Understand effective communication and interpersonal interaction in Health and Social Care
•Produce a staff handbook for new staff at a residential setting for people with learning difficulties and other communication difficulties including different forms of communication needs and preferences and the role of effective communication in team work and supporting individuals.
The two main contexts in which health and social care workers use the communication cycle are one-to-one and group communication.
One-to-one Communication – This interaction often involves a three stage process. 1) Greeting or warming up, 2) conversation or information exchange, 3) farewells or winding down. When you start a conversation with somebody you have to try and make them feel relaxed and it is important to create a positive emotional atmosphere. Very often people will start a one-to-one communication with a greeting such as ‘Good Morning’, as this shows you are helping them to feel relaxed by showing a positive and friendly attitude. This type of communication is effective within a health and social care environment because, if a nurse/carer had a new resident, then they have to set an example, so that the resident will feel safe, and will be able to build trust with the nurse/carer.
Group Communication – This type of communication is only effective if everyone within the group wants to be involved. It is right that the group has the right emotional atmosphere, as people may feel threatened, or may not be confident enough to speak up within a formal group conversation. Group maintenance is important, as this enables people to create the right atmosphere. Having a group leader can be useful, because they will be able to encourage people to express their ideas, and make sure people take their turn when talking.
This type of communication is effective within health and social care as there are many meetings, which could be discussing a resident’s needs/preferences. This is effective because everyone’s ideas will be taken into consideration and will be able to get the best outcome. However this type of communication can be confusing for people with hearing impairments, as if a person is deaf, they focus on one person to do sign language so it’s not too confusing for them, but in a group, a lot of stuff can be misunderstood and would be too confusing.
Communication between colleagues – Communicating with people at work is different that communicating with friends and family. This is because it is important to show respect to your work colleagues, as if this happens, you may fail to show respect to the people who use care services. Also colleagues have to develop trust with each other, and it’s important to show that you have respect for the confidentiality of a colleague. This type of communication is often informal but it is important that care workers use skilled communication in order to develop respect and trust. This type of communication is effective in health and social care, as it can boost productivity and improve employee satisfaction.
Formal – Formal communication is quite common within health and social care work. This type of language shows resect to others and shows your powerfulness, however formal language can sometimes come across as being ‘too posh’ or pretentious. This type of language is understood by a wide range of people, however some ‘speech communities’ may find it hard to understand so care workers usually adjust the way they speak in order for them to understand. An example of formal language in a health and social care setting would be a social services desk, they may greet you with a ‘Good Morning, How may I help you?’ rather than ‘What you after then?’. It shows respect and makes the person they are speaking to feel more welcome.
Informal – This type of communication is often used when we know them person we are speaking too, well, for example friends and family. These types of groups may use language that can only be understood between them, or local groups from particular areas may only use language that they understand. In health and social care this type of communication may only be used between staff. This is because if a care worker was to use informal language to a resident or patient, they may not understand or they may feel uncomfortable with how they are being spoken too. However if staff were to say to each other ‘hiya, how’s it goin’ they may just feel like this is a warm friendly greeting.
Forms: Communication enables us to give ideas and information. It helps people to feel safe, to form relationships and develop self-esteem.
Text Messaging – This type of communication within a residential setting for people with learning and communication difficulties, would be effective as if a person is deaf, or with hearing impairments than text messaging things like doctor’s appointments would not only make sure that they are reminded, but also that they have understood properly. They also would be able to correct themselves if they have misunderstood a translator.
Written Communication – This type of communication would be effective as when something is written down you can analyze it and change any mistakes or add anything in, which makes it reliable, whereas if you’re talking, changing your words all the time can be misinterpreted or it can cause service users to receive the wrong care or cause conflict between people. If a resident has autism for example, they find it difficult to form social relationships with people, so oral communication wouldn’t be as effective, whereas just writing something down could make them feel more comfortable.
Oral Communication – This type of communication would be effective in this particular health and social care environment, as if there is a person with dyslexia, it may be easier to speak to them orally, and repeat yourself, for them to understand, rather than writing something down which they may not be able to read properly and this may be easier for them to misinterpret what you’re trying to say. It is also used in many other care environments, like doctor’s surgeries, hospitals and old people’s homes. Oral communication in this environment would be effective as it enables care workers give important information quicker than written, and also explain medication so that the patient knows what to do. It can also help someone to gain trust for their doctor etc., as they will be able to comfort them through oral communication.
