Communication and Interpersonal Skills
Sending and receiving
Communication is verbal and nonverbal; tone, posture, and touch often carry more than words. Active listening - facing the resident, eye contact at their level, nodding, not interrupting - plus open-ended questions such as 'How are you feeling this morning?' invites real information. Closed questions get yes/no facts. Use plain words, not medical jargon, and confirm understanding by asking the resident to repeat back what they heard.
Therapeutic versus blocking responses
Therapeutic responses include restating, reflecting feelings, clarifying, silence, offering general leads, and giving information. Blocking responses include false reassurance ('Don't worry, you'll be fine'), giving advice, 'why' questions that sound accusatory, changing the subject, agreeing or disagreeing, and terms of endearment like 'honey' that strip dignity.
Special situations
Hearing loss: face the resident in good light, lower your voice rather than shout, and do not cover your mouth. Vision loss: identify yourself and announce when you leave. Aphasia: ask yes/no questions, allow time, and use gestures or a picture board. Dementia: one instruction at a time, and never argue about a false belief. Use a qualified interpreter, not a child. Document quotes as subjective and observations as objective.
Reporting
Report a change in condition, a complaint of pain, a refusal, and anything you were told that affects care. Report facts, not conclusions: 'Mr. B. says his chest feels tight and he is sweating' beats 'he looks bad.'
Traps
Test items reward empathy over advice and objective documentation over opinion.
Rule of thumb
When a resident is upset, name the feeling first ('You seem frightened') before you try to solve anything.