Learning Outcomes

• To become aware about relation between active listening and healthy communication
• To become aware about capacitative approach and its potential

Session Content

From active listening to “healthy communication”

Another point to consider if you want to effectively communication and create positive relationships is that you need to actively listen.

“I’m here listening to you, I’m interested in you and what you will say; you are at the center and not me, with my thoughts, my hypotheses, my expectations and prejudices; what you are and what you say is important to me! “ 

The ability to listen actively is very important to trigger a valid communication style. Listening actively means: assuming a series of behaviours with which we communicate to the interlocutor that we are considering him/her and that we intend to understand him/her.

Some examples:

• To emote the underlying emotions
  “I suppose this situation makes you…”
  “Sometimes I have found myself in a similar situation…”
  “What kind of emotions do you feel in this situation …”

• Check the degree of accuracy
  “You mean that, that is, I mean that you think that …”

• Find out where the person wants to go
  “Would it help if I told you…”
  “Where do you think you’re going based on what I’ve heard…”
  “Are you suggesting that we should …”

• Go beyond the first impression
  “Tell me more …”
  “There is something else besides what I heard …”

Tips for effective active listening:

1. avoid interrupting the interlocutor
2. avoid distracting yourself through external factors or innovating yourself
3. put yourself to the side and focus on the person speaking
4. don’t have prejudices but collect the information
5. increase your attention not only to what the interlocutor is saying, but to how he expresses it
6. reformulate once you have finished the speech, to see if you have understood the message or not.

The capacitative approach

The capacitative approach is a method that is based on listening to and consequently recognising the skills that the sick elderly person retains rather than on the deficits.

Focusing on the needs of the resident in relation to his/her stage of illness remains fundamental to care planning, but can have negative repercussions on the elderly person him-/herself and his/her quality of life because he/she too will adapt to the role as a sick person, now only in need of care, and will feel increasingly inadequate.

The capacitative approach invites practitioners to bring out and enhance the competences that are still present. Example: the elderly person forgets everything, but can still speak, we give him the possibility to do so even if we do not communicate.

The elderly person will then be able to perceive him-/herself again as a person who is able to do things.

Some considerations for the successful application of this method:

1. We recognise in the elderly person all the identities (parent, spouse, colleague, etc.) and the many worlds they have passed through (they have worked, had social interests, hobbies, etc.).
2. Do not consider the elderly person to be merely sick and a mere body to be cared for. If we learn to know and recognise them for what they have been and still show themselves to be, it will be easier to establish a positive relationship with them.
3. In everyone there is still a healthy part that we want to enhance. If we always consider an elderly person with dementia only as a dementia patient, he/she will also perceive him-/herself as such, unable to do anything. If, on the other hand, he/she is recognised for his/her still active competences, the healthy self will be better preserved and the well-being will improve.
4. WE RESPECT in every degree and form the:

– competence to speak: as far as possible

– competence to communicate: in their own way

– emotional competence: picking up and recognising signs of emotion

– competence to bargain/decide: let them express their will and recognise it as such (even if they cannot always be satisfied)

 

 

 

 

 

 

Introduction
Participants will learn how different forms, channel, codes and levels of communication are always applied in daily communication and how they may affect flow of communication.

Learning outcomes

• Being able to recognize the appropriate channel, code and level to communicate.
• Being able to apply the appropriate method and avoid inappropriate solutions

Session Content

Introduction

We spent the 75% of our day communicating.

Now, we know that not only what we say is important, but also HOW we say it, considering both the CODE we are using and the selected CHANNEL (type of communication used, as well as the tool, communication technique or communication level).

In particular, by CHANNEL we mean both the technical means external to the subject (i.e. telephone, mobile phone, mail, etc.) and the sensory means involved in communication, that is the communication technique.

A joint use of the different communication methods produces the most effective results. Learning varies with the variation of communication techniques and therefore of the different channels of perception.

 

Communication technique	Channel of perception	% learning
Verbal	Only hearing	20%
Gestural-graphic	Only sight	30%
Mixed 1	hearing + sight	50%
Mixed 2	hearing + sight + discussion	70%
Mixed + experience	hearing + sight + discussion + habits	90%

 

The transmission of the message can be direct (verbal, para-verbal or nonverbal) or indirect (use of external means, such as writing).

 

Communication levels and nonverbal communication

The communication we’re going to analyse, which is of greatest interest in the care relationship, is the “direct and interpersonal” one, that is, involving two or more people in a face-to-face-situation..

 

We can identify 3 main communication levels:

1. VERBAL COMMUNICATION
2. PARA-VERBAL COMMUNICATION
3. NONVERBAL COMMUNICATION

 

1. VERBAL COMMUNICATION

This refers to the content we express through the use of words (both oral and written).