Symbols – The use of symbols whether it be written or diagrams, all communicate different messages to people, such as traffic signs. In this particular setting, the use of Makaton will be used greatly, due to it helping people with learning disabilities, develop their language skills. Makaton may speak a word and perform a sign using hands and body language, and also there is a large range of symbols which also help people with learning disabilities communicate with others.
Technology – Information technology helps to provide enlarged visual displays of voice descriptions for people with visual impairments. This type of communication can support the residents because there is also voice typing for people with dyslexia, which can turn speech into writing. Some of the electronic communication systems can be activated by air pressure, meaning that a person can communicate using an oral tube connected to computerized equipment. However a more simpler way of using technology to communicate would be things like flash cards or picture books, which will improve the communication for people who do not use a spoke language or signed language.
Speech – Speaking clearly is essential when working with people with service users, as they may have problem with receiving or giving messages. Different localities, ethnic groups and work cultures all have their own words that they use; these may be referred to as different speech communities. Some people may feel threatened or excluded by these different speech communities. Some people think that just using formal language will solve the problem, but that is wrong, because care workers, who use jargon, can also create barriers for people who are not part of that different speech community. So in this type of setting speech would be very important as if a person has learning disabilities or hearing impairments for example, then speaking clearly would allow them to lip read, and understand what is being said.
First Language – This is the language in which you are brought up from birth to think and communicate with. People who learn a second language later on in life can’t communicate their thoughts as effectively as they can with their first language. This is usually the preferred language as they have been learned to think like that growing up. In a care setting, this type of interaction is important as if someone has learnt a different language, like polish for example, then their accent may change from their English accent, and make service users find what they are trying to say, hard to understand, as they have learning disabilities, they may get confused. Non-verbal communication – This type of communication is a way of studying a person so that you can understand whether they’re feeling sad, tired, happy, angry or frightened without speaking. It refers to the messages we are sending but without using words.
These messages are sent by our eyes, tone of our voice, facial expressions, position of hands and arms, gestures with hands and arms, the angle of our head and body posture. This type of communication is important in health and social care because it allows the care worker to see if a person is feeling sad or If they care worker has suggested something, and the patient/resident agrees with what they have said, they may not be thinking that, and show this with their emotions, so then the care worker can see this and then adjust what they have said. It is important in this setting because people with learning disabilities like autism, find it difficult talking to people about their emotions, so care workers can interpret this and help them without them having to struggle, however a care worker may also interpret it in the wrong way and do the wrong things. Posture – The way that you sit or stand can make a difference to how a person receives messages from you.
As a care worker you can sometimes be misinterpreted, as if you have your arms crossed it can mean ‘I’m not taking any notice’ but even if you just find it comfy, as a care worker you should never have your arms crossed, as it doesn’t make you look respectable. Leaning back whilst sat down can send messages like your relaxed or bored. So sitting forward would make you look involved and like you are bothered and interested. This is important as a care worker, working with people with disabilities as they may already feel lonely etc. so when you are folding your arms and leaning back this can make them feel worse. Facial Expression – Your face can indicate your emotional state. If a care worker was listening to what a resident was saying, then it is important for the care worker to convey the right impression. If the care worker was to smile it would indicate agreement or approvement of the message being received, where as a scowl would indicate displeasure and disagreement.
Most people can recognize emotions from others, but you also have to understand your nonverbal behavior may influence others. Touch – Touching another person can send messages of affection, care, power over them or sexual interest. To help you to understand what their touch may mean, the social setting and body language will play a massive part in helping you understand, however touch can be easily misinterpreted. A care worker may hold a person’s hand to reassure them and comfort them, but this can be interpreted as an attempt to dominate them.
In health and social care, this type of interaction is helpful as it is a way of communication without words, for example if a person was unable to speak, they may have dyslexia, then touch would allow the care worker to communicate to them without having to speak or make them speak, if the resident was to need a bit of affection, to reassure them, they may touch the care worker for them to touch back, however making sure this is done in an appropriate manner.
