Communication in Care Settings – Nursing Homes Example

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"Communication in Care Settings"  is a great example of a paper on nursing homes. Steve is a care assistant at The Oaks Care Center. Each day between 40 and 50 older adults attend the day center. The clients’ ages tend to be over 65 years of age. Most attend because; they lack social interaction as they live alone and have health and mobility problems which could cause them to become isolated. The manager of the setting has asked research to be completed using a variety of appropriate sources to provide a comprehensive analysis showing how two theories could provide care workers with guidance about the effect of communication on the service users and care workers.   Information will be included in the effects of appropriate and inappropriate communication.   Two communication theories can provide alternatives for care workers regarding the effects of communications between care center service users and the care workers.

The communications theories are the functional approach and the meaning-centered approach as presented by Shockley-Zalabek (2002). The functional approach is a more linear perspective and follows messages through the process of communications being passed from one source or person to another.

Communication is established; it defines the relationship; assists in setting the relationship goals; and is then the process whereby the activities are carried out. The functional approach is a repetitive pattern that becomes routine. The center is a complex web of various communications, which makes the functional perspective appealing for many caregivers and service users. Without the structure of a schedule of activities, a newsletter, and an activity leader directing a member as to what may be next on the agenda; some clients may sit and do absolutely nothing.

On the other hand, some of the more physically and mentally independent clients may resent too much structure. To allow for clients with a variety of health, mental capacities, and interests, research shows more than one communication theory can be the foundation for effective communication methods. Alternative communication theory is the meaning-centered approach. Using a meaning-centered approach means that there is a focus on communication and decision-making on utilizing influence, identity, identification, and socialization. The caregiver seeks to understand the service users’ unique perspective prior to proceeding with the communication to ensure accurate and complete transfer of the message (PHAC, 2009; Shockley-Zalabak, 2002).

Influence is utilized to consider who or what may impact the clients’ perspective. Identity is considered which includes beliefs, values, personal attitude, and preferences, how the client may make decisions, and what makes that client uniquely that person. Identification is considering how the client identifies him or herself. For example, there may be a particular senior who is a veteran from World War II and that is a source of pride for that person.

This is how that person identifies himself. That person may have received a purple heart. If the caregiver can prompt the client to talk about their service and that award, the client will be creating a relationship and be socialized into the care center appropriately (PHAC, 2009; Shockley-Zabalak, 2002). That clients’ life’ s successes are recognized.   And finally, using a meaning-centered communications approach is actively engaging the clients to help them learn behaviors that coincide with accepted norms and values of the care center. In this case, those clients joining the care center engage in dialogue appropriately (if able), speak using an appropriate level of volume, join in the activities that are provided (if able), ask other individuals about themselves and their interests.

Share information about themselves with others. Encourage others to be sociable as well. Communication is defined as “ on-going human interaction” (Shockley-Zalabak, 2002, p. 54). Articles. com (2009) reflects the meaning-centered perspective of communication theories by recommending “ respect the elderly person’ s background, knowledge, and values. Because an elder’ s life experiences may be very different from yours, it’ s important to invite the person to express those thoughts and feelings, and respect them even if you disagree” (para.

seven). The effects of the appropriate communication have been shown to provide financial and clinical success for facilities engaged in serving seniors (Meath, 2006). Communication best practices are provided. Articles. com (2009) states, the best type of senior facility can make a difference in the elder’ s ability to communicate. Facilities that use activities, intellectual stimuli, social interaction, and educational routines, can all be used to slow the decline of the communication process.

When communication is appropriate for the client, the client expresses satisfaction with the service provided and returns to the care center.     The effects of inappropriate communication can be damaging to the client for the rest of the clients’ life, particularly without proper rehabilitation as shown in Tam, IP, & Chan (2000). Tam, IP, & Chan found in their study that patients that have experienced long hospitalizations lose interest in their personal commitments, values, and goals that drive them as “ unique individuals” (p. 202). Clients being dropped off at the Care Center may very well have come from recent long hospitalization prior to their visit.

Because the hospital environment is not conducive to comfort and privacy, it creates problems in communication and a sense of isolation that can carry over in the client's home and other environments they may inhabit. The care patients in the Tam, IP, & Chan study showed a much lower self-concept than those who continued in a residential setting.   When left alone (isolated) the resident/client’ s self-concept drops. Leaving the caregiver to conclude that leaving a service user alone for too long of time would not be an appropriate service for the care center.

Even if the client is choosing to isolate themselves, the effect of the isolation is what the care center is trying to combat. The service provider would not want to accentuate the problem by ignoring or neglecting the resident/client. Conversely, raising a voice to a client could be considered adult abuse and grounds for legal action. There is no need to argue with a client. Arguing will not accomplish anything. Regardless of who is right or wrong, both lose in the process as the dialogue itself is very defeating.

It is a win-lose proposition.         In conclusion, as our society continues to age, Meath (2006) believes “ communications within every industry will become more important” (p. 347). There are a record number of Americans, 10,000, turning 65 each day. Those over age 65 are projected to skyrocket in the next 25 years. There is an urgent need for professionals to understand seniors’ wants and needs. The fastest-growing group of that demographic is the age group that is 85 and over.

Over 75% of the nations’ wealth is controlled by people 65 and over (Meath, 2006; SCSA, n.d. ). Whether attaining a Certified Senior Advisor or gaining education or training in communication skills, all of these things will be a wise investment in a person’ s skill set. Meath cites Dozier from 1995 as saying the most effective means of communication is a two-way model that includes giving and take. But what happens when communicates are occurring with those who are frail, experiencing health problems, unable to hear, see or truly communicate back in response to a message given?

The next report will discuss in more detail specific communication methods recommended when dealing with seniors.    


Anderson, J. (2010, November). Video: Effective communication with seniors or aging parent. Retrieved March 30, 2011 from (2009). Tips for Communicating with Your Senior Loved Ones. Retrieved March 30, 2011 from

Meath, M. (2006). Taking time to care: best practices in long-term care communications. Corporate Communications, 11(4), 336-352. Retrieved March 30, 2011, from ABI/INFORM Global. (Document ID: 1150387341).

PHAC. (2009, October). Communication with seniors: Advice, techniques, and tips. Retrieved March 30, 2011 from

SCSA. (n.d.). Why become a CSA? Here’s why anyone who works with seniors needs the CSA designation. Retrieved March 30, 2011 from

Shockley-Zalabak, P. (2002). Fundamentals of organizational communication. MA: Pearson Education Company.

Tam, S., Ip, Y., & Chan, C. (2000). Self-concepts of hospitalized and day-care psychiatric patients. The Journal of Social Psychology, 140(2), 202-9. Retrieved March 30, 2011, from ABI/INFORM Global. (Document ID: 53447090).

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