Communication and Interpersonal Skills
Communication has right and wrong answers
Therapeutic techniques: active listening, open-ended questions, clarifying, restating, reflecting feelings, silence, and offering your presence. These build trust and give you better information.
Barriers: medical jargon, giving advice, false reassurance ("you'll be fine," "don't worry"), minimizing feelings, changing the subject, and asking "why" (which can feel like blame). Arguing never works.
Hearing loss: get the resident's attention, face them, speak clearly at a slightly slower pace, lower your pitch instead of shouting, and cut background noise.
Vision loss: identify yourself when you enter, say so before you touch the resident, and describe the food tray by clock position.
Aphasia after stroke: allow extra time, use yes/no questions, gestures, and pictures; never finish the resident's sentences.
Dementia and confusion: short sentences, one instruction at a time, do not quiz or argue - redirect instead. Know the difference: dementia is gradual and progressive, delirium is sudden. Sudden confusion is a medical change and must be reported.
Nonverbal communication matters too: knock and wait, speak at eye level, use a calm voice, and respect personal space and culture.
Confidentiality: discuss care only with the care team - not in hallways, elevators, or with neighbors. Documentation is a legal record and must be factual, timely, and signed.
Traps the questions set
The right answer is usually the one that explains simply and lets the resident ask questions. The wrong answer is the one that reassures, argues, or rushes.
Rule of thumb
Never say "calm down." Say, "Tell me more about that."