Intergenerational Communication Across Cultures - Coursework Example

Introduction The health sectors across cultures are facing a grave dilemma which is the low patients’ compliance due to various interconnected factors. However, the problem can be summed up into one resolution, which is an effective interpersonal communication in health care. The IPC between health care provider and patient is overtly a significant aspect that could boost patient satisfaction, compliance and health consequences. Patients should clearly understand their health condition and the necessary treatment procedures which can strengthen their resolve to sternly obey the medical advices recommended by their health care providers. Moreover, effective communication between the patient and the provider ensures an open disclosure of vital information such as health problems. In an open communication, patients are motivated to entirely unveil their health illnesses to their providers so the latter could accurately diagnose and treat their health disorders. Yet, the success of a health care institution does not solely rely on the patients but also to the individuals and the community involved in the process of obtaining a quality health care system and outcome. Health care providers in general hold the key to an increase in patient’s compliance because of their learned capability to effectively communicate to their clientele. Patients will positively feel that they are genuinely being cared about through the competence of health care providers to establish a rapport. Numerous research studies were conducted in industrialized countries and data showed that there is a substantial increase in the quality of health care provided and improvement in health outcomes because of development in interpersonal health care communication. The individuals who are immediately involved in IPC are the patient and the health care providers (Curtin 1987). Nevertheless, effective communication is a difficult objective to realize. It is unhealthy to assume that a positive communication scenario constantly transpires naturally (Kim 1999). Just like any other rigorous personal management discipline, getting hold of effective interpersonal skills necessitates keen observation, practice and finally the application of interpersonal communication guidelines (Fallowfield 1998). Even the commonality among individuals within a territory is never a guarantee that people will innately exhibit an encouraging approach to interpersonal communication. Differences still exist within the confines of a community such as in educational, socioeconomic and cultural domains which can largely hamper the realization of an effective interpersonal communication (Huntington 1990). In the arena of health care, anticipation of the outcome of the encounter between the patient and the provider can de duly affected by factors such as personal problems, privacy and confidentiality issues and time limitations due to private and public responsibilities. On the other hand, the condition of health communication in a given population is the liabilities of multiple structure and process which are the government policy, health care decrees, the health care system itself and the degree of ethnicity in a culturally diverse society. These different societal institutions are apparently dissimilar in their approaches and objectives, yet there is one commonality among them that pervades, the interpersonal and intergroup usage of language in all forms. It is well-known that the language as a cultural element is extremely valuable in the advancement of patients’ well-being and other health care outcomes. Pieces of evidence illustrate that deficiency in effective communication in the health care sector results to negative consequences such as deprived access to health care. Insufficient helpful written and spoken communication can lead to failure in preventing primary and secondary disease, mistreatment of health care, increase in patient noncompliance and mounting health service cost. Intergenerational Communication in Geriatric Health Care Effective interpersonal communication between the provider and the patient is particularly important when the one receiving care or treatment is an elderly or an older adult. Old people commonly become physically, mentally and cognitively weak. Elderly patients oftentimes demand more intricate medical treatment due to their complicated medical conditions. In this case, geriatric providers confront a dilemma regarding multiple prescriptions which requires a painstaking explanation of the treatment procedure. The provider must keep in mind that the objective of the medical discussion is to enable the elderly patient to recall the information. This situation can be successful through effective communication between the provider and the patient. Memory retention is more probable in a bias-free and open communication (Levinson 1994). Aging is a physically incapacitating occurrence because impairments in the different senses such as hearing, seeing and thinking will inevitably happen. These physical problems brought by aging serve as an impediment to an effective physician-patient communication. These unique needs of the elderly people intensify the need for a thorough and careful explanation by the provider. Moreover, intergenerational differences in the psychological domain contribute to the already complicated communicational situation of the provider and the elderly patients. For instance, there are old adults who remain flaccid and less confident in front of their physicians, maybe because they are worried about the possible reaction of their physician to their attitude. This becomes a larger problem when the physician and the elderly patient have large generation gap. More often than not, during the giving out of the medical prescriptions, the elderly patient will just pose as submissive beings which are commonly manifested by their