Managing Communication Barriers

Communication is an important thing – it is how we express what we want and what we need.

It must be very frustrating if, due to a variety of reasons, the main way of communicating for someone is affected and they’re not understood. It can also be hard for the person or carer who is trying to understand them.

A few physical conditions you may have come across which may have caused a verbal misunderstanding include:

  • People who isolate themselves and do not want to communicate
  • Emotional barriers due to fear from previous relationship, maybe will only communicate with females or certain staff
  • Cultural differences different languages/accents
  • Hearing loss
  • Brain injuries
  • Sight issues
  • Voice problems such as dysphonia
  • Learning disabilities
  • Stroke
  • Dementia
  • Dysphasia

For someone who has experienced life with no health difficulties, it can be a real struggle to adapt when life goes in the opposite direction.

When you work in care you will probably come across a lot of setbacks in trying to connect with a resident. It can be challenging to both understand them and make yourself understood too. As the person without the ailment, you must remember to stay calm, give them time, and try to understand what they are expressing to you. Do this by listening to their words, watching their body language, and also using what you know about the person to guide you.

Life Stories
Looking into life stories and speaking with families can really help here. For example, a resident I knew who had dementia would say “parsnips” and touch his nose whilst stuttering and shaking. This meant he wanted to blow his nose which came from years of saying “bless your parsnips” to his children whenever they would sneeze.

Tone Of Voice
If someone has a sight impediment it is important to ensure your tone of voice is friendly. Introduce yourself starting with their name so they are aware you are interacting with them. Speak to that resident, never speak through them to a third person as this is very belittling.

Choose Words Carefully
Use descriptive words and instructions when speaking, and be specific if you can. For example say, “the door is on the left” rather than “the door is there”. When finishing the conversation, it is just as important to tell them that you are leaving the room. Every person with a sight impediment is different, so again, ensure you know your residents and their abilities.

Use All The Senses
Activities in care homes now need to be focused on individuals and adapted to suit the capabilities of the residents, but make sure you don’t assume that a resident can’t engage with an activity because of an ailment. Their senses are sill heightened by any interaction and there are myriad ways to be involved in an activity.

For example, ensure you still invite a resident who struggles to see to an art class. The smells may bring back memories of decorating their house, or painting pictures at school (the smell of paint and white spirit instantly takes me back to the days of my dad and grandad making statues in the shed at the bottom of the garden). The feel of the bristles of a paintbrush, and the coldness of the paint on their hands is a lovely sensory experience. The noise of people talking is comforting, and the sound of the paint on the paper is soothing and will make someone feel less isolated. Perhaps some of the residents could explain what they are painting?

If a resident wants to join in, but is anxious that they can’t see to do it, explain that they are contributing to the background of a project and that more hands make light work. Make their contribution feel valuable. A lot of residents I have met over time will do things to help others but not for themselves. Little do they know the benefits they will experience once doing this.

Other ways of communicating with people who may have difficulties communicating include:

  • Writing messages or drawing pictures on whiteboards.
  • Asking residents to squeeze your hand once for yes or twice for no.
  • Knowing which team member your resident bonds with, and opens up to the most, whether that be a receptionist or a chef.
  • Is there a staff member who can speak other languages? If not, you can download apps that translate for you.
  • Use one-word commands so as not to confuse the resident if their dementia has caused them to be unable to communicate.
  • Use facial expressions and a gentle tone of voice.
  • Picture cards for the resident to point at if you are serving two types of meals. Or picture cards with an image of the activity and a description underneath.
  • Sign language – is there a local course at a college? Could you undertake some brief training?
  • Braille.
  • Repeat what you say.
  • Ensure you are in a quiet environment.
  • Give them time to speak. Resist the urge to finish sentences or offer words.
  • Ask yes and no questions.
    Ask another staff member to come with you who may have a better understanding of what the person is trying to say.
  • Talking mats – these are mats to which pictures can be attached and rearranged as required. You can find out about them here
  • Jackie Pool Activity Level Instrument for occupational profiling in Dementia Care (PAL) can help support you to understand the capabilities of your residents.

It is important to do your research on the person. There will be information on the internet and leaflets to support you with certain illnesses. Each charity will have a support line for you to call to ask any questions. They may have resources they can send out to help the resident.