Family Medicine in Clerkship

Recommendations for Communicating with Parents in Pediatric Healthcare:

• Find a Private Setting for Discussion and Decision-Making

  • Ensure the conversation takes place in a quiet, private space to maintain confidentiality and allow for focused, respectful communication.

• Use Language the Parents/Family Can Understand

  • Avoid medical jargon; use simple, clear language that is accessible to the family’s level of understanding, ensuring they feel comfortable asking for clarification when needed.

• Use Visual Aids (Drawings, Models, and Radiographs)

  • Incorporate visuals such as diagrams, models, and x-rays to help explain complex procedures or conditions, making it easier for parents to understand and visualize their child’s situation.

• Pace the Information and Provide it in a Logical Sequence

  • Break down the information into digestible parts, ensuring it follows a logical order. Be prepared to repeat key points patiently and answer any questions the parents may have.

• Recognize Emotional Distress

  • Be attentive to signs of emotional stress or distress in the parents and offer reassurance. Address any concerns empathetically and acknowledge the emotional impact of the situation.

• Discuss Indications, Risks, Benefits, and All Reasonable Alternatives

  • Provide a comprehensive explanation of why a procedure is necessary, outlining the risks, benefits, and potential alternatives. This includes discussing the option of not proceeding with the treatment and what the consequences might be.

• Personalize the Information

  • Rather than delivering a generic explanation, tailor the discussion to the child’s specific situation. Use the child’s name and highlight details relevant to their care to make the conversation feel more personal and relevant.

• Ask Parents and the Child (When Appropriate) to Repeat What They Understood

  • Encourage the parents (and child, if appropriate) to repeat the information back in their own words to confirm understanding. This allows you to identify any gaps in comprehension and clarify any uncertainties before proceeding.

Source

Francesca Dicé, Pasquale Dolce, Assunta Maiello, Maria Francesca Freda. Sharing Medical Decisions with the Child. An Exploratory Survey in Paediatric Primary Care. Child Care in Practice. 2024;30(4):434-445. doi:10.1080/13575279.2021.1910488

Elderspeak, a type of simplified, overly affectionate, or infantilizing communication often used when speaking with older adults. It can lead to feelings of disrespect or reduced self-esteem in patients.¹

Here are a few key tips to avoid Elderspeak:

• Use Respectful Language: Avoid infantilizing terms like “dear” or “sweetheart.” Address older patients by their preferred name and title, just as you would any other patient.

• Maintain Professional Tone: Speak clearly but naturally without exaggeration. Avoid speaking in a slow, overly affectionate manner, as it can come across as condescending.

• Use Age-Appropriate Language: Explain medical terms in a way that is understandable but not overly simplified. Respect their intellectual capacity by providing necessary details without speaking down to them.

• Engage in Meaningful Conversations: Encourage open dialogue, allowing the patient to express themselves fully. Avoid reducing interactions to simple questions or commands.

• Encourage Autonomy: Present treatment options clearly and respect the patient's preferences. Reinforce that they are in charge of their healthcare decisions.

• Avoid Using Simple or Childish Vocabulary: Don’t over-simplify medical terms or procedures. Instead of saying “Are you in pain, sweetie?” say “Can you describe the discomfort or pain you’re feeling?”

• Show Respect for Independence: Encourage patients to do things for themselves, whenever possible. Avoid assuming they need assistance without first offering it or asking if they need help.

• Be Patient and Listen: Take time to actively listen to your elderly patients. Allow them to express themselves fully, and don’t rush the conversation, as it may feel dismissive.

• Avoid Speaking for the Patient: Always direct your questions to the patient, not their family members or caregivers. This reinforces the patient's autonomy and ensures they remain the center of the conversation.

• Use Positive Reinforcement: Offer encouragement without patronizing. For example, instead of saying “You’re doing great, grandma!” say, “You’re doing very well; thank you for your cooperation.”

• Maintain Eye Contact and Open Body Language: Demonstrate attentiveness and respect with eye contact and an open posture. This helps convey your respect for the patient and makes them feel valued.

• Be Mindful of Nonverbal Cues: Pay attention to the patient’s body language and emotional reactions. If they seem uncomfortable or upset, adjust your tone or approach accordingly.

Source

McLaughlin K. Recognising elderspeak and how to avoid its use with older people. Mental Health Practice. 2020;23(5):22-27. doi:10.7748/mhp.2020.e1472