Nonverbal Communication In Hospice

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Communication is the foundation of interdisciplinary patient care for those working with hospice and palliative care populations (Wittenberg-Lyles, Oliver, Demiris, Petty, & Day, 2008). Shared communication between the nurse, patient, and caregiver is fundamental in decreasing caregiver stress and improving both the bereavement process experienced by the family as well as the symptom management issues experienced by the patient (Ellington, Reblin, Clayton, Berry, & Mooney, 2012). Two types of shared communication methods often found in hospice include face-to-face verbal and non-verbal communication. The hospice admission visit is typically a face-to-face visit, using both verbal and non-verbal methods of communication. The ISBAR verbal communication model is a common process used during hospice visits to facilitate the communication between all members of the interdisciplinary team as well as the patient and family. As described by Marquis and Huston (2015), the ISBAR process begins with an introduction of both the team member and the reason for the visit. Next, the history of the illness is discussed, followed by an assessment of the patient.
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Examples of non-verbal communication often noticed by the team during these visits can include lack of eye contact, hunched posture, and silence, to name a few. The lack of eye contact for some cultures is a sign respect, but for others is an insult. Similarly, the use of caring facial expressions, for many, conveys a positive connection, whereas hunched posture may reflect indifference or pain (Luquis, 2014). The use of silence for some hospice patients is a sign of reflection yet for others is a sign of overload. The interpretation of nonverbal communication and behaviors may differ between various cultures and can be the cause of many communication issues if misinterpreted (Luquis,
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