During my first placement I was asked to assist in the care of Elsie (pseudonym), an 86 year old lady admitted to hospital with a fracture to her hip and a urinary tract infection (UTI). Elsie was suffering from frequent periodic episodes of confusion; however this was not due to a diagnosed cognitive disorder. Manos and Braun (2006) and Keenan (2011a) say that elderly patients with a bone fracture or a UTI often present with confusion; which is a disorder of brain function (Manos and Braun, 2006). The elderly are more prone to confusion when they are ill because, with increasing age, kidney size and renal blood flow decrease causing a reduction in renal threshold (Keenan, 2011b).
When Elsie was in a confused state I found it difficult to interpret what Elsie was trying to communicate to me because her responses to my questions did not make sense. When communicating with Elsie I consciously used the active listening SOLER (Sit square-on, Open posture, Lean forward, Eye contact, Relax) model (Egan, 2010) that I had been taught at University. I used this to show Elsie I was listening and to help me try to understand what Elsie was communicating. I felt frustrated because although I used SOLER, slowed down my normal pace of communication and repeated what I was saying, Elsie’s responses still did not make sense. The National Health Service (NHS, 2...
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...aching on a patient’s personal space. I should therefore use a calm reassuring voice with the use of touch. I find it comforting to know that Oliver and Redfern (1991) say that the use of touch is a skill that can be acquired and learnt.
Reflecting on my experience communicating with Elsie I have learnt about two communication techniques (reality orientation and the use of touch) that will help me communicate more effectively with an elderly confused patient. I have realised I need to find out more about using expressive touch in communication and the use of other verbal and non-verbal techniques that can help in communicating with elderly confused patients, such as effective use of paralinguistic communication. This will give me greater confidence in communicating with elderly confused patients because I will have additional strategies to bring to the situation.
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