Reconstructing nurses' relationships with older patients

This book will attempt to deconstruct communication patterns between registered nurses and older patients and propose methods for re-constructing the manner in which nurses and older patients relate to one another. The number of Americans over the age of 65 grew from 3.1 million in 1900 (about 4% of the population) to 35.3 million (12.4%) in 2001 and the population is expected to double by 2030. As older people experience chronic health problems, many become the recipients of inpatient health care services and find themselves in the care of registered nurses. These people are often treated in a manner that can be described as disrespectful and even infantilizing. The majority of older people report that they have experienced what is referred to as over-accommodative communication that uses simple vocabulary, high pitch, slow speech, the use of imperatives, repetition, and terms of endearment. This type of communication can result in an older adult’s feeling of increased dependence, lack of control and incompetence. This project explores how nurses can communicate with older patients such that in-dependence, a sense of increased control, and competency are promoted. Further, focus is on how independence, control, and competency improve health and well-being (both key functions of the nursing profession). Effective, person centered communication can lead to care delivery where people are assessed and treated appropriately and where people understand information that is presented to them and how that information impacts decisions. My hope is that nursing communication with older patients can be grounded in I-Thou relationships (Buber, 1958) where mutuality and honesty prevail rather than I-It where the person is used as an object in need. If older patients feel valued and honored, nurses can open the door to healing, inspiration, and self-determination. Using an appreciative approach, nurses and patients are interviewed and observed in order to understand the qualities and characteristics of their communication and the impact of that communication on participants. Findings from this project can influence ways of thinking in the nursing community so that the dominant discourse will become one of respect and dignity instead of paternalism and control