Everyone has a specialty and everyone is an expert in something. When one becomes an expert in a certain field, it simultaneously becomes more necessary and more difficult to convey the knowledge gained to those who will benefit from it. Conveying healthcare information in particular has never been an easy task, whether one is talking to a doctor about a health-related problem or trying to interpret health information for a loved one who is unable to do so for themselves.
This issue is multifaceted. Loved ones must talk with the doctor, understand what he or she is telling them and then interpret this information and relay it to the patient. There are worries that the process needs to be made more accessible. Healthcare professionals want to help patients and loved ones to become more knowledgeable about their care and become proficient in supporting themselves medically. This is the research of Paul Smith, a professor in the Department of Family Medicine and Community Health at UW-Madison.
Smith addresses both sides of the discussion through his pilot program called Care Talks. Through the pilot program, he advises doctors on how to better communicate with their patients.
“Care Talks are a series of four workshops that last about two hours each. They’re oriented toward the caregivers. A lot of [the caregivers] take care of folks with dementia,” said Smith.
In his Care Talks, Smith focuses on two parties: The caregiver and the care partner. The caregiver is the person providing aid; this person may be a spouse, a child or any person providing care to people who need it. The care partner is the person receiving the care. These people may have trouble advocating for themselves due to illnesses or disadvantages. Illness is commonly discussed as a major reason care partners may have trouble understanding their healthcare instructions, but a lesser known reason is the high limited literacy rate of adults.
“A survey of adult readers in the US found that one-third to half of all adults have a problem with written text. That’s a lot of people who have difficulty reading. This makes verbal communication hard too as people may have a smaller vocabulary for describing what’s going on.” said Smith. “The numbers of people who have trouble reading are alarmingly high, and conveying health related information is already extremely difficult. So it’s important we reach people and help caregivers better transmit information to their care partners,” he added.
“We work with Aging and Disability Resource Centers, specifically five different ones around the state. Their staff help caregivers provide care to people ages sixty and older and people with disabilities,” said Smith.
Although these conversations can be packed with difficult concepts, there are a series of small interventions Smith and his team can help caregivers master.
The first time the program was run, there were only 15 caregivers enrolled. After completion, Smith and his team surveyed for usefulness. They found that out of the 14 respondents, all of them had found the program beneficial and would recommend the program to a friend. Next, they’ll focus on how much it helped the care partners.
Low enrollment is an issue the team faces with this program. “It’s hard to engage the caregivers, because by the time they call they’re looking for immediate help. They’re busy and stressed,” said Smith.
Despite struggles to increase awareness and interest in the course, the program is doing well for something so new.
“It’s a pilot program. We are still trying to see how we can interact with care partners. It’s very early in the research project’s lifetime. If we can get positive results, we can do a larger study and get more people involved. We already have some ideas about how to do that,” said Smith.
Caregivers face unique challenges as they strive to provide care to their care partners. A side product of this program has been providing caregivers with a space to discuss their work with each other.
“Sometimes they talk about the issues of being a caregiver during the sessions, which has become sort of a support group for them,” said Smith. The other aspect of Smith’s work focuses on what he tells healthcare professionals, like doctors and nurses, about how to be effective during communication with caregivers or their care partners.
“We call it getting off on the right foot. Just sitting down when a caregiver talks with their care partner, looking them in the eye and smiling helps a lot. There’s an instant human connection when this happens in a conversation,” said Smith.
Beginning conversations like this makes care partners a lot more receptive to what their caregiver discusses with them. Small mannerisms like eye contact and smiling go a long way in starting the conversation correctly, but maintaining attention throughout the conversation is just as important.
“We naturally sometimes speak faster when we’re talking, which makes us hard to understand. The care partners don’t have time to think about it, process it and decide what’s going on. Ideally, we will help caregivers speak more slowly, then check the understanding of the care partner. That’s not something that’s commonly done in healthcare,” said Smith.
Checking for comprehension is an important step of Smith’s model because it’s the main determinant of whether the program is able to actually improve healthcare communication. In addition to checking for comprehension in the care partner on the individual conversational level, Smith and his team follow up with surveys to assess the program’s efficacy.
Communication is vital when providing care and translating the information that caregivers have into information that can actively aid in providing healthcare to others. Smith’s research program will continue to help these expert caregivers share information more effectively with their care partners and their healthcare professionals.
