Communication is not only one of the most important parts of care relationships, but also oftentimes one of the most problematic.
Our guests share with us what makes this so important, and so challenging, and share their insights for improving communication in care.
Special thanks to all our guests, and to the organisations that helped:
Looking for some inspiration? Check out these great resources and links:
SNACK has been produced by COTA Queensland as part of the Homecare Workforce Support Program, which receives grant funding from the Australian Government.
Andrea Petriwskyj 00:00
We acknowledge the traditional owners of the lands on which this podcast has been produced and we pay our respects to elder’s past and present. Most
Niaomi 00:08
of us listen to respond rather than listen to just listen. So you
00:12
may spend more time providing a particular service or doing a particular task. But in the end, as long as they try to understand and communicate,
00:26
when people speaking to an older person, in this context, rudely or shortly, they might think that they’re not, they’re just working fast or whatever, but it’s really obvious we see it a lot.
Andrea Petriwskyj 00:46
Welcome to snack, the aged care podcast where we break down some of the big questions around what it really means to be person centred. I’m Dr. Andrea Petrovsky. I’m a gerontologist, and I’m passionate about hearing and sharing the real life experiences of ageing. Today, we’re talking about something that is not only one of the most important parts of care relationships, but also oftentimes one of the most problematic, and that’s communication. Our guests share with us what makes this so important and so challenging, and share their insights for improving communication and care. These are the kinds of issues that professional advocates can see a lot. So we spoke with Naomi and Renee, who are both advocates from ADA Australia. So Naomi, we know that communications one of the big cause of complaints and issues that arise in care, what are some of the ways the personal care workforce can really look at or develop their own role in communication? Yeah,
Niaomi 01:49
look, that’s definitely true. Sometimes it helps to think about how we would like to be spoken to if we were a client. So it’s really important that we treat them with respect. Allowing the client to be able to express how they’re feeling and actively listen is really important. Most of us listen to respond rather than listen to just listen. Sometimes we can become reactive. So I’ve seen clients be interrupted or spoken over by service providers, which of course we know is not okay. Just taking a moment to think before responding, it can be really helpful. Yeah, another factor is talking to clients, so they can hear you.
Andrea Petriwskyj 02:30
Okay, so what about clients who have hearing impairments? Does that impact on the relationship from a communication point of view? Great
Niaomi 02:38
question. And yes, it does. And a lot of clients, I find do have hearing impairments, or may have communication difficulties, I find speaking at a volume so that they can hear you, whilst also not shouting at them. Also, not trying to speak too fast, is really important. If you aren’t sure it’s okay to ask the client if they can hear you. Okay? Or if you are going too fast when talking to them. So stopping and saying, Look, can you hear me, okay? That’s an okay thing to ask. And a lot of them do value that it does let the client know, it’s safe to speak up for them to speak up and let you know, a lot of clients think speaking up might embarrass you. So letting them know you are okay with them. Doing so helps foster a trusting relationship, paying attention to how a client responds, when we interact with them. Smiling when you see a client is so simple, but very effective, it helps the client know that you’re happy to be there to provide them a service, validating a client’s experience. So you know, if they are talking to you, you know, saying things such as that sounds really difficult or sounds like it’s been a hard time for you, you know, that really is very valid and really makes that person feel listened to and heard.
Andrea Petriwskyj 04:06
Renee also shared some great insights into the value of reflecting on our own practice, and being open to feedback and learning for our own sake, as well as the benefit of the person we’re supporting.
04:19
Though, I think it’s really crucial to have that self reflection and do that reflective type of practice. So you know, when you’ve done a visit or something, say that you’re having a particularly bad day, and you think, oh my gosh, I think I was quite short with this person, for example, but it’s really great. If you say, You know what, last time that we that I was here, I just wanted to apologise because I was not having a great day and I hope I didn’t come across as, you know, being short or you know, like acknowledging that there are some things that we do that might play a role in the service that we’re providing. Having chats and debriefs. If If it’s available to you, with colleagues, this is what I’ve done. This is what they’re saying, This is what I’ve tried, is there something that I might have missed, or there’s something that I might be doing to contribute? Because sometimes people and you’ve got to take into consideration that people do have different personalities, different diversity and those types of things. And one thing that I see a hell of a lot, is people not wanting to work with or engage with people that have what people may describe as a difficult personality. But it’s not realistic to think that everybody is going to be tickety boo, when all happy, go lucky and never have a bad day themselves, or, you know, those types of things. So I think that we can make the mistake of going well, he’s rude to me, I’ll be rude to him. And it just creates this big Loggerhead of, you know, that Argy bargy between people. And I think it’s also around practice makes perfect, you know, nobody feels comfortable at the start of their career or particular jobs, having difficult conversations, but I think that it’s a skill that people should really have and really look into. Because the conversations that you’ll be having are actually really important. Yeah.
