Posted by Dr. El - February 8, 2009 - Anecdotes, Communication, Customer service, Dementia, Resident education/Support groups
97-year old Rosebud, whom I mentioned in my 11/15/08 post, was a social worker, raised two children, and now lives in a nursing home. She would like to share with you the following thoughts about recreational activities:
“Old folks know a lot and need to have their minds stimulated. We residents can’t speak back and forth, so there’s a lot of lonely time. We’ve lived different lives and we need to find out what we have in common so we can be drawn together. The recreation staff can help us talk to each other about our lives.
I have the will to have a purpose, but now I need assistance grabbing onto it. Just as we residents need help with cooking and serving our meals, but have the will to eat, we need help in putting our thoughts together to work on a project with a purpose. Growing older, I would like to use my wisdom to help someone else. I want to contribute to a larger cause.”
Posted by Dr. El - December 8, 2008 - Communication, Medication issues, Resident education/Support groups
Talking to a medical doctor is not like talking to a normal person. In a regular conversation, one person says, “Hi. How are you?” The other says, “Fine. And yourself?” And they go from there. If busy Dr. Shah stops by Ms. Crenshaw’s room, inquires how she is, and hears that she’s “Fine,” he’s likely to be on to the next room before Ms. Crenshaw can utter another word. I prefer the Newspaper Headline Approach.
Newspapers grab the attention of readers by revealing the most important and tantalizing details first, so we’re compelled to read on. The same approach, applied to a visit from a physician, would look like this:
Dr. Shah: “Hi. How are you, Ms. Crenshaw?”
Ms. Crenshaw’s headline: “I Have Pain.”
Now she has Dr. Shah’s attention and he will almost certainly ask her where she has pain and other follow up questions.
Another possible headline: “I Have Two Things I Want to Discuss with You.”
This indicates to Dr. Shah that he’s going to need to stick around after the first issue is complete, and it helps him estimate how much time he can spend on each matter. Following the Newspaper Headline Approach, the most important problem is revealed first. This way, if Dr. Shah has to leave, at least Ms. Crenshaw had her most pressing concern addressed, and her doctor is aware there is more to be discussed.
Perhaps all this sounds simple, but it’s surprisingly difficult not to answer the question, “How are you?” with the response, “Fine,” even when we’re not. It takes practice to resist the temptation and tell the physician, from the start, what’s really going on.
