Home' Australian Pharmacist : Australian Pharmacist May 2013 Contents 36 Australian Pharmacist May 2013 I ©Pharmaceutical Society of Australia Ltd.
Stay FOCUSED and get the
Research into communication strategies,
particularly for people with cognitive
problems, has resulted in the development
of the FOCUSED system which has proven
to be very effective.
Professor, School of
co-director of the
UQ Ageing Mind
Initiative and also
of the Australian Psychological Society's
Psychology in Ageing Interest Group,
said the system would greatly assist
pharmacists and other health professionals
communicating with older people.
'This is a great way of communicating with
older people and ensuring messages such as
health messages are understood and can be
acted upon,' she said.
'Each letter stands for something
that is really important when you're
communicating with older people'. Here
she explains the program:
F: Face-to-face. Talk directly to the person.
A lot of times people mumble or, for
instance, the nurse speaks to a person
when they are in the shower and so are
behind them. The thing is as you get older
your hearing deteriorates and you naturally
gravitate towards lip-reading to help your
hearing. So you should always be face-
to-face and have eye contact with the
person you are speaking to. The pharmacist
shouldn't continue talking as they turn
around to select the medicine from a
cabinet as the person they are talking to
may miss that part of the conversation.
O: Orientate. This means orientating the
topic so you say to the patient: 'Now we are
going to talk about your blood pressure
medicine' and then they're on topic.
C: Continue. This means continue staying
on topic and perhaps talk about one
medicine at a time rather than all five or
six the person may be taking.
U: Un-stick. This is interesting because
this means helping the person when they
become stuck for a word. If they are having
difficulty remembering a word and you
don't help them they may take so long to
find the right word that they lose their train
of thought. If you think you know what the
person is trying to say, then help them out.
S: Structure. Structure your conversation,
and particularly your questions, so that the
person you are talking to can give 'yes' or
'no' answers. So you ask, 'Are you able to
take this medicines at meal times, is there
someone to help you?'You must avoid
vague questions. For instance, 'Do you think
you've got all that?' after talking about
medicines is a terrible question. Be specific
and structured in your questions, or employ
a forced-choice question such as, 'Do you
think you want to take your pill in the
morning or night?' rather than 'When do
you want to take your pills?'
E: Exchange. This means the conversation
must include opportunities for
information to be exchanged back and
forth so it's not a one-sided conversation.
Sometimes people are talked to in an
infantilised way or talked to as if they're
not there, or in a very authoritarian way
like 'you do this'. That's not a conversation,
that's a command! A lot of older people
who are spoken to like this say they're
not back at school. They have lived full
lives, often had positions of authority or
just done a really great job, but this all
goes out the window in the way they are
spoken to and it's just not right or fair.
D: Direct. Keep it direct and simple -- this
might include helping things out with a
drawing. For instance, for a pharmacist,
giving the person a picture of their
medicines may be very helpful. If a person is
told by their doctor to buy a pill-cutter, then
giving them a drawing or picture of it can be
a very good communication tool because
the words pill-cutter may be hard to recall.
The FOCUSED program was developed in
1990 by Danielle Ripich and May Wykle.
know what is going on and that they are
going to follow the recommendations
because they are part of the solution.
'I often talk to people who don't understand
why they need to take a medicine, so they
don't take it, even if it's really important,
because they don't know why it's important.'
One question is whether Australia should
go down the path of Britain's Nursing
and Midwifery Council and actively
discourage terms of endearment.
The Chair of the Nursing and Midwifery
Board of Australia, Anne Copeland, said
it was important that patients and nurses
spoke to each other in a way that ensured
there was trust and respect between them.
'However, the board's Code of Ethics
and guidelines speak in terms of what is
expected of nurses and midwives rather
than the other way around,' she said.
'It is of course important when
communicating with older people
that you speak clearly and that there is
clarification that they understand what
you are speaking about.'
Unlike its British counterpart, the board
does not advise against the use of terms
of endearment but rather its Code of
Ethics emphasises: 'Nurses value respect
and kindness for self and others' and
explains that 'valuing respect for self and
others encompasses valuing the moral
worth and dignity of oneself and others.
It includes respecting the individual
ethical values people might have in the
context of health care. Kindness is the
demonstration of simple acts of gentleness,
consideration and care. The practise of
kindness as a committed and everyday
approach to care reduces the power
imbalance between a person requiring or
receiving care and a nurse, by placing the
nurse at the person's service, which is the
Its Code of Conduct states: 'Nurses respect
the dignity, culture, ethnicity, values
and beliefs of people receiving care and
treatment, and of their colleagues' and
explains 'this includes according due
respect and consideration to the cultural
knowledge, values, beliefs, personal
wishes and decisions of the persons being
cared for as well as their partners, family
members and other members of their
nominated social network.'
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