Andrea Petriwskyj 06:13
So really keeping a dialogue open with people about, you know, a two way respectful dialogue. Yeah,
06:21
absolutely. And asking them about, you know, some of their, their life and that type of stuff. Like I’ve worked with one person. And they said to me, I haven’t told these stories in over 20 years. And you could just see, literally in front of your eyes, a sparkle come back into their eyes, and massive laughter and tears streaming down their face, and you just think, wow, like, I actually had such an enjoyable conversation. But for you, that was life changing.
Andrea Petriwskyj 06:47
So much of our communication is actually not about what we say. So we asked both Naomi and Renee about nonverbal communication, and how important it is in person centeredness. So
Niaomi 07:00
open body language, so thinking about how you’re sitting, or you’re standing, when you’re talking to the client, nodding when they’re talking. So that shows that you’re listening to what they’re saying, being mindful that you’re not projecting your own stresses onto that person, you know, ensuring that when you’re there, you’re being present, and you’re mindful that you are focused on them and what they’re saying in their needs.
07:26
I have sometimes seen people working in the space and genuinely I’m at a loss as to why they’d be working in a service delivery type role, or interacting with humans, because they couldn’t be making it any more clear that they don’t want to be there. And that comes across in everything. whether, you know, it’s the way that people are spoken to, or about whether that’s the, you know, pushing everything away and saying, Oh, you’ve unplugged this again? Well, it’s their own home. So it’s actually okay, if they did do that, or if they struggled, and also being aware of how difficult some things are, that we might find quite easy. You know, if you’ve got a PowerPoint that’s under your desk, in your office, for example, and you’re on your hands and knees, and you’re thinking, goodness, me, I’m banging my back, and I can’t get the plugin. And you know, if that was every single thing that you were trying to do was a lot more difficult than it used to be. And, you know, that’s compounded efforts, you know, I can’t turn my taps on properly anymore, I can no longer use knives anymore. I think that if you think about that compounding effect overall of those things, and then be mindful of, you know, showing your frustration, I think, you know, you can take a couple of deep breaths, do the best that you can and then you know, sing it out in the car on your way from leaving with the client.
Andrea Petriwskyj 08:44
There’s a whole range of skills and strategies you can develop in communication, including particular ways of asking questions to help someone open up to you and get to understand them. When we spoke with Jenny, for example, she talked about the gentle inquiring approach that a cat assessors use in the short time they have with people and the importance of how you then respond to that information to help build up trust and your understanding of their perspective. In the conversations with Rene and Naomi, we also heard some examples of particular techniques that you can learn to support communication.
09:23
I had my strokes in 1998 I couldn’t do anything. I had to learn how to walk again, everything speak everything. I still have problems to this day, but I am even constantly trading to talk to you.
Andrea Petriwskyj 09:37
So what are some of the important things you think carers professional carers can do to support people better who have difficulty communicating?
09:47
Well, I think, well, I’m at the moment trying to work on a card, a little card that sort of says I’m a stroke survivor. I’m communication says difficult So please be easy. And you know, listen to what I can get out. I’m trying to get that one going for people that have had strokes because they have aphasia, and I couldn’t talk properly or anything like that. And I think, yeah, I mean, if someone says something, and you know, you can burst into tears at the drop of a hat, or walk away, because you can’t get the word out. So and I think something is a little explanation. So you need something that’s just simple and easy to hand over because from it is down to your mouth inside your own head. You sound like you’re talking completely. Right? You know, everything’s perfect. But what comes out with your muscles if they’ve been damaged? You don’t hear. So what you hear what I hear and what you can hear at the beginning of his stroke. When persons first has a stroke, it sounds perfectly alright to you, but the other person can’t understand a word you say?
