Communication

• Ask questions
• Distinguish perspectives
• Build self-awarenessfu
• Recognise the complexity
• Avoid stereotyping
• Respect differences
• Listen actively
• Be honest
• Be flexible
• Think twice

• National Culture: Values, Attitudes, education, language, legal system, symbols, tradition, religion, climate, history, geography
• Company Culture: Tradition, values, vision, brand, business area, founder, history
• Family Culture: history, values, up-bringing, parents/grandparents, status/class, history

• Power distance
• Sequencial vs. Synchronic
• Direct vs. Indirect
• Masculine vs. Feminine
• Context Ambiguity
• Individualst vs. Collectivist
• Formal vs. Informal
• High vs. Low context
• Uncertainty avoidance

Patient has a decline in cognitive abilities and sensitivity to emotional distress.
Staff-patient ratios are often inconsistent and there is not enough time to spend with each person.
Environmental challenges can consist of unfamiliar challenging environments.

In dementia, the information stored on the left side of the brain (vocabulary, formal language etc.) is lost, while the right side (racial slurs, forbidden language etc.) are retained

1. Aggressive speech or actions
   2. Confusion about time or place
   3. Poor judgement or cognitive problems

- Argue
- Order the person around
- Focus on what they can't do
- Be condescending
- Don't ask questions that rely on memory
- Don't talk in from of them as though they aren't there

Maximise attention

Expression and body language

Keep it simple

Support the conversation

Assist with visual aids

Get their message

Encourage and engage in communication

S- Setting - private setting, setting without interruptions
P- Assessing the Patients Perception - Checking what the patient has already been told and checking their understanding of the situation.
I- Obtaining the patient's INFORMATION- Some patients font ask about the situation, so asking about how they would like the information (all at once, alone etc.)
K- Giving KNOWLEDGE and information to the patient - Can start by 'warning' the person that they are about to be told bad or sad news. Can be useful to give info in chunks and check understanding as you go along.
E- Addressing the Patients EMOTIONS with Empathetic responses - Observe and identifying the emotions apparent, connect the emotion with the reason, ask if unsure.

Perception is how we organise and interpret information in our environment determined by how we communicate about the information and the environment.

- Takes no part in decision making
- Gives group complete freedom
- Supplies materials if asked but is otherwise uninvolved
- Makes frequent, spontaneous comments to members
- No attempt to be involved in progress

- Reporting and record keeping
- Rights and responsibilities
- Communication
- Conflict of interest
- Consent
- Confidentiality and the management of information
- Professional boundaries and dual relationships

A 'psychological space' or distance between individuals, one that is often used to emphasize the clinician's stance of anonymity, neutrality and objectivity.

A professional enters into a dual relationship whenever they assume a second role with a client, becoming [health professional] and friends, employer, teacher, business associate, family member or sex partner

takes place outside of real time.
- Enables flexibility
- Less pressure to act or respond
- Lacks a sense of immediacy and drama
- There's less immediate interaction
- An be out-of-date by response

(real-time):
- Closely resembles a face-to-face or phone
- Collaboration is not as flexible as asynchronous

- Power is part of all interpersonal messages (aggressive, assertive, passive).
- Power varies from person to person (power is rarely static).
- Power is frequently used unfairly (failure to assert may be due to lack of perceived power).
- Power follows principle of less interest (greater interest= least power).
- Power has an age, gender and cultural dimension (high vs low power distance).

- High personal control (internal locus of control) is associated with lower levels of personal distress, stress and communication.
- Strong sense of control related to good health.
- Stress impacts on health and communication.
- Multiple facets of control (behavioural, cognitive, decisional, informational).

Pseudo- apparent, not real, a conflict waiting to happen, prelude to a conflict.
Fact- simple conflict, conflict over message accuracy (lack on understanding).
Value- deep-seated beliefs about what is good or bad, worthwhile or worthless, moral or immoral = conflict over beliefs.
Policy- Conflicts over what should be the appropriate plan/course of action.
Ego- 'winning' or 'losing' is central to maintaining self image, self concept, identity, how competent people are, who has power etc.
Meta-conflict- conflict about communication and how you speak to someone during a conflict.

Task conflict - awareness of differences in opinions pertaining to the task/goal.
Relationship conflict- awareness of interpersonal incompatibilities, includes an emotional component such as tension and friction.
Process conflict- awareness of controversies about aspects of how task accomplishment will proceed (passive people get handed more work to do and not the work they want).

Mediation is a collaborative approach involving a third party or mediator to assist the disputing parties to reach a mutually satisfying solution to their conflict.

Employ:
- Empathy
- Active listening (especially reflection of emotion)
- Self-disclosure
- Questioning for understanding
- Reframing
Do not:
- Jump in to trying to solve the problem
- Give advice unless asked
 

- This traditional model is victim-based.
- Focus on negative outcomes and how to alleviate these outcomes.
- Outcomes include: depression, withdrawal, PTSD, anxiety/distress, poor communication.

- This model is survivor-based
- Focus on the strengths a person has to survive extraordinary challenges.
- Still feelings of distress, but also positive outcomes.

1. Denial and isolation
2. Anger
3. Bargaining
4. Depression
5. Acceptance
 

respect, reciprocity, recognition

➢Low context communication = meaning is conveyed verbally and is explicit

➢High context communication = meaning is conveyed by situation and context

 is the extent to which a culture values status  and power and expect that these are distributed unequally.

 ➢ Low power distance cultures are more consultation or democracy

 ➢ High power distance cultures are structured and hierarchical approach to communication with those in power