Transcript TIPS TO MASTER MORE EFFECTIVE COMMUNICATION WITH

Tips to Master More Effective
Communication with Patients
and Caregivers.
Dr. Martha Carmichael MD, M.Sc., FRCPC
Fellow in Geriatric Medicine, University of Toronto
Dr. Samir K. Sinha MD, DPhil, FRCPC
Peter and Shelagh Godsoe Chair in Geriatrics and Director of Geriatrics
Mount Sinai and the University Health Network Hospitals
Assistant Professor of Medicine,
University of Toronto and the Johns Hopkins University School of Medicine
Health PEI - Making the Connection Conference
15 October 2015
Twitter: @DrSamirSinha
Why is Effective Communication
is Important…
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Helps prevent medical errors.
 Better outcomes for patients and caregivers.
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Strengthens provider-patient/caregiver relationships.
 Increases patient/caregiver and provider satisfaction.
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Helps make the most of limited interaction time for
all those involved.
National Institute on Aging. 2011.
Misunderstandings Are Common
From Our Interactions…
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Medical terminology is often poorly understood.
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Health Providers…
 Underestimate patients/caregivers’ needs for information.
 Overestimate patients/caregivers’ understanding of
information.
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“You could die from this disease”.
 46% disagreement (!)
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Misunderstandings can cause the entire
encounter to fail.
Lerner et al. 2000; Hancock et al. 2007; Fried et al. 2003.
With Older Patients…
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Health Care Professionals are felt to be:
 More condescending, authoritative
 Less patient
 Spending less time, giving less information

Older Patients and Caregivers:
 Don’t ask questions, don’t want to be a bother
 May withhold symptoms that they think are “normal”
 Are more afraid to challenge their provider’s thinking.
Gerontological Society of America. 2012.
Older Patients Are Unique…
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Often have Complex Health and Social Care Needs
 More health problems, medications, community supports
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Heterogeneous – No two are the same…
 Life Experiences, Ethno-Cultural Background, Education
 Fit vs. Frail
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Age-Related Changes May Be Present:
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Sensory Deficits: Hearing or Vision Impairments (25%)
Slower Processing Speeds to Understand Things
Decreased Functional Capacity.
Cognitive Impairment May Be Present
“At a time when older patients
have the greatest need to
communicate with their healthcare providers, life and physiologic
changes make it the most difficult”
Robinson et al. 2006.
Familiar Scenarios?
You are talking with an older woman who you think may have a
hearing impairment. You talk louder, but she still seems to have
some problems hearing and understanding you.
As you talk with an older man and his wife who is caregiver, you
get the feeling that neither of them really understand you, despite
assuring you that they do when you ask them. When you explain
things again, they simply smile and nod their heads “yes”.
You are in the middle of an encounter that seems to be going
well. All of a sudden, you sense that the older person has become
quiet and withdrawn. You know you did something to contribute to
the change in their demeanor, but you just can’t figure out what.
Gerontological Society of America. 2012.
The Good News…
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Good Communication IS a teachable skill!
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Learning and Using Effective Communication
Skills Leads to Improved…
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Communication with Patients and Caregivers
One’s Ability to Build and Assess Relationships
Time Management
More satisfying relationships
Become more skilled at managing patients’care
National Institute on Aging. 2011.
Not Specific to Physicians…
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NPs, RNs, LPNs
Home Support Workers, Resident Care Workers,
Community Support Workers
Managers
Social workers
Occupational Therapists
Physiotherapists
Dieticians
Reception/Administrative Staff
Our Challenge Today…

Start Where You Are
 Comfort level varies

Remember “One Size Fits All” Does NOT Apply
 Individualize An Approach that Works for YOU!
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Embrace and Use These Basic Tips!...
Tips to Master
More Effective Communication…
Tip #1:
Allow extra time for older patients.
Tip #2:
Avoid distractions.
Tip #3:
Sit face to face.
Tip #4:
Maintain eye contact.
Tip #5:
Listen.
Tip #6:
Speak slowly, clearly and loudly.
Tip #7:
Use short, simple words and sentences.
Tip #8:
Stick to one topic at a time.
Tip #9:
Simplify and write down your
instructions.
Tip #10:
Use charts, models and pictures.
Tip #11:
Frequently summarize the most
important points.
Tip #12:
Give patients an opportunity to ask
questions and express themselves.
Our Takeaways Today…

Start Where You Are + Practice Makes Perfect!
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Individualize an Approach that Works for YOU!
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Effective Communication Benefits EVERYONE!

Effective Communication is Often Simple, Honest
and Straightforward in Its Approach.
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Every Patient and Caregiver is Unique and
Requires an Individualized Approach.
Thank You
Samir K. Sinha MD, DPhil, FRCPC
Peter and Shelagh Godsoe Chair in Geriatrics and Director of Geriatrics
Mount Sinai and the University Health Network Hospitals
Provincial Lead, Ontario’s Seniors Strategy
[email protected]
@DrSamirSinha
References
Fried et al. 2003. Prognosis communication in serious illness: Perceptions of
older patients, caregivers and clinicians. JAGS. 51:1398.
Gerontological Society of America. 2012. Communicating with older adults:
An evidenced based review of what really works.
Hancock et al. 2007. Discrepant perceptions about end of life communicatio:
A systematic review. Journal of Pain and Symptom Management.
34(2):190.
Lerner et al. 2000. Medical Communication: Do our patients understand?
American Journal of Emergency Medicine. 18(7): 764.
National Institute on Aging. 2011. Talking with your older patient.
Robinson et al. 2006. Improving communication with older patients: Tips
from the literature. Family Practice Management.