Proximity – This is the space between you and the person that you are communicating with. It shows how friendly or intimate the conversation is. There are different cultures which have different customs regarding the proximity between people when they are talking. In Britain there are expectations for how far you should be away from someone. An arm’s length away would be when talking to strangers, although shaking hands may bring you closer. Relatives and partners may not have restrictions as to how far or close they can come. In this setting, proximity is very important as if a care worker assumes that it is fine to enter the personal space of a service user, without asking or explaining why then this can be seen as dominating /or being aggressive.
Communication and Language needs and preferences: the individuals preferred method of communication.
It is important to understand that many people use different types of communication which are specific to them. If a person uses British Sign Language for example, it may be important to employ an interpreter. However some carer’s learn these things so that they are able to communicate with people. A person who is blind or has visual impairments may use braille as opposed to text, so that they can read information.
British Sign Language – BSL is the preferred language for many deaf people within the UK. It was recognized as an official language for deaf people in 2003, which has led to funding and an increased awareness of the language and how much it helps deaf people to communicate. In this health and social care setting, BSL would be important for communicating to the residents who are deaf, as it is important to talk to them about their medication, needs or preferences. It’s also important for the care workers to be able to understand what the deaf people are trying to say, and so that the care workers understand what they want.
Makaton – This is a language programme using signs and symbols to help people to communicate. It is mostly commonly used for people with learning disabilities, as it is designed to support spoken language and the signs and symbols are used with speech, in spoken word order, so that if the speech is unclear, the symbols may help a person to understand. So if the child or adult with the learning disability has trouble with their speech, Makaton will support this and then many people drop the signs and symbols naturally at their own pace as they develop speech, but some people use Makaton for their whole lives.
Braille – Braille is used for people who are blind or visual impairments. It allows them to read text and write information. It is a system of raised marks that can be felt by the fingers. It can be processed by modern computer software, and be printed out using special printers. It is effective as it allows the blind to be able to read and write through touch, meaning that they can communication with other people, important in health and social care, as they will be able to explain pain or read their own medication etc.
Argyles Communication Cycle
For communication to be effective it involves a two way process in which each person tries to understand the view point of the other person. Good communication involves the process of checking, understanding, and using reflective or active listening. An example of this would be when working with a resident and the care worker using touch when listening to a resident, as this can be shown as effective, and can show that the message was received and decoded, but this can be misinterpreted if not used in the right way. Another example would be if a care worker is explaining something to a patient, the patient will show understanding by nodding or using other nonverbal communication. This shows that the patient has received the message clearly and has understood the care worker, which will then allow the care worker to know that the patient is sure what has been said. This is important in this setting as people with learning disabilities find it more difficult to understand things, so showing understanding will allow the care worker to either help the resident or know that they understand the conversation.
This is the communication cycle:
1 An idea occurs – You have an idea of what you want to communicate 2 Message coded – You think through how you are going to say what you are thinking. You put your thoughts into language or into some other code such as sign language. 3 Message sent – You speak or perhaps you sign, write, or send a message in some other way. 4 Message received – The other person has to sense your message, they hear your words or see your symbols. 5 Message decoded – The other person has to interpret your message. However this is not always easy as the other person may make assumptions about your words or body language. 6 Message understood – If it all goes well then your ideas will be understood but it might not be the first time.
Tuckman’s Stages of Group Interaction
The communication within groups can be influenced by how people feel with each other. When people meet for the first time they often go through a process of group formation, which will allow them to communicate effectively. Tuckman’s theory is set into four stages:
1 – Forming is the first stage which involves group members to form a team or group discussion. At this stage the members would ask questions about the purpose or aims of the group and also share information. This stage is important because it allows people to exchange personal information and get to know each other. 2 – Storming is the second stage which involves the growth of the group. This stage eliminates the strong groups from the weaker ones, and some groups may not make it past this stage. The relationships will either be made or broken at this stage, it is important for the team to have a strong leadership at this stage.
3 – Norming is the third stage in which all the team agree on the rules and values by which they operate. They begin to trust each other and individuals may take greater responsibilities so the leader can now take a step back. Personal, intimate and realm opinions are expressed in this stage. 4 – Performing is the last stage and not all teams make it to this stage. Structural issues are resolved in this stage which allows roles to become flexible and functional and group energy is channeled into the task. There is a high level of respect in the group and they are more strategically aware of what is to be done.