Comprehensive Fall Prevention Management: Effective Communication and Coaching

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Comprehensive Fall Prevention Management
Effective Communication and Coaching

• Part II
• Holly Lookabaugh-Deur
• President Generation Care

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Always Remember

• It doesnt matter how smart you are, how much you
  care, how great your plan isif the
  client/patient doesnt listen or perceive any
  value in your message.
• Nothing works if they dont come back.

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An intangible component of effective fall
prevention care

• How mature is the geriatric-focused culture
  within your work environment?
• HIPPA compliance is important when you are
  working through history using a variety of
  sources.
• Lets take a look at physical and
  communicative/attitude barriers

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Eliminating Potential Physical Barriers
Suggestions for Referral Sites

• Parking valet service
• Heavy doors
• Clear, POSITIVE wording on signs
• Send forms and surveys HOME so there is adequate
  time to do them first
• Consider tables and chairs instead of clipboards

• Warm things up decorate for the season!
• Offer easy to self serve snacks
• Consider a variety of chair types in waiting room
• Privacy in the waiting/ information area
• Consider offering a freebie key chain,
  calendar card, etc.

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The Single Biggest Barrier to Effective Client
Communication occurs when

• A patient or client is required to wait, without
  explanation, for more than seven minutes. The
  longer the wait, the greater the frustration the
  client has at the onset of the appointment (time
  value).
• The case manager seems rushed, bored, or
  frustrated working with older clients.

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Eliminating Potential Cultural Barriers

• Use Mr. or Ms./Mrs. until given permission to
  be more familiar
• For all first time visits/calls, welcome warmly
  and sincerely, orient to the purpose,
  expectations, and environment
• Never make a blank promise and break it
• Condescending voices use of sweetie
• NO RUSHING

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Barriers to Effective Communication

• Sentences too long, with too many clauses and
  phrasestendency toward allowing client to drift
  into different thought
• Verbalize an example
• Communicating in non-laymans terms, without
  considering educational level, or talking in a
  condescending tone
• Interviewer assumes the client understands
  something that he/she does not (describe real
  example)

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Older Adult Culture Today

• Respects the physician white coat authority
• Is not always trustworthy of younger health care
  professionals and caregivers
• Is very compliant if VALUE is perceived in what
  they are doing
• Feels most health care is undignified
• Listens more to peers than what is in print

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Other Cultural Considerations

• The role of religion and spiritualism for older
  adults varies greatly it should not be assumed
  or disregarded
• Describe method of discovering its role
• The role and expectations of family care giving
  vary greatly discuss research on Hispanic,
  African American, Asian American, and
  nuclear/extended family issues briefly

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No one really knows what its like

• Avoid I understand since unless we are the
  same age, we really cant ever know
• Try I can imagine
• Build trust by respecting opinions and feelings
• Be sincere

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Ageism from the CLIENT!

• Older adults may have pre-conceived notions about
  what is truly possible.
• Use success stories to capture their interest and
  curiosity.
• Wall of Fame can be used to show before and
  after stories
• Fear of falling more verbalized by women
  difficult to see initially

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General Tips for Interview Time

• Avoid noise, clutter, interruptions
• Avoid distractions whenever possible
• Lighting is critical use mirrors for testing
  area when possible
• Have several types of flooring during evaluations
• Tuck away different assistive devices for
  spontaneous lets try this instead
• Small benches for family/caregivers

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Effective Case Managers are

• Genuine, down to earth, sincere
• Great listeners, but able to direct conversation
  and stay on track
• Aware of community resources
• Able to communicate well with physicians
• Able to cope with setbacks and focus on the
  positive
• Non-territorial team oriented get it done

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Once you know your clients reasons for being
there

• Start and end each session with a comment
  acknowledging the clients priority.
• Make sure they know that you remember their
  biggest fear, personal goal, or priority.
• I know you are most worried about falling going
  to the BR at night, but everything we are doing
  will help you prevent another fall wherever you
  are.

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Simultaneous Assessment

• Time is money. And casual comments by the client
  are very meaningful, especially from an older
  adult
• Example While you may be ambulating to get ready
  to start a Timed Up and Go Test, you can ask
  about how much he/she walks during the day does
  anyone help get groceries how far is the
  mailbox, etc.

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Clients are Most Compliant

• When WE are compliant
• When they connect a value to using their time and
  energy
• When they can focus on a long or short term goal
• When they are rewarded and praised
• When there is variety and fun involved

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Lets look at some examples

• Refer to script and samples of actual
  conversations
• The interviewer stayed on track obtained
  information connected with the client,
  listened intently, and repeated the clients
  priority at the end
• At the end, the interviewer emphasized the
  actions expected by both the client and the
  interviewer

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Questions?

• In your setting, whether you are working from a
  telephone or face-to-face, in which situations do
  you feel most unprepared and/or are difficult to
  manage?