Charles Berner Theory of Communication Health and Social Care

Commentator on social care

Posted 20 February 2020

In social care, communication goes beyond knowledge and expertise to incorporate every aspect of interaction and experience. Care workers need to have the ability to empathise when needed and talk about potentially complicated procedures and issues calmly. Confrontation or disagreements can happen, and the need to defuse these challenging situations is perhaps the most important use of strong communications skills in care.

Why is it so important?

Help them feel in control – As you can expect once people enter the care system, they can feel like they've lost control of their lives. Simple things they took for granted become harder, day to day tasks might be dictated by a nurse or carer. Having good communication can avoid the person feeling like this, creating the opening to use their voice more and have their say on their care service.

As you probably already know, people should have control over their own care and how it is delivered, in so far as they are able to. Even if your organisation is rightly giving people that control, poor communication skills can make them think the opposite and undermine your person focused approach.

Ease their anxiety – Being anxious or having depression in care homes has become more prevalent. A report from the independent Mental Health Taskforce to the NHS in England stated that "40% of older people living in care homes are affected by depression". Finding out about tests and treatment you'll need, not seeing your family as often and the fear of the unknown are some factors that affect the way the patient feels.

Communication is key in this instance, these problems for the resident can often lead to out of character moments, aggressive or anti-social behaviour, or self-isolation. It's important to notice if characteristics that highlight anxiety issues are present. Does the person often feel nervous, are they breathing quicker, or have they had a panic attack? Good communication is important to keep the person calm. Care workers must assist at the persons pace, let the patient talk and choose their words carefully to reduce these anxieties and build up their confidence.

Save money and avoid errors – It's not always about patients either, in a healthcare environment communicating effectively with colleagues and co-workers is important. Poor communication skills can lead to errors such as mistakes on tests and prescribing and administering the wrong medicines. Research by the Nursing Times, the UK's leading healthcare magazine tells us that these mistakes cost approximately £1 billion per year. Learning to communicate effectively with colleagues should be a top priority for a care business.

What communication skills does a care worker need?

Care workers need a select set of skills to be successful when communicating. These develop during their time in care, but must always be present in their role. Some examples include:

• To be able to organise a conversation and keep it going, to draw out all the information they need from a service user as they can come across barriers.
• Have good listening skills so they can check understanding with the person.
• Using non-verbal communication is key. There may be times the service user struggles verbally. Understanding their requirement without the need to be verbal and making sure they understand is important for their treatment.
• Understand cultural differences and how they might impact communication.

These skills should come naturally to a care worker as along with their core English, number and general employee skills, they need to have natural empathy and be a 'people person' which is something a lot of residents require in their day-to-day lives in care.

Promoting effective communication

Communication goes two ways. Giving and receiving messages requires consideration of both the carer and service user to make it effective.

The Cycle of Communication (below) is key to this and is the process of the sending, receiving and decoding of messages. Now, this does not mean you are going to have to start learning Morse Code. The Cycle is totally applicable to the kind of verbal communication that is going on all the time in care, especially with people who may have diminished communication skills, dementia, or difficulty expressing themselves.

This theory of effective communication was first developed by Charles Berner in 1965 and is when someone decides to communicate. The process involves taking action (message sent), which is then received by the other person (message received). This person then works out the meaning (message decoded) and lets the other person know they have understood (feedback). The feedback is the response to the message and then the whole cycle may start again.

With this there are various factors to consider when promoting communication between service users and workers.

In a care setting it's important to think about the needs of the service user, since this is the core part of the care workers' job role. Not all service users are the same, so the purpose of the communication is to establish what the individual requires.

Overcoming barriers in communication

Communication barriers are common across all social care, for example if the person has dementia, autism or a hearing impairment. It's important to adapt to these similarly to the way we spoke about dealing with anxiety earlier.

For example, when communicating with someone with dementia it's important to;

• Speak at a slower pace, allowing plenty of time for response.
• Don't speak as if the person isn't in the room, or like a child.
• Ask questions one at a time and don't make them complicated.
• Avoid asking direct questions. Someone with dementia could become frustrated if they can't find the answer.

Although a lot of these barriers are transferable between conditions, preparation is the key to success. Care workers need to be ready for any problems that may arise with poor communication, so they can deal with it effectively and in the best way for the resident.

Charles Berner Theory of Communication Health and Social Care

Source: https://www.theaccessgroup.com/en-gb/blog/hsc-effective-communication-health-and-social-care/#:~:text=This%20theory%20of%20effective%20communication,other%20person%20(message%20received).

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