Understand factors that influence communication and interpersonal interaction in health and social care environments
This booklet is about people who may have difficulty communicating with someone else and may need extra added help and how to overcome the communication barrier.
One to one between a care worker and a service user who has a hearing impairment. It is morning and the service user is just getting up after a difficult night’s sleep and in turn will be having breakfast in the main dining room. Argyle’s stages of communication cycle is a 6 stage cycle made up of-an idea occurs, message coded, message sent, message received, message decoded and message understood.
First stage-Ideas occur
You think of something that you want to communicate. It might be an idea or to persuade someone to do something. Communication always has a purpose.
Second stage-Message coded
You think about how you are going to communicate and figure out what form it’s going to be in for example, spoken or sign language. You put this into your head.
Third stage-Message sent
You sent the message in the way that you want to communicate.
Fourth Stage-Message received
The other person you have communicated with senses that you have sent a message has been sent for example, hearing you speak or seeing your signs.
Fifth Stage-Message decoded
The other person has to interpret what you have said/signed. This is known as decoding.
Sixth Stage-Message Understood
If you have communicated clear enough for the other person to understand and the other person has listened, there will be no barriers to the communication therefore the other person understand your ideas. They show you this by giving you feedback for example sending you a message back.
As the carer enters the service users room on a one to one basis to wake them up for breakfast it is dark. The first thing they must do is turn the light on this is so they can both see each other and everything around them and also the carer may startle the patient if they just went up to them in the dark. It will be quiet in the room as it is just 2 people however the patient is deaf so they won’t be able to hear. If the patient is still sleeping the carer will have to go in and wake the patient up by touching the patient for example by tapping them. As the patient is deaf they will have to communicate in another way other that speaking. The carer will sign language to the patient, if the carer can’t communicate using sign language then they may need an interpreter to overcome this barrier, this is someone who will listen to either the carer or the patient and communicate to the other one using either sign language or speech depending on who they are talking to. In this case though the carer can do sign language so as the patient wakes up they will start by using sign language however even though the patient is deaf the carer should also lip read at the same time because they might not of had a hearing impairment all their life and this may help them just that little bit more.
The carer should sit in front of the patient so they can see each other because by turning around and doing sign language then the patient won’t be able to see what they are doing so it will be useless. As the patient has had a bad night’s sleep they might be grumpy so you should give them a bit of space in the morning for them to wake up but they should also keep track of time because they could be late to breakfast. The patient is deaf but they don’t have any other major disability so they won’t need any other help getting to the dining room. Whilst leaving for the dining room the carer realises they are running a bit late but by trying to hurry up the patient they get angry and ask for them to stop bossing them around. The carer should politely ask the patient if they could hurry up a little bit as breakfast has already started. The patient is anxious as they enter the dining room because they are late and everyone is already seated and eating, the carer should make the patient feel more comfortable by helping the patient to their seat. They should also be sat opposite each other so they can communicate effectively because if they were sat next to each other then the patient wouldn’t be able to lip read or see what the carer was signing at all. There are no signs of depression in the patient. The carer should be trained on sign language and be able to use it effectively so there is no barrier however if the carer is new to using sign language then they may feel a bit nervous which would maybe make them mess up abit so they might get something wrong which could confuse the patient.
They should be able to assess what the patient wants and they should help the patient out by doing that for them if it is possible. If the patient has a preferred method of communicating with people then the carer should be trained on using this method because it would make the patient more comfortable for example they may prefer text rather than sign language also some patients feel more comfortable with certain carers so the carer should try build the relationship between themselves and the patient so everyone feels comfortable together. The patient hasn’t had much sleep so they may be quite aggressive with the carer so they should give them some space to wake up and back off a bit. The carer should use friendly gestures towards the patient like smiling when speaking this will show that the carer is friendly and only wants to help out, this is a good non verbal way to communicate because the patient won’t be able to hear the tone of voice the carer is using so by doing this the patient will know that they are happy with what is happening.
If the patient has a technologic aid to help them communicate with people then the carer should make sure they have helped the patient with this before they leave for breakfast for example if the patient has a hearing aid then the carer should make sure this is attached to the patient. All the things that the carer had done to help the patient are overcoming a communication barrier. They are becoming more comfortable with each other which is forming a better relationship between them both so the patient will confide in the carer more and will have more trust in them.
