Reflecting on Communication Barriers in Geriatric Physiotherapy

This reflective statement discusses challenges faced when providing physiotherapy to elderly residents with diverse linguistic backgrounds. It highlights key areas such as the importance of effective communication strategies, cultural competence, and personal development in language skills. The writer reflects on their intention to improve access to physiotherapy services through volunteer work at geriatric centers, enhancing both verbal and non-verbal communication techniques. Additionally, the use of interpreters and educational materials like pamphlets is considered essential for facilitating better decision-making processes among clients. Overall, this reflection emphasizes a commitment to professional growth in serving elderly patients more effectively by addressing language and cultural barriers.

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 P INF
REFLECTIVE STATEMENTS
Reflection allows you to critically think about what you have learnt. Reflective statements show how you intend to
implement or integrate new learning into your practice. Conversely you may reflect on why an activity was not
useful and has not been incorporated into your practice.
Examples of reflective practice you may choose to write about include:
 Learning from managing a particularly complex
patient
 Learning from a particular working environment
e.g. an inter-professional setting, or your first
evening on-call;
 The evidence base for selecting a particular clinical
treatment;
 How you accommodated a person’s cultural needs
in your practice;
 How you resolved an ethical dilemma;
 Issues when establishing a new protocol;
 Researching information to enhance service
delivery;
 A conference or course attended.
Please provide all reflective statements on this template. Reflective statements provided in other formats will not
be accepted. Adjust the relevant boxes to fit the content you insert.
Note: Please think carefully about the information you are including in your reflective statements. The
Physiotherapy Board does not request information about identifiable individuals such as patients or colleagues as
such information may constitute a breach of professional standards and ethics. You are advised to exercise
sound ethical judgment when deciding which information to include – consider how relevant the information is to
the point you are trying to make.
Reflective statements should be focused on you as a physiotherapist and what you have learnt, rather than the
patients or others involved in your learning.
Name of applicant:
Date of activity:
Name of activity:
Provider:
Learning category (if
appropriate):
 Work based  Professional activity
 Formal education  Self-directed learning
What did you do?
I was transferred to an aged care facility for offering physiotherapy to older adults with the aim of preventing and
managing elderly falls.
However, on going there I found that most residents were suffering from a range of physiological conditions such as
dementia, poor vision or lack of balance coordination that make them trip or slip during walking. This resulted in injurious
falls and the elders suffered from fractures or head injuries. I tried to build a rapport by introducing myself. This was
done to establish a good carer-client relationship. I established myself as a calm and competent care giver and tried to
empathise with them. While engaging in an effective conversation, I tried to identify the underlying risk factors that might
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REGISTRATION APPLICATION Part 7: REFLECTIVE STATEMENT