 

2. PARA-VERBAL COMMUNICATION

• Vocal productions that “shape” our way of speaking: tone, rhythm, accent, volume, but also coughs, pauses, laughter

• It is expressed through the variations of the voice and it is possible to capture the emotional conditions of the interlocutor (rhythm and pauses)

• If we move the voice towards high tones, we denote tension and irritation

• Towards the low tones, calm and security

• Lowering the volume of the voice, insecurity, raise it shaking or bullying.

 

3. NON VERBAL COMMUNICATION

It considers the mimic, gestural and spatial aspects: facial expression, gestures, mimicry, posture, physical distance with people.

 

It is less easily controlled by the broadcaster and therefore portrays actual feelings, moods, opinions.

 

On this communicative level we can see the importance of the SPATIAL BEHAVIOR factor, that means how we act and how we manage the space in the interaction (ease / discomfort).

 

We can identify different spaces thanks to the proxemics (“Language of proximity”):

• Intimate (0 to 0.5m)
• Personal (from 0.5 to 1 m)
• Social (from 1 to 3/4 m)
• Public (more than 3m)

 

We also have to consider:

• Aptica = body contact; vulnerable and non-vulnerable areas; culture of contact.
• Orientation = face to face, side by side, from behind.

 

Functions and limits of non-verbal communication

PROS:

• It is an expressive communication (emotions)
• It facilitates interrelationships
• It’s a regulator of interrelationships / communication (source of feedback)
• It supports – replaces – emphasizes – colors verbal communication
• It’s spontaneous, sincere, immediate and powerful communication.

 

CONS:

• Unsuitable for conveying definitions or knowledge
• Fast but to a small extent (quantity)
• We cannot speak of universality (culture, sex, age).
• Hardly controllable

 

 

 

Learning Outcomes

• Being able to explain the basic principles of good communication and having knowledge about the importance of communication and especially good communication

Session Content

Introduction

Communication must be targeted, and diversified according to the person in front of you and their specific needs.

Communicating with an elderly person is therefore very different from communicating with a young colleague, an adult or a child.

The category of elderly people (together with children and disabled people) deserves a closer examination of the case, as it is a risk category with which to better target communication strategies.

 

Characteristics of the elderly person in the communication relationship

Even if they belong to a risk category, it is necessary first of all to overcome certain clichés that always see them as fragile, sick, confused, inactive people.

First of all, the general state of health must be considered (hearing, attention, sense of smell, memory, any medication in place, etc.).

Next, other peculiarities of the elderly person:

• Decreased adaptive capacity
• Less expertise in defending against external threats
• Slower recovery
• Lower levels of anxiety and shorter duration
• Emotional trauma acts deeper, emotionality is less visible, the elderly tend to suffer quietly, often refrain from asking for help.
• Tendency towards autonomy and self-sufficiency

 

Communication and behavioural strategies to be adopted

Following on from this, here are a number of strategies to adopt and avoid in order to build a positive communication environment with the elderly person.

 

When communicating with an older person, non-verbal communication is crucial because it is even more evident how important it is to consider not only the content – the WHAT? -as well as the HOW, i.e. both the words used and the way in which they are spoken.

 

What to do

• Do not communicate using metaphors but simple, clear language with consistent gestures
• Keeping a calm, reassuring, courteous attitude
• Controlling transfers and movements
• Keeping dangerous objects away
• Ensuring correct lighting
• Helping to maintain independence in life activities
• Explaining the non-verbal signals received from the elderly person to reassure him or clarify doubts; (e.g. inhaling, closing the lips, leaning forward, raising the head and looking for the gaze, wanting to speak, to have his say);
• Being attentive and receptive
• Keep our non-verbal communication active (nodding, friendly facial expressions, nods of understanding and attention);
• Finding the right distance and verbalising the movements;
• Leaning and orienting towards the patient, mirroring his postures and words;
• Participative and welcoming look
• Shaking hands, respectful contact

 

What not to do

• Being loud and authoritarian or agitated and annoyed;
• Disqualifying the patient as an interlocutor;
• Being cold, not very participative;
• Not paying attention to overt and latent behaviour (emotional words and attitudes);
• Do not be intrusive (modesty);
• Being silent or mumbling during tactile examination or medical/nursing manoeuvre;
• Cross your arms;
• Constantly leaning against the backrest and distant from it

 

A final fundamental consideration when dealing with an older person is to assess the social network and support around the person.

Try to solve the following quiz about Schulz von Thun’s communication model. Can you remember everything?

Take a look at the poster. Here, Schulz von Thun’s communication model is repeated again. Furthermore, a critical view of this model is given.

 

Read through the two reflection questions and try to answer them. There is no right or wrong way to answer the questions.