unwillingness to ask for questions because they are anxious to be labeled as disrespectful by their physicians (Beisecker & Beisecker 1990). Several studies show that the nature of the physician-patient communication can be attributed to the physician’s communication style. Researchers such as Greene, Adelman, Charon and Hoffman found out that physicians are less courteous, tolerant and sympathetic of their elderly patients relative to their younger patients. Another finding is that in a medical discussion between a provider and an elderly patient the former dominates the communication which leaves a very congested room for the concerns of the latter. Also, physicians are less enthusiastic to the subject matters opened up by their elderly patients. In the research studies, it was further discovered that the type of communication style that the providers make use of in conversing with their geriatric patients are explicitly simple and patronizing (Winograd 2002: p. 444). A severe kind of this patronizing communication style is the “secondary baby talk” which is linked with the infantilization of the elderly. This speech pattern is characterized by high pitch and overstated modulation commonly used for infants. This type of communication resulted to the elderly people’s feeling of being patronized in the doctor’s office (Hummert and Mazloff 1993). Plenty of studies show that health outcomes in geriatric patients are improved when the providers undergo seminars and other learning activities on the opportunities of an effective communication with older populations. In America, large percentages of its people are unaware of the true condition of the geriatrics in terms of intergenerational communication. They were not informed that the health care industry is suffering a loss because of geriatrics gap. In 2002, the Opinion Research Corporation released a commissioned study for the Alliance for Aging Research which shows that recently 96% of Americans believe that the providers must endure further development through training, particularly regarding the elderly patient (futureageconsulting 2008). Characteristics of an Effective Intergenerational Communication The process of effective intergenerational communication generally comprise a motivating two-way conversation and establishing a joint venture between two individuals—the elderly patient and the provider; these approaches to communication ensure an atmosphere devoid of extreme technicalities of the medical discourse. An entrenched trust of the elderly patients to their physicians can be obtained through bridging the generation gap and other social influences. A geriatric provider must learn how to use both the verbal and the nonverbal cues in communication so as to create an environment conducive to free talking and discussions. Moreover, effective intergenerational communication is reinforced by the elderly patients’ educational level and the capacity to recognize technical details of the recommended course of therapy and treatment directives. The provider should first evaluate the aptitude of the elderly patients to recall information so as to devise a method in which the patients would feel that their health conditions are treated with compassion and empathy; in this manner, recalling of important bits and pieces would be much probable (qaproject.org 1999: p. 5). Providers and geriatric patients should view health care as an alliance or a partnership wherein both parties attempt to exploit positive health outcomes. Human elements that could make intergenerational communication successful are mutual respect, faith and cooperative decision making process. Geriatric patients must remove the insecurities they feel in front of their physicians which is largely due to the discrepancy in the social position. Even though the provider is a specialized medical representative the geriatric patients should still assert their rights for clarification and suggestions since both the patient and the provider are liable to the result of their interaction. Geriatric patients should refrain from disclosing statements that are half-true. Elderly people usually lie about their true health condition because of their lack of confidence to their physicians. So, providers must learn how to establish a rapport with the geriatric patients in order for them to be successful in the field of intergenerational communication. Likewise, the provider must take advantage of trainings and seminars on communication because their task to diagnose and treat geriatric patients is crucial. Patients’ trust and confidence are difficult to obtain but through compassionate treatment by their physicians they gradually develop a pleasant perspective towards their health condition and the course of therapy needed. Effective intergenerational communication can be further bolstered by a serene, clean, and systematic environment that is relaxed and heartening which in turn could motivate a productive style of communication between the physician and the elderly patient. In this type of scenario, the geriatric patient could feel a commitment and genuine concern from their health care providers. An environment that is in severe opposition with the characteristics mentioned previously can be viewed by the patients as a disrespecting and unenthusiastic approach to their health care needs (7). An important factor that effective communication should consider is the socio-cultural-economic aspects of the members of a particular society. These factors range from the individual level such as gender, age, race or ethnicity to a larger setting such as economic status or class. The common dilemma hampering the complete realization of a successful intergenerational communication in geriatrics is is the age gap between the physician and the elderly patients. For instance, an elderly patient discussing a medical concern with a highly educated and a young physician can be distantly apart