Communication

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his assignment discusses barriers to, and methods of, effective communication with people who are confused by reflecting on my experience in communicating with an elderly confused patient. Specifically, and within the scope of this assignment, I reflect on two methods of effective communication with elderly confused patients; one verbal (reality orientation) and one non-verbal (touch).  During my first placement I was asked to assist in the care of Elsie (pseudonym), an 86 year old lady admitted to hospital with a fracture to her hip and a urinary tract infection (UTI). Elsie was suffering from frequent periodic episodes of confusion; however this was not due to a diagnosed cognitive disorder. Manos and Braun (2006) and Keenan (2011a) say that elderly patients with a bone fracture or a UTI often present with confusion; which is a disorder of brain function (Manos and Braun, 2006). The elderly are more prone to confusion when they are ill because, with increasing age, kidney size and renal blood flow decrease causing a reduction in renal threshold (Keenan, 2011b).  When Elsie was in a confused state I found it difficult to interpret what Elsie was trying to communicate to me because her responses to my questions did not make sense. When communicating with Elsie I consciously used the active listening SOLER (Sit square-on, Open posture, Lean forward, Eye contact, Relax) model (Egan, 2010) that I had been taught at University. I used this to show Elsie I was listening and to help me try to understand what Elsie was communicating. I felt frustrated because although I used SOLER, slowed down my normal pace of communication and repeated what I was saying, Elsie’s responses still did not make sense. The National Health Service (NHS, 2010) says that speaking slowly may help when communicating with a confused person. I have, however, found no evidence that repeating verbal communication helps a confused person understand what is being conveyed and on reflection I only did...
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