Oral or verbal communication uses words to present ideas, thoughts and feelings. The communication cycle demonstrates that effective oral communication is a two way process, the ability to both explain and present your ideas clearly through the spoken word, and to listen carefully to other people. This will involve using a variety of approaches and styles appropriate to the audience you are addressing. Care workers need a range of oral communication skills to: respond to questions, find out about an individual’s problems or needs, contribute to team meetings, break bad news, provide support to others and deal with problems and complaints.
Visual communication is a way of showing ideas through a visual display. This could be used as a way of therapy for anger management. Therapy is basically medical treatment for disabilities and diseases. In this case it is used to control behaviour. This type of therapy would be used in hospitals or public halls.
Touch communication could refer to blind people and the way they communicate through brail. Most public places will have brail underneath signs or at the bottom of leaflets allowing blind people to know what it says. It helps them to understand and respond.
Music and drama communication, for example, theatre. Theatre can teach us about moral values. Music and drama help people to express themselves and communicate to an audience about what they are like. Music and drama are also similar to visual communication; they can also be used as a form of therapy.
There are some care related situations where a person’s ability to express their thoughts or feelings is impaired or limited. This might occur if a person has a learning disability, a brain injury or a condition (such as dementia) that limits their ability to use or understand language. Some people who are experiencing mental health problems also struggle to talk about experiences or to express thoughts and feelings that are distressing and painful. In situations like these, a care professional may make use of objects of reference for example toys, clothes, jewellery or photographs, that have a special meaning for the individual and which are used to reassure, comfort and remind them of happier times.
Arts and crafts communication helps people to communicate using colour and other objects. Artwork, objects and ornaments can also communicate emotions to certain people. As well as being sentimental value in some cases, vases, paintings and photos can describe to someone about a place or person; it can provide a lot of information.
Communication using technology is used by the majority of people. Examples of communicating with technology are:
• E-mail
• Text-messaging
• Telephone
• Mobile Phone
• Msn Messenger
• Websites
These are used when trying to communicate with a person remotely. People can be contacted by using these simple devices. There are advantages and disadvantages of using technology as a way of contacting someone:
The advantages are that they can be used virtually anywhere, with the exception of computers unless they are laptops. Someone can ring you up on your home phone if your there and if not, they can try your mobile number. A large percentage of people nowadays use text-messaging and MSN Messenger on the computer as a way of contacting their friends.
Disadvantages of using these are that people on the receiving end cannot always tell how a person is feeling. This can cause confusion.
Interpersonal Interaction
There are many different types of interpersonal interaction such as Speech, Language (1st language, dialect, slang, jargon), Non-verbal (posture, facial expression, touch, silence, proximity, reflective listening, body language) and Variation between cultures
Speech is the most basic form of communication however it may be expressed. Different localities, ethnic groups, professionals and work cultures all have their own special words, phrases and speech patterns. These localities and groups may be referred to as different speech communities.
First language refers to the language that a person was born into. Steven Pinker (1994) estimated that there may be about 600 languages in the world. There are many more minority languages. Some people grow up in multilingual communities, where they learn several languages from birth however many people in the UK have grown up using only one language to think and communicate. The first language that people learn to think in usually becomes their preferred language.
Language is also split up into dialect, slang and jargon. Dialect refers to words and their pronunciation, which are specific to a geographical community. It is like accent and is dependant upon where someone is from, e.g. Liverpudlians have a strong and sometimes hard to understand, dialect.
Slang is informal word and phrases that are not usually found in standard dictionaries but which are used in specific social groups and communities. It is different everywhere you visit. Different towns and cities have their own slang and may have the same words but different meanings. If someone visits a town and doesn’t understand, it could become uncomfortable for that person and they may have to ask them to say it again.
Jargon is words used by a particular profession or group that are hard for others to understand. Jargons are terms used by staff in certain environments. In a hospital environment, jargon would be used all the time, patients and the public would hear staff using medical terms which they would not know themselves.
Non-verbal means ‘without words’ so non-verbal communication refers to the messages that we send without using words. We send these messages using hand gestures and basic body language such as posture, facial expression, touch, silence, proximity and reflective listening.