Group meeting between service user, who has had a slight stroke, resulting insome speech impairment and movement loss. Service users relative, nursing and care staff from the nursing home, doctor, social worker and physiotherapist to develop a suitable individual care plan.
Tuckmans stages of group interaction is a 4 stage process involving forming, storming, norming and performing. Stage 1-Forming
There will be high dependence on the leader to start the conversation and the individual roles and responsibilities will be unclear. The leader must be ready to answer a lot of questions from the rest of the group about the purpose of the team. In this scenario everyone will be polite to each other and welcome each other happily.
The team will address problems that they are supposed to solve, how they will function together properly and what leadership model they will use. The team members will open up to each other and talk about each others ideas they have. In some cases this can be resolved easily sometimes storming never gets completed. The supervisors will be there but will be trying to get the problem sorted and will point in the direction for this to happen. The team members will resolve their differences and will be able to participate with each other more comfortably. The main thing is that they want to feel that they will not be judged and be able to share their points and views. The doctor might be in a rush so he might start getting angry with the other people, they must make sure they stay calm and try resolve the problem they are having.
The team manages to come up with one goal and then will form a plan together to work out how they are going to get to this goal, however some of the people might have to give up their ideas and agree with other peoples to make the goal successful. All the team members take responsibility and have ambition. In this stage the members of the group will all tell each other what they think should be involved in the care plan and come to a final decision.
It is possible for some of the teams to reach this stage. These teams will be able to function together to find ways of getting the job done without anything going wrong or and inappropriate conflict. They will be motivated and knowledgeable by this stage. The team members will be now be able to handle the process without any supervision and will make most of the decisions. The care plan will be now created.
As the patient enters the room they realise that there is a lot of people. The patient feels intimidated straight away as they don’t feel comfortable the carer that is helping him should make him feel better straight away by telling him that everything will be fine. There will be quite a bit of noise as there is many people in the room so they might be paper being turned and chairs being scraped so this might make it harder for the patient to communicate therefore one of the members of the group should ask for them all to quiet down. Depending on where the patient is sat they may feel uncomfortable, if they are sat in the middle and everyone is watching them then they may feel like they dont want to speak, they should place the patient somewhere they feel comfortable or next to someone they feel comfortable speaking to, this would be a good way to communicate because the user has got a speech impairment instead of speaking to everyone at the same time they could speak quietly to someone then they could then tell it back to the whole group. If the lighting is too light then they might not be able to see each other and it could be reflecting in people’s eyes, they should keep the lighting on a appropriate setting for all the members of the group.
If the table they are all sat around is too small then they might be all cramped up and squashed together which wont be very comfortable after a long time, to prevent this from happening they should make the table a bit longer but not too long that they have to shout to each other to be able to communicate. The time could become a problem in a situation like this because some of the people could only have a small amount of time which could make the service user become uneasy as they have a lot to discuss in such a small amount of time so therefore they could get stressed out, they should all arrange a certain amount of time to speak and make sure they can stay throughout the whole meeting without having to leave without a final care plan being created. As the service user has suffered from a stroke and now has movement loss then a wheelchair might be needed for them to help them get around if this is the case then they should make sure they are in a suitable room and around a suitable table where the service user can feel part of the group. The users personality could become unhappy throughout the meeting for example if they are not listening to what he wants and doing what they think is right but making it harder for the service user then they could become defensive and angry, the other members of the meeting should always listen to the service user and take into account what they want as they are the one that the care plan is going to be revolving around in the end.
By listening to the user this will make them feel happier and relieved that something good is going to come out of the meeting. The users self esteem might be down because they have just recently lost some speech and movement so they should make sure that they are cheering them up and making them feel better about their selves as they could be at a pretty low point. Submissiveness could also play a big barrier in this situation because the user may feel like they are useless in this meeting and are not getting listened to so could just be agreeing to everything that is being said and not actually saying their point of view and what they want. As the carer they should make sure that they are persuading the user to speak and tell them their point of view as they could be left very unhappy with the end conclusion. Everyone should be assessing the need of the user and thinking what is best for them rather than themselves.
Because there is many people in the room then the user might have a closer relationship with one of them more than they have with the others so that person should be there for them and defending them at all times as the user will rely on them as they have built up a relationship over time. No technical aids are needed in this situation. The main things that have been spoke about in this booklet is about how everyday situations there may be a communication barrier that could stop 2 or more people having a conversation and what someone has to do to help the service user in this case overcome the barrier that they are facing.