physical capabilities (i.e., physical coordination,
mental orientation, reduced eyesight).
management should be modified to accommodate the
individual patient. Show genuine respect and warmth
with the elderly. Avoid using terms like gramps or
granny. You should always show the elderly respect
by treating them as the adults they are.
Give older patients the opportunity to control as
many aspects of their self-care as possible. Allowing
patients to self-pace their own care may take more
time, but it will result in reducing their feelings of
frustration, anger, and resentment. Listen to patients
and allow them to reminisce if they wish to. The
conversation can be used as a vehicle to bring todays
events into focus for the patient. Remember to involve
family members, as needed, into the patient education
process. Some of your elderly patients will require
assistance from family members for their medical
needs once they are back home.
LEARNING OBJECTIVE: Recognize
communication techniques used in a
Communication is a highly complicated inter-
personal process of people relating to each other through
conversation, writing, gestures, appearance, behavior,
and, at times, even silence. Such communications not
only occur among healthcare providers and patients, but
also among healthcare providers and support personnel.
Support personnel may include housekeeping,
maintenance, security, supply, and food service staff.
Another critical communication interaction occurs
among healthcare providers and visitors. Because of the
critical nature of communication in healthcare delivery, it
is important that you understand the communication
process and the techniques used to promote open, honest,
and effective interactions. It is only through effective
communication that you are able to identify the goals of
the individual and the Navy healthcare system.
THE COMMUNICATION PROCESS
The human communication process consists of
four basic parts: the sender of the message, the
message, the receiver of the message, and feedback.
The sender of the message starts the process. The
message is the body of information the sender wishes
to transmit to the receiver.
The receiver is the
individual intended to receive the message. Feedback
is the response given by the receiver to the message.
Feedback, at times, is used to validate whether
effective communication has taken place.
Verbal and Nonverbal
The two basic modes of communication are verbal
and nonverbal. Verbal communication is either spoken
or written. Verbal communication involves the use of
words. Nonverbal communication, on the other hand,
does not involve the use of words. Dress, gestures,
touching, body language, face and eye behavior, and
even silence are forms of nonverbal communication.
Remember that even though there are two forms of
communication, both the verbal and the nonverbal are
inseparable in the total communication process.
Conscious awareness of this fact is extremely
important because your professional effectiveness is
highly dependent upon successful communication.
Barriers to Effective
Ineffective communication occurs when obstacles
or barriers are present. These barriers are classified as
p h y s i o l o g i c a l , p h y s i c a l , o r p s y c h o s o c i a l .
Physiological barriers result from some kind of
sensory dysfunction on the part of either the sender or
Such things as hearing impairments,
speech defects, and even vision problems influence the
effectiveness of communication.
consist of elements in the environment (such as noise)
that contribute to the development of physiological
barriers (such as the inability to hear). Psychosocial
barriers are usually the result of ones inaccurate
perception of self or others; the presence of some
defense mechanism employed to cope with some form
of threatening anxiety; or the existence of factors such
as age, education, culture, language, nationality, or a
m u l t i t u d e o f o t h e r s o c i o e c o n o m i c f a c t o r s .
Psychological barriers are the most difficult to identify
and the most common cause of communication failure
A persons true feelings are often
communicated more accurately through nonverbal
communication than through verbal communication.
Listening, a critical element of the communication
process, becomes the primary activity for the
healthcare provider, who must use communication as a