have contributed to the falls among the residents. However, one major challenge I encountered was associated with
language comprehension. Dementia and stroke often results in aphasia, a condition that impairs speech (Sajjadi et al.,
2012). Thus, the elderly residents were unable to explain the reasons of their falls and I failed to comprehend their
healthcare needs. Language barriers acted as a major challenge. I failed to explain the importance of physiotherapy to
Non-English speaking residents. Thus, I took help from a local teacher, with a working knowledge of English to
communicate.
What did you learn?
I learnt that elderly falls are the most common cause for hospitalization among people over 65 years of age. 20% of
older people sustaining falls suffer from serious injuries that require immediate medical and physiotherapy intervention
(Ambrose, Paul & Hausdorff, 2013). Fractures to the hip and arms are the most common effects. I learnt that
physiotherapy plays an essential role in maintaining mobility, strength and independence of the elderly. Furthermore,
liaising with other healthcare professionals for applying home safety interventions and exercise programmes can help in
identifying the risk factors and reducing the susceptibility to such untoward incidents (Mirelman et al., 2012). I further
realized that applying tailor-made interventions improves the quality of life of individual patients and helps them live
independently. Although, it is not possible to learn all languages, having a sound understanding of the means of
communication of the service users and their healthcare wants is imperative to effective practice. I realized that all
clinical information must be presented in a lucid way. Gaining a clear understanding of non-verbal communication skills
for talking to older people who suffer from speech impairment will help in understanding their wants and also making
them realize the actual purpose of the intended physiotherapy program (McCarthy et al., 2013). Using translators works
best in such cases and helps the clients understand that their healthcare concerns shall be adequately met (McCormack
et al., 2013).
How did this activity affirm or influence your practice?
This reflection helped in providing me with the opportunity to realize that in addition to showing compliance to the
guidelines and principles of physiotherapy, it is extremely important to discern the healthcare gaps that are found to
prevail in the procedure of delivering holistic healthcare services to the older adults. Visual deficits, musculoskeletal
disabilities, loss of neurological function and frailty make older people highly disadvantaged when compared to other
age groups. This increases their likelihood of suffering from falls (Damián et al., 2013). Thus, all falls should be
considered as symptoms rather than diagnosis. Hence, it is essential to discover the psychological, physiological and
social changes for effectively preventing and managing falls (Gillespie et al., 2012). This reflective practice will enhance
my physiotherapy skills, as I will assess older clients for lower limb strength, urinary incontinence, and osteoporosis, and
cardiovascular disease, problems in balance, gait and cognitive function. Older people often healthcare organizations
and carers who are able to meet their cultural and linguistic needs (Cameron et al., 2012). Therefore, my focus will be to
treat them with dignity and respect by using formal language and speaking slowly in a pace that will enable them to
understand what I intend to say.
The reflection assisted me in increasing my skills to meet the healthcare and linguistic needs. Therefore, in future
practice, I wish to work as a volunteer in geriatric service centres, for increasing the access of the residents to
physiotherapy interventions. I will also work with the aim of protecting client advocacy and intend to enrol in a course
that will enable me learn the basic verbal and non-verbal communication skills needed for interacting with clients in a
better manner. In addition to exhibiting a respect for the language and culture of the elderly, I will focus more on my
language skills. I intend to provide them help during decision making process, related to the physiotherapy program the
wish to be administered on themselves, by providing facts on the benefits and side effects (if any) of the interventions. I
wish to prepare colourful pamphlets and leaflets using diagrams, models, and images for explaining the concepts and
guidelines of physiotherapy. I will also seek help from interpreters in cases where I fail to understand what the clients
are conveying.
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Signature of applicant: Date:
Day/Month/Year
References
Ambrose, A. F., Paul, G., & Hausdorff, J. M. (2013). Risk factors for falls among older adults: a review of the
literature. Maturitas, 75(1), 51-61.
Cameron, I. D., Gillespie, L. D., Robertson, M. C., Murray, G. R., Hill, K. D., Cumming, R. G., & Kerse, N. (2012).
Interventions for preventing falls in older people in care facilities and hospitals. The Cochrane Library.
Damián, J., Pastor-Barriuso, R., Valderrama-Gama, E., & de Pedro-Cuesta, J. (2013). Factors associated with falls
among older adults living in institutions. BMC geriatrics, 13(1), 6.
Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L. M., & Lamb, S. E. (2012).
Interventions for preventing falls in older people living in the community. The Cochrane Library.
McCarthy, J., Cassidy, I., Graham, M. M., & Tuohy, D. (2013). Conversations through barriers of language and
interpretation. British journal of nursing, 22(6), 335-339.
McCormack, L., Sheridan, S., Lewis, M., Boudewyns, V., Melvin, C. L., Kistler, C., ... & Lohr, K. N. (2013).
Communication and dissemination strategies to facilitate the use of health-related evidence.
Mirelman, A., Herman, T., Brozgol, M., Dorfman, M., Sprecher, E., Schweiger, A., ... & Hausdorff, J. M. (2012).
Executive function and falls in older adults: new findings from a five-year prospective study link fall risk to
cognition. PloS one, 7(6), e40297.
Sajjadi, S. A., Patterson, K., Arnold, R. J., Watson, P. C., & Nestor, P. J. (2012). Primary progressive aphasia A tale of
two syndromes and the rest. Neurology, 78(21), 1670-1677.
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