Communicating with the Aged Patient: A Systems View

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Abstract
The articles prior to January 2008 are part of the back file collection and are not available with a current paid subscription. To access the article, you may purchase it or purchase the complete back file collection here Dianne P Bakdash Mrs. S, an almost deaf 65-year-old woman, usually sat in a corner of the dayroom by herself. She mumbled incoherently whenever anyone stopped to talkwith her. She would get extremely angry if anyone asked her to repeat what she had said. She took great pride in showing the staff or volunteers her neatly kept room that contained her collection of old photographs, jewelry, several old geography books, and other assundry items. Mrs. Κ, a widowed 73-year-old woman, kept her graying hair dyed a bright red. She often sat in the dayroom with two other ladies chatting amicably with them. Mrs. Κ was usually able to carry on a coherent conversation. However, whenever she seemed anxious she would launch into a delusion, declaring that she was an "Italian countess with several million dollars," or into her hallucination that her "husband talked with her often through the wires in the ceiling." Mr. C had been an engineer before he retired about five years ago at age 62. About that time his wife also died of a stroke. He had been living with his daughter and her family until about two months ago when they brought him to a nursing home. Mr. C's daughter said that he had become increasingly absent-minded, often forgetting recent events and certain activities of daily living such as eating meals regularly and dressing appropriately. He also seemed somewhat depressed and withdrawn. However, Mr. C would recall some vivid, past memories with some of the staff members who stopped to talk with him. The commonalities in these examples are that each person described is in the geriatric segment of the population and each has a tremendous need for meaningful communication. "Meaningful" as referred to here is "purposeful, goal-directed activity and... the pursuit of goals in certain predetermined ways."1 The primary purpose of this paper is to describe various communication techniques based on a holistic view of the geriatric patient and his environment. Hopefully, such techniques within the framework of a systems approach will ultimately be of therapeutic value to the aging patient. In assessing the patient, the nurse should focus on the "linkages" between systems and between subsystems as illustrated in Figures 1 and 2. This systems approach is one way to organize a variety of interrelated variables. Often the nurse restricts her view to the patient and his needs (Fig.l), but she should also analyze the transactions between the patient and the other systems (Fig. 2). Only by examining the communication processes at the "linkages" in relation to an assessment of the patient's needs can the nurse plan effective, scientifically-based interventions. The nurse can also use this framework to evaluate her nursing interventions.… 10.3928/0098-9134-19770901-07

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