Andrea Petriwskyj 11:10
Do you feel like staff are trained the way they need to be to work with people who have difficulty communicating? For example, someone who has had a stroke? No,
11:23
definitely not. I think they are if they get used to see you, because I’m probably trying to my own way. But they need to have training about the communication, they need to be taught about different people with disability. You This is training, they do need training, how to communicate with people themselves, and then No, SmartLook alright, and Schmuck, and he may look alright, and everything else, he might be a bit grumpy, but he can’t get the words out properly. Swearing is a good word. It just, I never used to sweat. But you when you first have strokes, they just seem to fall out very quick, like a click of a finger, the word will come out. What do I say that did I say that? The person just says to have been taught to have patience and to listen. Or if you can’t get the word out, you need a pen and paper if you can write it, I couldn’t even write. But you’ve got to sort of walk in their shoes to understand what they’re going through.
Andrea Petriwskyj 12:30
We’ve heard in previous episodes about the importance of being inclusive of people living with dementia. So we asked Shareen from Blue care about what that means for how we communicate.
Shareen 12:41
Sometimes we approach someone who has dementia and we have assumptions about what what that person is likely forget to look at what their abilities are, and making sure that when we start to communicate that we’re thinking about, well, what do we need to do so that communication is the best for them? And simple things? Like? Do they need their hearing aids, so that they can hear about? What’s their vision? Like? Can they see me? If I’ve got some written information? Like is the print large enough for them to see, so lots of things about communication that we need to start by thinking about who that person is, and what their abilities are? Yeah, and really, one of the another big issue is just that how we sometimes make decisions and talk about people above them instead of including them. So, you know, we really need to always assume that that person does have capacities, we’ve got to do everything we can so that they never feel like they’re stupid, because they don’t understand what’s going on. We never feel that never make them feel like humiliated or never make them feel like they’re less of a person because they’re not able to keep up with what’s being said to them and how it’s being said to
Andrea Petriwskyj 14:11
them. Yeah, absolutely. So how can people build those skills in communication? Yeah, well, look, I
Shareen 14:18
think really, the first step is about trust, that we need to really take the time to develop trust with the person that we want to communicate with. And that means understanding who they are as a person. We need to listen more and be hearing what that person is saying to us. Look, pick up on the cues and maybe the cues are going to be their nonverbal communication as much as as the words that they’re using. Love, there’s some really great courses out there in communication. So it’s good to think about doing a call As it relates to people living with dementia, but also just role modelling, you know, see someone that’s communicating well and go, I could try that approach that seems to work really well.
Andrea Petriwskyj 15:14
Is it a particular skill to in being able to just notice and reflect on and really learn from the cues that people are giving as well, if you are speaking too quickly, or making someone anxious, by the way that you’re communicating with them? There’s a kind of skill in the awareness of being able to pick up on that and respond to it, isn’t that?
Shareen 15:34
Absolutely, yeah. Yeah. And I suppose that’s feedback all the time, isn’t it that? Yeah, that if they’re, if they’re becoming confused, not to think of that said, dementia, but to think, what’s happening for this individual person that’s making them like this? What is that got to do with something that I need to change in? Behaviour needs to be different when I’m working with this person? Yeah.
Andrea Petriwskyj 16:02
And so what I’m hearing from you is also about creating a space where people can trust you that can trust that you’re going to give them a space to process to think to respond in the way that works for them. Yeah,
Shareen 16:17
yeah, that’s right. And that’s, that’s so important for someone who’s living with some problem, who may have difficulty processing language that they Yeah, they, they don’t want to be totally shut down because they’re not answering quickly. But they need that space and time to be able to process and think of a way that they can communicate their needs back to you.
Andrea Petriwskyj 16:49
What we’ve been hearing in today’s episode is that communication is a skill, an absolutely vital skill, and one that you can learn and develop. Importantly, I think we heard a clear message that communicating isn’t just about what you say, but how you say it, how you act and how you are with someone. And you need to be able to adapt to people their particular communication needs, which might not be obvious to you. We’ve heard a couple of examples in this episode of health or cognitive issues that might present different communication needs. But there is of course, much more to know than we could fit into this episode. So it’s important to be open to reflecting on how you do things, hearing what you might need to do differently, and developing this as a skill set. That’s today’s snack. Thank you so much for joining us and a big thank you to our guests for sharing their insights and ideas. If you want to find out more, you’ll find some great resources and other good stuff on our website Kota QL d.org.au. You’ll find links in the show notes. And please don’t forget to subscribe wherever you get your podcasts to make sure you get the next episode as soon as it’s out. Until next time, thanks again and goodbye from the codec Queensland team. This podcast is part of the homecare workforce support programme which receives grant funding from the Australian Government
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