Thesis: Therapeutic Communication the Communication O Be Evaluated

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Therapeutic Communication

The communication o be evaluated took place on February 24, 2009 in the early afternoon. The setting was a residential care facility for the elderly. The conversation took place between me and a patient named Helen. Helen is an 86-year-old Caucasian female with Alzheimer's disease. Her family visits frequently and she recently lost her husband. She has been feeling depressed and is need of someone to talk to. The following evaluates our conversation.

Narrative entered the room and Helen was sitting in a wheelchair facing the window. She had her hands on her lap and appeared to be staring out the window. I entered the room and she did not immediately acknowledge me. I walked across the room and gently touched her on the shoulder. She looked up and said "Hello." I greeted her and asked her how she was feeling. She turned her wheelchair to face me and said, "Ok, I guess." From the tone in her voice, I could tell that this was only a polite response and that there was more behind it than the words revealed. In her response, she showed no emotional expression, no smile or connection.

We began our conversation by talking about the weather and chit chatting. She responded politely, but made very little eye contact. She showed little sign of engagement. I had to prompt the conversation, as there was little spontaneity from Helen. She provided rather short answers to my queries.

A then attempted to get her to open up by asking an open-ended question. I asked it anything was bothering her that she would like to share. Her eyes darted to the picture of her late husband on the wall. She answered, "No, not much." I said that "not much" sounded like something. I tried to sound cheerful and understanding. I leaned forward and tried to make eye contact. I reached out and held her hands.

This brought tears to her eyes and she began to talk. She spontaneously told me how she missed him and how she didn't want her children to worry about her. She talked about good times with him and told some of the crazy things that they did when they were young. As she talked about the happy memories, the tension in her face settled out and she began to smile. Her eyes brightened as she recalled old times. I engaged in active listening, laughing, and responding with interest. I kept an open body language.

I asked her how they met. She told the story in a rather animated fashion. Her eyes became distant, but she grinned as she told the story. It was almost as if she forgot herself for a moment and became lost in the moment. I continued to ask open-ended questions to get her to respond. She responded readily and continued to tell stories of her life. We laughed together and shared jokes during the conversation. She appeared to be having a genuinely good time.

A said, "It sounds like you have led a very interesting and fun filled life. You have many happy memories." I then restated some of the happy times that she had shared with me. She agreed that she had enjoyed some good times indeed. Her face was brighter than at the beginning of the conversation.

I told her that sometimes when we are sad, it is good to remember the good times and that she had many good times to remember. She looked up at the picture of her late husband again and her face once again became gloomy. I asked her to tell me how she was feeling at the moment. She said that she was sad because the good times were over and she missed him. I restated that she was feeling sad because she missed her husband. She nodded confirmation. I told her that she still had her children and those wonderful grandchildren that we see coming in to see her. She managed a small smile.

A suggested that the next time her grandchildren come to visit, that she ask to go outside and spend some time with them. I told her that I was certain they would enjoy hearing her stories as much as I did today. She responded that she wasn't sure they would want to listen to old stories because they had their own lives to live. I assured her that they would love to hear her stories. It would give them some good times to look forward to in the future. Helen agreed and her face once again relaxed.

Her gaze became distant, but this time a smile was on her face. I asked her what she was thinking about now. She said that she was thinking about her grandchildren and their smiles. I told her that if she needed help remembering what to say, I would be glad to help her remember her stories, especially the one about the dog not recognizing her husband when he came home from the service. She laughed again, only this time it was a laugh in earnest.

A prepared to leave and told her that I would be available anytime she needed me. She smiled pleasantly and thanked me. She called me "Sweety." She went back to staring out the window, but this time she was smiling ear to ear as she gazed. I quietly left the room.

Technique Analysis used a number of therapeutic communication strategies in this interaction. The first and most difficult task was getting Helen to open up and tell about her troubles. I used open-ended questioning, and active listening to encourage a spontaneous response from Helen. In the beginning, Helen refused to respond with anything more then a short answer in response to the question. I had to think creatively of ways to incorporate open-ended questions that could not be answered with short, succinct answers, but that required a longer, more in-depth response.

When Helen was finished with her stories, I used restatement to highlight the good times and summarized her happy times. The purpose was to turn her away from her unhappy thoughts and grief to memories of her good times. I wanted her to focus on the positive, rather than the negative parts of her life.

A then suggested a strategy to help Helen connect with her Grandchildren by telling them about the stories of her life. Helen needed an action that she could take to refocus her thoughts on her happy memories instead of dwelling on her grief. Suggesting the strategy of thinking of stories to share with her grandchildren served multiple purposes. It re-focused her on happy times and gave her a "project" to work on. Sharing memories with her grandchildren would help her to build even more memories with them and to grow in closeness to them. This would have a beneficial affect on building happy memories for the children as well. This will give Helen and the grandchildren something to look forward to on their visits and will build memories that will last a lifetime.

A used humor to help develop a connection with Helen. She responded with humor, which lightened the mood. The main focus of the humor was on laughing and sharing common experiences. I was careful not to let Helen think that I was making fun of her. I used laugher at the appropriate times as a form of encouragement to get Helen to open up further about her memories and experiences. I used it to show genuine interest in what she was saying.


Throughout the therapeutic communication session with Helen, I used a variety of techniques to allow her to express herself. I wanted to provide Helen with a way to cope with her grief in a positive manner. One of the key strengths… [END OF PREVIEW]

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