even though both of them share the same language. The social distance between the providers and the geriatric patients could certainly impede quality communication in health care because the medical language will be harder to grasp for the patients and it then will surely double the necessary effort of the health providers to diagnose and treat their health condition (Roter 1991). Importance of Intergenerational Communication in Geriatrics Life is an endless venture which is characterized by ever-changing experiences embossed into memories. Yet, while age progresses the retention of memory for many of the elderly remains a disturbing predicament. Those providers who work for the older population confront a serious challenge which is to carefully understand the aging process which commonly brings problem in comprehending the complicated medical needs of the elderly patients. Young physicians in the service of the geriatric health care will more probably have a negative sentiment towards an unproductive intergenerational encounter if they are not prepared by credible learning institutions on the importance of personal strength and competent communication skills. Young geriatric caregivers should recognize the intricacies of the aging process in different ways because individuals experience diverse incidences in terms of prevailing social factors which in turn mingle with communally shared attitudes, beliefs and prospect. A case in point is the age group in US from the World War II which shares personality characteristics which are distinctive to that generation. The subsequent generations such as the Baby Boom and Gen X uphold dissimilar outlook from those collectively possessed by the previous generation. In an interpersonal experience, these differences among generations could result to sentiments of deep-rooted disappointment, antipathy and even antagonism when confronted by incompatible attitudes or unattended expectations due to the impersonality of the market economy. In the United States, large numbers of elderly people reported that they were disrespected and misunderstood rather deliberately by the young individuals caring for them (futureageconsulting 2008). The elderly patients’ contentment and gratification in the provided geriatric services can be shown in frequent health encounters. Patients usually visit health centers to fully understand their health condition. Patients’ enthusiasm in visiting health institutions particularly of the elderly could be bolstered through the efficiency of the geriatric providers in storytelling or the ability to commence on a natural conversation. This storytelling form of medical discussion is a potential catalyst of healing since patients will have the leeway to express their insights and viewpoints regarding their health condition. The health care provider then is consequently benefitted by the patients’ eagerness to disclose relevant information that could quicken their health therapy and recovery. Care givers of the elderly patients could precisely evaluate, understand, deduce and investigate on the significance of the health indications and signs that the patients manifest. A patient’s conception and sentiments about a health problem might be severely important in stipulating the suitable treatment (qaproject.org 1995: p. 9). A health problem may intensify because of the psychological effect of a bad intergenerational communication in geriatrics. A substantial degree of distress may originate from the detrimental perception of a patient regarding the graveness and gravity of his/her infirmity. Geriatric providers should be very cautious in handling the emotional facet of the elderly patients because anxiety is rapidly developed in older populations. Providers should aim for the alleviation of fretfulness among the elderly patients and not for the strengthening of it (9). However, health care providers often pursue individual methods to interpersonal communication hence disregarding the valuable, functional and applicable principles and teachings of good IPC skills (Kim 1999). Death and Dying Death has two countenances, the natural or which is commonly called a “projected death” and the aberrant which is usually characterized by accidents and other unforeseen circumstances. Habitually, death is described either qualitatively which is normally on spontaneous demises such as the cause of it, its effect on the loved ones, its provoked excess baggage like “death anxiety” (Benton et al, 2007) or quantitative which is routinely done on induced deaths such as those reported on the television and radios as “death tolls” proceeding a natural disaster or man-made catastrophe. Richard Schulz (2008), a professor of psychiatry, reckoned that a large percentage of death in the United States is due to physiological malady such as “heart disease, cancer, stroke, and respiratory diseases” and most of the victims of these pathologies are elderly people. These humdrum diseases have a serious degree of incapacitating ability thus the elderly carriers of these illnesses necessitate a care giving procedure from their family members or relatives. Furthermore, Schulz signified that care giving is complicated as well as hazardous to the individual eliciting the care-program. Schulz alleged that caring for a debilitated loved one draw on negative outcomes from both the care giving experience and post-bereavement such as stress and psychiatric problems; correspondingly, Schulz delineated three responses to death which are depression, normal grief reactions, and complicated grief or the inability to sustain a fine interpersonal relationships and normal life as of death, to solicit aid for the invention of therapeutic programs or interventions that will arrest these negative responses. Medicating a downbeat care giving outcome entails an understanding of the dialectical relationship between pre-bereavement and post-bereavement. A caregiver’s experiences