What are the Myths and Realities about communication?

Following are some common myths:

MYTH: We communicate only when we consciously and deliberately choose to communicate.
REALITY: We also communicate when we are not consciously aware that we are communicating.

MYTH: Words mean the same thing to our listener as they do to the speaker. REALITY: Words alone don't provide meaning. It is the understanding of words that influences how others receive communication.

MYTH: We communicate mainly with words.
REALITY: Most of the messages we send are nonverbal symbols.

MYTH: Communication is a one-way activity.
REALITY: Communication is a two-way activity.

MYTH: One can never give someone too much information.
REALITY: People can feel overwhelmed when they receive too much information.

Communication is an active process. It includes verbal and non-verbal signals. Examples of non-verbal signals include, body language, eye contact, gestures and voice tones. 80% of communication is non-verbal.

What factors affect communication?

Some factors that can make communication difficult occur within the patient, family, society, or the health care system. These include:

1. Factors related to Family Systems
1. Family members may interpret information received from the health care team in different ways.
2. Lack of experience with death in the family may be a new experience. Existing coping skills may not be helpful. New coping skills may be required to deal with this difficult experience.
3. Perceived or real lack of support among family members may contribute to feelings of distress with the current situation.
4. Inability to care for family member, either physically or emotionally may lead to stress in family caregivers.
5. The crisis of death of a loved one affects the family member's ability to hear and understand information.
6. Illness, dying, death and grief are still a taboo topic for many families. Members may try to “protect” others by not telling the truth.
7. Communication gets stressful when a family member is dying. This is due to the “importance” of the content and the “intensity” of the feelings involved.
2. Financial/Educational/Physical factors
1. Concerns about payment of medical expenses, lost time from work, and other costs may rob families of financial security.
2. This may lead to anxiety, stress, and grief in family members.
3. The education level can affect the ability to understand the impact of the illness. This also affects the ability to make informed decisions about treatment.
4. Too much medical information, many care providers, complicated treatments, and the use of medical words can lead to information overload.
5. Lack of sleep and physical tiredness negatively influences the caregiver's ability to communicate and care for the patient.
6. Age related sensory changes -- Older adults may have vision and/or hearing problems, which contribute to lack of understanding.
3. Physical Limitations
1. The ability to understand and the ability to communicate may be affected by medical and pre-existing conditions.
2. Loss of the ability to speak due to surgery or due to medication can make it difficult for the patient to verbally make wishes known.
3. Other patients such as those persons affected by stroke, need special attention.
4. Factors related to Coping / Grief
1. Anticipatory grieving of the loss of self or another are significant issues impacting communication for families experiencing terminal illness.
2. Anger concerning the en of life situation can also have an impact on communication.
3. Fear of a future without a loved one and concerns about life after death should be addressed using counselors, chaplains, and others as needed.
4. Spiritual concerns, perhaps related to regrets about earlier life decisions or lifestyle choices should be explored.
5. Changes in family dynamics/roles during serious illness and expectations of death roles will evolve. Care givers need to be prepared to assist families as they work through these concerns.
6. Terminally ill patients are at risk for experiencing depression. Such depressive symptoms should be measured regularly.
7. Patient and family members may wish to "hide" medical information in an effort to protect one another. Team members should strongly encourage honesty among family members when discussing treatment and medical issues. Importantly, children should be told the truth at a level they can understand. They should be allowed to visit the sick parent if they choose, and daily routines should be maintained as much as possible.
8. Family caregivers require lots of support for the stress and burden of caregiving. There are many emotional and physical stresses in the daily care of a loved one. The use of caregiver support groups can help coping with these feelings.
9. A feeling of helplessness as one loses independence or watches the decline of self or a family member is disturbing to all. Provide opportunities for individuals to express these concerns. Patients will experience loss of control as independence reduces and physical functions decline. Assisting families to maintain hope in the face of decline is important.
10. The ability of the family to deal with previous stressful conditions will predict how they cope with the present situation.