Posture is the way you sit or stand and this can send messages about your attitudes or feelings. For example, somebody who is sitting or standing in a very upright, stiff
way may be seen by others as ‘tense’ in mood or as having a serious or
aggressive attitude. Closed postures, in which a person has their arms or legs (or both) crossed, tend to suggest defensiveness, anxiety and tension. Open postures, where the person has their arms by their sides and where they lean forward slightly, tend to indicate that the person is relaxed and comfortable.
Care practitioners can use their understanding of postural messages to read a person’s mood and feelings. This can give useful information during assessment interviews and in one-to-one counselling sessions. Similarly, in everyday care situations a person’s posture may indicate they are in pain, are unhappy or feel uncomfortable. However, it is always best to check your interpretation of a person’s postural message with them before jumping to any conclusions. This can be done by sensitively asking the person a question about how they are feeling, to avoid reading too much into how they are
standing or sitting.
The human face is very expressive and is an important source of nonverbal
communication. When we read a person’s facial expression we look
at their eyes to see are the pupils dilated or contracted? Large, dilated pupils tend to suggest ‘interest’ or excitement. We look at their skin colour to see if the person is blushing or sweating. We look at their mouth to see if the person is smiling or frowning or if the person’s mouth is dry. We look at their facial muscles to see if the muscles in the face are tight or relaxed. Different facial expressions involve very subtle changes in each of these features. However, most people become very good at reading other people’s facial expressions and at using their own to express their thoughts and feelings non-verbally. These facial messages can be used by care professionals to assess a person’s mood and to judge their response or reaction to a situation, like being given the results of medical tests.
Touch is another way of communicating without words. Care professionals are in a special position with regard to touching other people. In many settings where personal care is provided, the usual barriers that restrict where and how often we touch others in everyday life are suspended. Care professionals are generally allowed and expected to touch others as part of their work. In this context, care workers can use touch as a way of communicating reassurance, to carry out care procedures and to show concern for others; it is important that touch isn’t misinterpreted or used as a way of communicating dominance or sexual desire. Asking whether it is okay to hold a person’s hand or to touch them in another way – and explaining why this is necessary – can reduce anxieties and also ensure that the message that is communicated through touch is an appropriate one.
Silence is an important part of many interactions in care settings. A care professional who can listen in silence is more likely to be listening actively to the other person than a care professional who interrupts or who doesn’t allow the speaker time to pause and collect their thoughts. Care professionals who are unaware of the importance of silence sometimes interrupt conversations or fill any silences by talking themselves because they are embarrassed or feel nervous. Silence can be very helpful in enabling a person to disclose sensitive or very personal information; the care professional should use their body language to show they are interested in and respectful of the speaker.
Proximity refers to the physical closeness between people during interactions. The amount of personal space that a person needs during an interaction tends to depend on their cultural background, upbringing and the type of relationship that they have with the other person. We tend to require less personal space when our relationship with the other person is a close, intimate or personal one. Relationships that are more formal and less personal, such as with work colleagues, tend to require more personal space for interactions to be comfortable and effective. There are many different situations where a care practitioner needs to be aware of ‘personal space’ issues. For example, entering a person’s room, touching them on the arm or simply sitting down next to them to have a conversation could feel intrusive or unsettling if the person thinks their personal space is being ‘invaded’. A service user, if they are able, will usually adjust their proximity (by moving their chair or standing position, for example) to acquire the amount of personal space they need during an interaction. However, if the person is not physically able or lacks the confidence to do this, a care practitioner who adjusts their own proximity with sensitivity will improve the quality of the interaction and communication by doing so.
Reflective listening is sometimes called ‘active listening’. It involves paying careful attention to a person’s verbal and non-verbal communication and then reflecting back the messages you think they are sending as a way of checking your understanding. Reflective listening might involve summarising what the person has said every now and then, to recap and check you are following their communication. You may have to use paraphrasing stating what they have been saying in your own words in order to clarify that you have understood them correctly. People who are able to use reflective listening have the ability to pay attention and use their own body language to show that they are interested and are listening. They will hear and remember what the speaker says while also noticing and ‘reading’ the speaker’s non-verbal communication. They can summarise and paraphrase appropriately and ask questions to clarify their understanding.
