Not everyone communicates in the same way and it is important that you make sure that you are able to communicate with the people you support in the best way for them. 

Why is communication important in health and social care?

People have a wide range of communication needs, which involves the consideration of many different factors such as:

• sensory ability
• cultural background
• language
• self-confidence
• level of learning ability
• physical ability

As a professional, it is your responsibility to make sure that your communication skills meet the needs of the people you support. You should not expect people to adjust their communication to fit in with you. The best way to find out about what people want and need, of course, is to ask!

HEARING LOSS

A loss or reduction of ability to hear clearly can cause major differences in the ability to communicate.

Communication is a two-way process, and it is very difficult for somebody who does not hear sounds at all or hears them in a blurred and
indistinct way to be able to respond and to join in. The result can be that people who are hard of hearing may feel very isolated and excluded from others around them. This can lead to frustration and anger that may cause them to present behaviour that provides you, as their carer, with some challenges. 

Profound deafness is not as common as partial hearing loss. People are most likely to suffer from loss of hearing of certain sounds, at certain volumes or at certain pitches, such as high or low notes. It is also very common for people to find it difficult to hear if there is background noise – many sounds may jumble together in this instance, making it very hard to pick out the voice of one person.

Hearing loss can also have an effect on speech, particularly for those who are profoundly deaf and are unable to hear their own voices as they speak. This can make communication more difficult.

VISUAL IMPAIRMENT:

Visual impairment causes many communication difficulties. Not only is an individual unable to pick up the visual signals that are being given out by someone who is speaking, but, because they are unaware of these signals, the person may also fail to give appropriate signals in communication. 

This lack of non-verbal communication and lack of ability to receive and interpret non-verbal communication can lead to misunderstandings about somebody’s attitudes and behaviour. It means that a person’s communications can easily be misinterpreted; they may even seem to be behaving in a way that is not appropriate for the situation.

PHYSICAL DISABILITY:

Obviously, the effects on communication will vary, depending on the disability. People who have had strokes, for example, may have communication difficulties, not only in forming words and speaking (aphasia), but the damage the stroke has done to their brain may result in an inability to comprehend language (dysphasia). People can lose the ability to find the right words for something they want to say, or to understand the meanings of words said to them. This condition is very distressing, both for the person and for those who are trying to communicate with them. 

Often this is coupled with a loss of movement and a difficulty in using facial muscles to form words. 

In some cases, the communication need is a symptom of a condition. For example, many people with cerebral palsy and motor neurone disease have difficulty in controlling the muscles that affect voice production, and so clear speech becomes very difficult.

Some people living with Parkinson’s disease and Myasthenia gravis for example, may find it difficult to convey emotions via their facial expressions, as the muscles in their face – or the nerves that control them - can be affected, resulting in minimal expressiveness, which the person has no control over.

Other conditions may have no effect at all upon voice production or the thought processes that produce spoken words, but the lack of other body movements may mean that non-verbal communication is difficult - or not what you may have expected.

LEARNING DISABILITY:

Dependent upon severity, a learning disability may cause differences in communication in terms of the level of understanding of the individual and their ability to respond appropriately to any form of communication. 

This will vary depending on the degree of learning disability of the person you’re caring for, but broadly the effect is to limit their ability to understand and process information given to them. It is also possible that individuals will have a short attention span, so this may mean that communications have to be repeated several times in an appropriate form for them.

EFFECTIVE COMMUNICATION IN HEALTH AND SOCIAL CARE

Barriers or Misuse of Communications Skills:

• Not active listening – e.g. Yawning, checking watch, gazing out window etc.
• Emotional leakage – verbal and non-verbal messages do not match, true feelings show over professionalism
• Too many open/closed questions – like interrogation or not allowing for opinion
• Aggressive or intimidating body language
• Patronising tone, pace too fast or slow
• Lack of empathy or support
• Turn taking – no silences to think or time to respond

Environmental Factors: 

• Noise – Background or sudden, external
• Heat – too hot or too cold
• Lighting – interrogation bright light or too dull and intimate!
• Space – too small room or large open area, lots of windows
• Interruptions – other people coming in the room or turning the TV on
• Room set up; positioning of communicators, seating etc. 

Identification Communications Needs - Reminder:

• Check what each person’s communication needs, wishes and preferences are.
• Remember they can be dictated by cultural as well as physical factors.
• Examine the effects of the communication for each individual.
• Use all possible sources to obtain information.
• Make sure you have all the skills necessary to communicate, or look for extra support and/or training where necessary.

COMMUNICATION IN HEALTH AND SOCIAL CARE

Many communications situations are – or can be – difficult. In the Health and Social Care setting they can also begin positively and then become increasingly fraught. However, if we are to maximise both patient outcomes and quality of life – and our professionalism – improving our communications is a must.

To find out more about Effective communication read our other blog Communication in Care