Communicating With Patients
Talk with patients who have hearing, vision, language or memory barriers, and answer questions you are not allowed to answer.
Table of contents
Most of care happens through talking. A patient who understands you will cooperate, tell you when something hurts and trust you with what is worrying them. A patient who cannot hear you, or feels ignored, may refuse care or hide a problem. Good communication is a skill you can practice, and it changes with each person you serve.
What You Will Be Able to Do
- Use listening habits that help a person open up.
- Adjust how you talk for hearing, vision, speech and memory problems.
- Work with an interpreter.
- Respect cultural beliefs in everyday care.
- Respond to medical questions that are outside your role.
Basics That Work With Everyone
- Get on their level. Sit or stand where they can see your face.
- Use plain words. Say "blood pressure," not "BP," and "walk," not "ambulate."
- Give one idea at a time, and pause.
- Listen more than you talk. Let people finish. Silence can be useful.
- Check that you understood. "So your knee hurts more when you stand. Is that right?"
- Notice body language. Crossed arms, a clenched jaw or a look away can say more than the words.
- Show you care. "That sounds hard" is often better than advice.
Avoid baby talk, false cheer and phrases like "you'll be fine." You do not know that, and the person knows you do not.
Adjusting for the Person in Front of You
| Barrier | What helps | What to avoid |
|---|---|---|
| Hard of hearing | Face them, speak clearly at a normal pace, use good light, reduce background noise, check that hearing aids are in and working | Shouting, covering your mouth, talking from another room |
| Low vision | Say your name when you enter, describe where things are, tell them before you touch them, keep objects in the same place | Moving their things, pointing and saying "over there" |
| Trouble speaking (aphasia) | Ask yes-or-no questions, give extra time, use pictures or a writing board | Finishing their sentences, pretending to understand |
| Confusion or memory loss | Short sentences, calm voice, one step at a time, repeat without frustration | Arguing, quizzing, giving long explanations |
| Severe pain or fear | Lower your voice, keep it brief, address the pain first | Rushing, making jokes |
A shout distorts speech and can make hearing harder, and it can look like anger. Most people with hearing loss also rely on seeing your lips and expressions.
Working With Language Differences
Patients have the right to language help. Use your employer's qualified interpreter, phone line or video service for anything about health, consent or instructions. Family members, and especially children, should not be used as interpreters except in an emergency. They may leave things out, change the meaning or learn things the patient wants to keep private.
When using an interpreter, look at and speak to the patient, not the interpreter, and use short sentences.
Respecting Culture and Belief
Culture affects food, modesty, touch, who makes decisions, how pain is shown and what is done around death. Respecting those beliefs builds trust, and people are more likely to accept care from someone who respects them. Disrespect can offend a person and lead them to refuse care.
- Ask, do not assume. "Is there anything about your beliefs or customs I should know about for your care?"
- Remember that one person does not speak for a whole culture.
- Accommodate prayer times, food rules and modesty requests whenever you can.
- If a belief conflicts with a care plan, tell the nurse. Do not settle it yourself.
When Patients Ask Questions You Cannot Answer
Patients often ask aides what their test results mean, whether they are dying or whether they should stop a medicine. It is natural that they ask you, since you are the person there. But giving medical advice, explaining a diagnosis or predicting an outcome is outside your role.
- Do not guess, and do not brush it off.
- Acknowledge the question. "That is an important question."
- Refer it. "I can't answer that, but I'll tell your nurse you want to talk about it."
- Actually tell the nurse, and soon.
- If they seem scared, stay a moment. You can listen even when you cannot answer.
Talking With Families
Families are worried, tired and sometimes angry. Listen, stay polite and bring in the nurse or your supervisor for anything about the diagnosis, the care plan or a complaint. Do not take sides in family disputes, and do not criticize other caregivers.
Common Mistakes
| Mistake | What it costs |
|---|---|
| Shouting at someone who is hard of hearing | They hear less and feel scolded |
| Using a child as an interpreter | Wrong information and lost privacy |
| Answering a medical question to be kind | A patient may act on wrong advice |
| Talking over a patient to a family member | The person feels invisible |
| Saying "you'll be fine" | Shuts down the real conversation |
Check Your Understanding
1. A patient with hearing loss keeps saying "what?" while the TV is on. What do you change?
Turn down the TV with their permission, make sure their hearing aids are working, face them and speak clearly at a normal pace.
2. A patient who speaks Spanish needs instructions about going home, and her 12-year-old grandson offers to translate. What do you do?
Thank him and use your employer's qualified interpreter service.
3. A patient asks, "Is this cancer going to kill me?" What do you say?
Acknowledge the question, stay with them for a moment, say you cannot answer but will get the nurse, and tell the nurse right away.
4. A patient will not eat pork for religious reasons and it is on the tray. What is the right response?
Respect the request, do not pressure them, and ask the nurse or kitchen about a replacement that fits the diet order.
Key Takeaways
- Face people, speak clearly and listen more than you talk.
- Change how you communicate to fit each person's hearing, vision, speech and memory.
- Use qualified interpreters, not children or family.
- Ask about beliefs and customs instead of assuming.
- When a question is outside your role, acknowledge it and pass it to the nurse.