicate effectively. The health professional often has no history with us as a client/patient and that changes the way we both communicate. Health care often involves taking a risk. How can you take a risk when you don't know the person you are talking to? If either of us doesn't feel safe it changes they way we BOTH communicate.

The Three Types of Communication

Passive

Passive communication often involves: no eye contact, sing-song quality of voice, very soft voice, leaning-out posture. They often see themselves as powerless.

Aggressive

Aggressive communication often involves: sarcastic tone, abrupt, condescending words, charging posture. Aggressive communication is intimidating and overwhelming. Those who use the type of communication are driven by a need to demonstrate that they are right. As they see it you are someone who doesn't need to be paid attention to. This behavior arouses mental and physical confusion, frustration, a sense of helplessness. The most common reactions are to run or fight back. These reactions rob us of the ability to deal coolly and competently with the situation. To deal with an aggressive communicator you should be friendly but, you must stand up for yourself and not let yourself be pushed around. Get them to sit down, let them run down and when they lose momentum, hold your position, look directly at them and speak from your point of view. If they interrupt you say very firmly " I wasn't finished and you interrupted me." Avoid a head-on fight as this is a win-lose situation.

Assertive

Assertive communication expresses feelings and wants honesty and involves: firm eye contact, relaxed posture. It denotes mutual respect. Assertive communication gives you energy, improves relationships, improves decision-making, and achieves results.

Another communication skill that is helpful is active listening where you acknowledge what the other person said as this lets them know that you understood and took them seriously. The easiest way to do that is to paraphrase what you think their main points were.

The hardest emotion to deal with is when someone is angry. It might help to use following strategies:

Be calm

Lower your voice

Distance yourself a little

Use calming words

Use silence

Use restatement

Use reflection

Clarify

Set limits

Gather information

Be precise and accurate.

Remember the acronym- CAR

Commonality

Let the person know you have mutual respect

Acknowledge

Show you understand his point of view

even though you don't agree

Redirect

Distract the person or gradually change

the conversation

Deal with one situation at a time

Make "I" statements

Be clear and direct

Don't insist on your own way

Do not get stuck on the problem. Look for a method to resolve

the problem.

Empower not overpower

Develop solutions together.

Keep in mind that people feel significant

Remember we have the same goal in mind- restoring the client/patient's health.

The Stroke Network, Inc.

P.O. Box 492 Abingdon, Maryland 21009