According to the U.S. Department of Health and Human Services, almost 70 percent of all Americans over age 65 will need long-term care at some point in their lives. While many people receive that care in a residential facility, even more people are choosing to remain at home as long as possible. This means receiving care and services from home health providers.
Staying at home is usually more comfortable, not to mention more cost-efficient, for most people. However, problems often arise when there isn’t adequate communication between the patient and his or her caregivers, which includes both the medical professionals who come to the home and family members who are involved in the care. Miscommunication about medication, symptoms, patient status, and other issues can be irritating at the very least (no one likes to be inconvenienced by a missed appointment) and life threatening at the worst (such as when medication instructions aren’t properly conveyed.)
But why does communication seem to break down so often when it comes to home care? In some cases, it’s simply the effects of aging that lead to difficulties; i.e., the patient has trouble hearing, or neurological conditions affect the ability to understand or speak. However, more often than not, communication problems boil down to one key aspect of communication: Listening.
Why Listening Is Important
Multiple studies have shown that good communication is vital in home care settings. One study in the Journal of Palliative Medicine found that about 59 percent of hospital readmissions among elderly people are avoidable, and are often related to issues such as relapse, problems with medications, and problems with caregivers.
That same study also found that many of those issues could be avoided with better communication; while problems can arise when patients don’t understand or adhere to plans, they can also arise when the caregiver doesn’t really hear what the patient or family is trying to say.
Additional studies have found that good communication is directly related to improved relationships between patients and caregivers, and that those good relationships contributed to more positive outcomes overall. More specifically, better interpersonal relationships led to better medication management, better mood and emotional regulation, and improved cognitive and physical abilities. In short, communication is the foundation of quality health care.
Communication in the home care environment not only requires caregivers to convey messages effectively in terms that the patient and his or her family can understand, but also that families and patients, when appropriate, do the same.
Unfortunately, because of differences in terminology and communication styles, though, those messages are lost. And because time is often short, both parties don’t give adequate attention to what the other is saying, but instead focus on their next response or question. As a result, they only hear a fraction of what is being said, and eventually, care is likely to suffer as a result.
Improving Listening in Home Care
Improving listening, from the provider’s perspective, often comes down to using the right tools and techniques.
One of the best ways for caregivers to improve communication is to engage in the practice of active listening, a technique often used in conflict resolution and counselors to ensure that they have accurately heard what the other party is saying.
The cornerstone of active listening is paraphrasing what the other person has said, both verbally and via nonverbal cues, to demonstrate comprehension and clarify any misunderstandings. It might take the form of “So what I am hearing you say is . . .,” which gives the other person the opportunity to correct or confirm the statement. Active listening forces you to focus on the other person’s words, and not your next response, and ensures that everyone is on the same page, so to speak.
However, because home health providers are often working with adults who are experiencing cognitive decline, active listening is just one way to improve communication. Many providers have implemented home care software to help improve communication between providers, patients, and families, for example.
Software allows providers to share more detailed notes, or even connect to telehealth or remote monitoring and communication systems that improve two-way communication. By using electronic tools, providers can communicate with other caregivers even when they aren’t there, and keep more meticulous records of communication to help prevent future misunderstandings.
Still, technology is most useful when the providers using it are able to communicate effectively with their patients, and have the skills to truly listen to what patients and their families are saying. When patients feel heard, they develop better relationships with their providers and receive better care overall.