Communication and Interpersonal Skills
Therapeutic communication and reporting
Good communication is a clinical skill. Use open-ended questions ("Tell me how you're feeling") to invite information, then closed questions to confirm details. Practice active listening: face the resident, make eye contact as culturally appropriate, nod, and repeat back what you heard. Use empathy rather than false reassurance. Saying "Don't worry" or "It'll be fine" shuts down conversation; saying "That sounds frightening" invites more. Avoid "why" questions that can sound accusatory, avoid giving personal advice, and do not argue with a resident who is confused or hallucinating-acknowledge the feeling and redirect.
Adapt to the person. For hearing loss, reduce background noise and face the resident; do not shout automatically. For aphasia, ask yes/no questions, allow time, and use gestures or a communication board. For dementia, use short sentences, one idea at a time, and a calm tone. Use a qualified interpreter when needed, not a family member for sensitive information. Keep protected health information private and discuss care only with the care team.
The documentation trap is charting opinions or conclusions ("resident was difficult") instead of objective facts ("resident refused bath at 9 a.m., stated 'not today'"). Report changes promptly and use the chain of command if a concern is not addressed.
Worked example: a resident says, "I'm just a burden now." Respond, "It sounds like you're feeling that way. Tell me more about what's bothering you," listen, and report the statement to the nurse so it can be assessed.