prior to the death of a loved one such as the pressure of a required multi-tasking lifestyle and depressions put forth by the idea of losing someone dearly loved intricately affect the adjustment to be done after the death. Nevertheless, countless researches are conducted nowadays to examine the feasibilities of the various intervention methods for the treatment of disconcerting outcomes of a death of a loved one. Meanwhile, Arthur B. Shostak (2007) took a different route in portraying the countenance of death. Dissimilar to the United States wherein the population is fairly distributed within age generations, Japan as an industrialized nation in Asia confronts the despondent predicament of an aging society. Countless of death which is led by elderly people in the small nation is featured by acute loneliness and misery due to the weakening familial and social ties. This dilemma of aging alone hence dying alone is resolved by the Japanese community by instituting social services that will somehow enliven the dank spirits of the aged such as welcoming programs to regurgitate the lost genuine social connections. Yet, the compassionate efforts of both the non-governmental and governmental organizations have to still traverse a difficult path in creating death a serene and a pleasant affair for the aged Japanese. On the other hand, death that is provoked by natural calamities and disasters is increasing globally. A case in point is Florida which experienced eight major hurricanes and which documented thousands of casualties. The lack of sufficient and effectual forewarning of an imminent calamity and evacuation programs contributed much on the massive loss of human lives. Nonetheless, the state of Florida learned its painful lesson and it is recently endeavoring on the improvement of their emergency preparedness and policies (Hyer et al., 2006). Death is the endpoint of everything that thrives in this blue planet; however, people are consciously aware of their own looming termination (Benton et al, 2007). Whenever people become too much aware of their transience, they purposely create a defense mechanism that will outmaneuver their mortality (Greenberg, Solomon, & Pyszczynski, 1997 as cited in Benton et al, 2007). The various facets of death and dying only concur to the reality that human existence is not the most favorable. Death and dying truthfully imply nature’s equity towards all the living. Conclusion Individual differences across cultures have been a problem to the realization of an effective communication among individuals and groups in health care sectors. Motivating a patients’ sense of power and encouraging compliance from them are tough tasks especially for health care providers. Compliance, ideally, should be ruled by a good rapport between individuals involve in a medical communication in order to elicit a form of obedience that is grounded on the complete understanding of the health situations and of the significance of following essential medical advices to the fullest. Another useful approach in producing patient compliance, particularly the elderly, and sense of power is the promotion of the idea that their self-identity lays on their own effort to do things for themselves (Myers 2005: p. 595). The effectiveness of this approach lies on the confrontation of a health problem that seems to be unsurpassable. Elderly patients become hopeless and desperate whenever their health illnesses are unclearly explained to them. Elderly patients’ depression was the outcome of the health care providers’ failure to satisfy the geriatric patients’ expectations from them. Motivational social interaction (Henderson 1994: p. 309) by means of clearly explaining the objectives and principles of the health care treatment and of establishing a compassionate relationship between the provider and the patient, the latter will feel a high-degree of power or control over the realization of the purpose of following advices. Works Cited Books Greenberg, S., et al. (1997). Terror Management Theory of Self-Esteem and Cultural Worldviews: Empirical Assessments and Conceptual Refinements. San Diego, CA: Academic Press. Henderson, J. (1994). Psychology 101. Madison, Wisconsin: Brown and Benchmark Publisher. Myers, D. (2005). Social Psychology. Boston: Mc-Graw Hill. Journals Beisecker, A. E., & Beisecker, T. D. (1990). Patient information seeking behaviors when communicating with doctors. Medical Care. Benton, J. P., et al. (2007). Death Anxiety as a Function of Aging Anxiety. Death Studies. 337. Fallowfield, L. et al. 1998. Teaching senior oncologists communication skills: Results from Phase I of a comprehensive longitudinal program in the United Kingdom. Journal of Clinical Oncology. Huntington, D. et al. 1990. User’s perspective of counseling training in Ghana: The mystery client trial. Studies in Family Planning. Hyer, K., et al. (2007-2008). Nursing Homes and Assisted Living Facilities: Planning and Decision Making for Sheltering in Place or Evacuation. Disasters and Older Adults , 29-30. Kim, Y.M. et al. 1999. Client participation and provider communication in family planning counseling: transcript analysis in Kenya. In Press: Health Communication. Levinson, W. (1994). Physician–patient communication: A key to malpractice prevention. Journal of the American Medical Association. Schulz, R. (January 2006). Bereavement After Care Giving. Geriatrics , Volume 63. Shostak, A. B. (September-October 2007). Japans Approach to Aging and Dying. Society. Winograd, C. (2002). Physical Therapists’ Nonverbal Communication Predicts Geriatric Patient’s Health Outcomes. Psychology and Aging, Volume 17. Online Sources Quality Assurance Services (1999). Improving Interpersonal Communication Between Health Care Providers and Clients. Center for Human Services. http://www.qaproject.org/training/ipc/ref.pdf Future Age Consulting Inc. viewed 31 July 2008. http://futureageconsulting.com/elderaware.html Read More