By: Jennifer Beach, LSW, MA, C-SWCM
The long-term effects of pandemic isolation — finding new ways to reconnect and stay engaged — continue for many people. Face masks, for example, have become part of our medical experience. They are required for doctor visits, tests and visits to hospitals and other health facilities.
Last week, I attended a doctor’s appointment with my client. Rosemarie was seeing a geriatrician for the first time, a primary care doctor with additional training to treat older adults.
Rosemarie has hearing and memory loss, mobility issues, arthritis and cognitive changes. She was looking forward to meeting her new doctor and had several questions and concerns she wanted to discuss. Because of the masks, Rosemarie’s hearing loss and the small amount of time allotted, it was not the experience Rosemarie was hoping for. Fortunately, I was there to relay information and asked the doctor to repeat herself slowly so Rosemarie could hear and process the information.
Barriers
About two-thirds of people over 70 have hearing loss, making communication difficult, even without a face mask.
Face coverings impair communication far beyond speech transmission; they affect interpersonal connection and the willingness and ability to hold a conversation. This was the case for Rosemarie.
Masks make lip reading impossible and limit facial expressions. When the doctor was talking and asking Rosemarie questions, she could not hear her and had absolutely no idea what the doctor was saying. It is easy to see how this barrier could influence the doctor’s overall assessment of Rosemarie and her ability to understand, process information, make decisions and determine if she can remain safely in her home or community.
Without seeing someone’s face, mouth and expressions, the entire communication exchange is affected. When we know someone well, often it only takes one look at their face to know if they are happy, upset, afraid or in pain.
I see this disconnect happen with masks at medical appointments and in long-term care settings. Aides and nurses enter an individual’s room, wearing a face-covering as required, all the while talking quickly, stating several directives at one time, and not always looking directly at the individual. The patient has no idea who or why someone just came into their room.
The result? The individual is labeled “uninterested,” “not able to follow directions,” “refuses to shower” or “unable to attend an activity,” all because of poor communication.
Here are ways to help older adults improve communication and their overall experience at medical appointments or other situations where facial coverings are required:
- When appropriate, use written communication along with verbal communication. Write questions and answers on a pad or computer screen, use pictures or simple drawings, if needed, to help the older individual be a part of the conversation. Let the medical provider know this process will help your loved one. Be sure to allow time for the individual to read and respond.
- Consider face masks with clear windows to enable lip-reading and the ability to see expressions.
- It is important to use a more sustained tone and a lower pitch of voice. Face masks damage high-frequency transmission in speech; try lowering the rate of speech by slowing the rhythm and raising the volume.
- Face the person you’re talking with. Seeing eyebrows and upper cheeks can enhance the emotional messages connected to speech. Face-to-face talk allows a person to read facial expressions and catch visual clues and gestures. Don’t talk to someone unless you are looking directly at them.
Face masks and social distancing are now a part of our medical and long-term care communities. The challenges can have harmful psychological and cognitive consequences that can easily be prevented. We can avoid most of these issues by improving our communication awareness and speaking directly to people, especially when wearing face coverings.
Original Article: https://www.northeastohioboomer.com/blogs/caregiver-corner/masks-older-adults/