Robert M Arnold

When clinicians communicate effectively, patients retain more information, have higher trust and a better quality of life. Such a patient-centred approach is the future of clinical care, and this book is an essential how-to guide on improving these skills. Grounded in innovative and evidence-based methodology, perfected through over twenty years of teaching in the VitalTalk training program, content includes foundational communication skills, how to help patients plan for the future, what to do when you are really stuck, and strategies to work through conflicts with colleagues. In this updated edition, emphasis is placed on the roles privilege, race, and power play in the medical encounter, and new tools are provided to help clinicians navigate this landscape with greater self-awareness and sensitivity. This practical guide is filled with skills and roadmaps, demonstrating how to be clearer when sharing information, more competent at understanding patient concerns, and more effective when making recommendations.

In few places in American society are adults so dependent on others as in nursing homes. Minimizing this dependency and promoting autonomy has become a major focus of policy and ethics in gerontology. Yet most of these discussions are divorced from the day-to-day reality of long-term care and are implicitly based on concepts of autonomy derived from acute medical care settings. Promoting autonomy in long-term care, however, is a complex task which requires close attention to everyday routines and a fundamental rethinking of the meaning of autonomy. This timely work is based on an observational study of two different types of settings which provide long-term care for the elderly. The authors offer a detailed description of the organizational patterns that erode autonomy of the elderly. Their observations lead to a substantial rethinking of what the concept of autonomy means in these settings. The book concludes with concrete suggestions on methods to increase the autonomy of elderly individuals in long-term care institutions.