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Watch Your Language: How Communication Influences the Care Relationship

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“No one likes to be given bad news, and a diagnosis of dementia is devastating. How wonderful it would be though if the bad news and negative language stopped at that point.”

So begins a short article by Wendy Mitchell, who is living with dementia.  Wendy says the manner in which care providers communicate can have a profound effect on a patient’s ability to cope with a chronic medical condition.

As a senior care professional, your words carry weight. Your language choices can influence the power structure of the client relationship, impact a client’s overall quality of life and convey (or deny) respect. Here are three ways in which you can use language to the client’s advantage in a care relationship.

Setting the Power Structure

Few interpersonal relationships exist at equilibrium. Usually one party in a relationship enjoys more power than the other person. Think of the parent-child relationship or that between a doctor and patient.

Older adults who require care assistance may feel disempowered and vulnerable. They may perceive care providers as physically or mentally imposing and comply with directives out of fear. In fact, unscrupulous individuals may use this power imbalance to exploit seniors. It is important for senior care providers to set up a balanced power structure in the relationship by using language that clearly signals the client’s equal status.

One way to do this is by avoiding authoritarian language, such as “you must” or “you will.” Instead, try a technique discussed by educator Maryellen Weimer: change “you” to “we” when giving instructions. Instead of saying, “You must take a bath today,” which diminishes the power of the client to say no, try saying, “When should we do your bath today?” This collaborative language elevates the client into a position of power over their body and schedule.

Positive Framing to Enhance Quality of Life

Numerous studies have demonstrated the ways in which positive or negative framing affect decision-making. For example, one famous study by Amos Tversky and Daniel Kahneman found that study participants were more likely to choose a course of action that was framed positively versus the same choice framed negatively.

To do this, consider your word choices before describing a client’s situation or his choices going forward. For instance, don’t say a client is “suffering” from Alzheimer’s disease. Instead, frame the situation positively by saying the client “lives with” the condition.

You also can use positive framing to focus on the client’s abilities instead of disabilities. Instead of saying to a client with dementia, “You can’t heat the soup anymore, John, because you forget to turn the stove off,” try saying, “While you make your sandwich, I’ll heat the soup and then you can enjoy a nice lunch.” This subtle shift to framing lunch as an opportunity for the client to be autonomous instead of dependent can boost his quality of life and self-esteem tremendously.

Showing Empathy and Respect

Language is key to conveying empathy and respect to senior clients. Clinical empathy can make you a better care partner, and expressing respect to clients shows that you value them.

Try these simple tips to help use language in a way that conveys respect and empathy:

  • Refer to the client as “Mrs. Smith,” not “hon” or “sweetie.”
  • Avoid talking about the client to another care partner while the client is in the room. Include the client in the conversation.
  • Lower your vocal register. Speaking in a deeper tone generally is associated with calmness and empathy.
  • Use phrases that verbalize your perception of the emotions the client is expressing, such as “that sounds very distressing” or “you look happy when you say that.”
  • Do not counter emotions with facts. If a client expresses anxiety about the course of their disease process, do not recite mortality statistics to them.

Language is one of the most powerful care tools in the professional’s kit. When senior care professionals wield words wisely, both the client and the entire care relationship benefit.

Last revised: December 28, 2017

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