Authored by Tina Fredette

“The two words information and communication are often used interchangeably, but they signify quite different things. Information is giving out; communication is getting through.”

Sydney Harris (American Journalist) 

Communicating information is a two way system. At Cascade Health Solutions, we understand that teaching is a dialogue that involves listening and watching, not just talking. We feel that good communication requires collaboration between a therapist or nurse and the patient. We understand that patients follow recommendations when they make sense and fit into their personal needs and environment. One size doesn’t fit all, so we listen and personalize instruction, doing our best to connect with patients to reach their goals and make a positive impact on their healing process.

Listening is done with eyes and ears. What we hear is only part of the message. As a matter of fact, 70% of a message is non-verbal.   It includes watching body language that might say, “I can’t do this” or “I don’t want to do this.” It includes seeking to understand our patients’ needs, both physical and emotional.

“What you do speaks so loudly that I cannot hear what you say.”

Ralph Waldo Emerson                                                                     

As a Speech Language Pathologist, I work with people who have swallowing difficulties. Take, for example, a theoretical patient who has ALS (Lou Gehrig’s Disease) and has troubles chewing and swallowing a cheese sandwich. A swallow test of this patient shows that there is a risk of choking on such challenging foods as sandwiches and meats. It’s my job to evaluate and educate the patient about the risks and recommendations for avoiding choking. I would recommend pureed foods only. Without connecting with this patient, I could simply say, “You can no longer eat solid foods. Everything must be put in a blender before you eat it.” In this situation, I would be talking, but not effectively teaching. Perhaps this patient understands the risks of choking, but wishes for quality of life to continue eating favorite, hard foods. By listening and watching, I can determine if my recommendations are being received effectively. For that reason, I would say, “It is no longer safe to eat solid foods without a significant choking risk. Eating a diet of pureed texture foods would be safest, but what do you think about this problem?” I am open to the patient’s personal choices. I appreciate that some people in this situation may choose to puree all foods to minimize the risk of choking while others may choose to keep eating favorite foods for optimal quality of life. With the patients’ feedback, I can provide recommendations for how and what to puree or techniques and food choices to minimize choking risks. It is a collaborative process. It is my professional responsibility to provide information about what is safest, but it is my job to help people make their own, informed decisions. I judge success to be when a patient reaches their set goals and feels successful.