Psychiatric Care How to Reduce Communication Barriers

You can deal with psychiatric patients by learning how to acknowledge and reduce the communication barriers to have effective care.

At first, it is difficult to imagine if how can you deal with psychiatric patients but by learning on how to acknowledge and reduce the communication barriers, it is easy to promote effective communication with the psyche patients.

Difficulties in Language or Language Differences

Make sure to use the words appropriate for the patients.  Consider their culture as well as educational level.  Avoid using medical terms that will make him more confused. Avoid words that may provide several meanings especially your local slang words.  If the patient speaks a different language or uses foreign dialect, look for an interpreter to interpret your conversation clearly. However, make sure that you introduce the interpreter and explain the purpose because having a third person will make the patient more anxious and uncomfortable.

Inability to Hear

If the patient has an impaired hearing, he will surely misinterpret your messages and queries.  Assess if he or she is wearing hearing aid and turn it on.  If not, talk slowly and assess if he has the ability to read lips movement.  When talking to this patient, go in front so he could see you clearly and talk using commonly used words. Keep your sentences direct to the point and pattern it to become simple.  If he has severe hearing problems, you can communicate by writing.  Also, interview the folks in order to get more ideas on how they communicate with the patient. Since elderly usually have hearing problems, you should have patience and don't be annoyed in repeating your statements. Make sure that you speak slowly and in front of them.

Inappropriate Responses

There are many non-verbal actions that the psychiatric patients may misinterpret.  Avoid sudden change of topic because the patient may feel that you are not interested to listen.  Focus and listen while the patient is talking and don't force the patient to answer your question if he is not yet willing to talk.  Some patients need more time to establish trust to their caregiver, and by that time comes, you will know because they are willing to share everything to you.  

Thought Disorders

If the patient is having thought disorders, then the patterns of his understanding are incoherent, or irrelevant.  The patient may be unable to understand the messages accurately, respond to the interview, or participate in the nurse-patient communication. When gathering data, ask only simple questions about specific topics, and clarify his responses. Encourage him to express himself clearly but do not force. 

Paranoid Thinking

A tap on the shoulder could be a relieving touch to a friend or a therapeutic touch to other patients but to a paranoid patient, touching might be interpreted as abuse or threat.  Always approach this patient in a non-threatening way. Paranoid patients will suspect you in every words you say and actions you do whether he may have a motive or not.  It is very difficult to establish relationship with them but with proper treatment, they will develop their trust.  Also, paranoid patient may not mean the things he says.  The problem sometimes may arise if that paranoid patient already developed his trust to a certain nurse but as a psychiatric standard, the caregivers observe shifting schedules which may again result to the beginning process of establishing rapport.

Hallucinations

Hallucinations is seeing something or hearing something without stimuli.  A hallucinating patient can’t hear or respond appropriately. Show concern but don’t reinforce his hallucinatory perceptions. Be as specific when giving commands.

Delusions

A deluded patient defends irrational beliefs or ideas despite factual evidence to the contrary. Some delusions may be so bizarre that you’ll recognize them immediately. Others may be hard to identify. A delusion is having false belief.  Don’t agree with delusional beliefs, and don’t dismiss a statement because you think it’s delusional. Instead, gently present reality without arguing.

Delirium

A delirious patient experiences disorientation, hallucinations, and confusion. Misinterpretation and inappropriate responses commonly result. Talk to him directly and ask simple questions

Dementia

The patient with dementia, a permanent deterioration of memory may experience changes thought patterns. His language may become distorted or slurred. When assessing, minimize distractions. Use simple, concise language and avoid making statements that could be easily misinterpreted.

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