Communication and Language Needs and Preferences
Care professionals communicate effectively when they are able to ‘connect’ directly with other individuals. To be able to do this well, a care professional must adapt to the communication and language needs and preferences of others. Spoken and written English are not the preferred system of communication for everyone. There a number of ways of communicating for language needs and preferences such as British Sign Language, Makaton, Braille, Use of Signs and Symbols, Finger Spelling, Communication passports, and human aids to communication.
People who have hearing (or dual hearing and sight) impairments sometimes communicate through the use of specialist forms of nonverbal signing. Sign languages are often taught and used in settings where service users have limited ability to use verbal language due to learning disabilities. There are a number of different sign language systems such as dactylography (finger spelling), British Sign Language
and Makaton.
Finger spelling enables signers to spell out words that do not have a general sign, or words that may be misunderstood such as the names of people and places.
British Sign Language is a language in its own right – not simply a signed version of spoken English. The British Deaf Association explains that British Sign Language is the first or preferred language of many Deaf people in the UK.
Makaton is a system for developing language that uses speech, signs and symbols to help people with learning difficulties to communicate and to develop their language skills. People who communicate using Makaton may speak a word and perform a sign using hands and body language. There is a language range of symbols to help people with learning difficulties to recognise an idea or to communicate with others.
The different gestures and symbols, and the grammar involved in putting together meaningful sequences of signs, have to be learnt before a person can use signing to communicate. It is useful, sometimes essential, for care practitioners to develop signing skills if some of the users of their care services communicate in this way.
Braille is a system of written communication based on raised marks that can be ‘read’ by touch and is based on the sense of touch for those who have limited vision. It is named after Louis Braille, who invented and first published it as a blind 20-year-old in 1829. This system is now widely used for reading and writing by people who cannot see written script. It is now possible to have computer-based text, such as emails, messages or reports, printed out in Braille using a specialist printer.
Signs, symbols and pictures are graphical or image-based ways of communicating small amounts of information in a direct way without using words. Many large care organisations, such as hospitals and local authorities, use lots of signs to direct people to various parts of their buildings and to impart other information; health and safety information is often communicated through the use of specific symbols. Signs, symbols and images that are used for communication purposes have to have a clear, easy-to understand meaning to be effective.
Communication Passports are usually small personalised booklets containing practical information about a person and their communication needs and preferences. A communication passport is designed to give people, such as care professionals, useful information about an individual so that they can adapt or adjust the way they communicate with the person. Communication passports often include photographs or drawings that may help care workers to gain a better understanding of the person who owns the passport. They are put together by working with the person with communication difficulties and his or her carers, the person tells their own story of their likes, dislikes and communication styles.
In situations where people speak different languages or prefer to use different communication systems – such as British Sign Language or Makaton – effective communication may only be possible if assistance is provided by a third party. Care organisations and agencies may use one or more of the following human aids to ensure that communication is effective. Interpreters who act as a link or bridge between speakers of different languages. Interpreters usually listen to a person speak in one language and then communicate what they have said to a second person using a different language. Translators who translate what is written in one language into a second language. Signers who use forms of sign language to communicate what has been said or written into a sign language such as British Sign Language or Makaton.
Some carers learn to use communication systems in order to help them to communicate with people. If you are communicating with a hearing impairment you should always make sure that the person can see your face clearly so they can see your expressions and the way you move your lips.
Ireland and Britain are multicultural countries. Care professionals need to have an
awareness of and sensitivity to cultural differences when communicating with others. For example, people speak a range of languages, use different words, phrases and dialects in different regions of the UK and may use different forms of non-verbal behaviour to express themselves during interactions. If care professionals don’t develop an awareness of cultural variations in communication and in interaction styles and preferences, communications may be misunderstood or may make no sense at all.
Health and social care professionals have to develop all these effective communication skills in order to work with the diverse range of people who use and work within care services. Care professionals need to understand how communication and interpersonal interaction occur in both formal and informal contexts. Knowing when to communicate formally and when to use informal communication improves the effectiveness of a care professional’s communication and interactions. Care professionals communicate effectively when they are able to ‘connect’ directly with other individuals. To be able to do this well, a care professional must adapt to the communication and language needs and preferences of
others.
by
ciararushe (student)
