Mindfulness and Empathy Can Aid Understanding With Noncommunicative Patients

In an era when many caregivers suffer compassion fatigue and burnout, encouraging them to find ways to relieve their stress and that of their patients is crucial. Being mindful and empathetic may deepen your staff’s understanding of post-acute care clinical situations, relationships with family members and other healthcare providers, and ultimately themselves.

Mindfulness

A mindful approach is conducive to providing better care and ensuring improved health outcomes, especially for individuals who are unable to communicate. Your caregiving team should be aware of best practices for providing socialization, presence, and holistic care to these patients.

Mindfulness, which is an evidence-based practice for cultivating focus, attention, and presence, helps caregivers better attend to the experiences of others. This approach enables your team to respond with more understanding, empathy, and compassion. So what exactly does this mean for you?

Stress Reduction for Chronically Ill Patients

Jon Kabat-Zinn created an eight-week stress reduction program in the 1970s for chronically ill patients who were not responding to traditional medical treatments. This program is now called the Mindfulness-Based Stress Reduction (MBSR) program.

Today, Kabat-Zinn defines mindfulness as a purposeful, nonjudgmental focus on paying attention to the present moment, often to achieve self-understanding and wisdom. For professional caregivers, this means being intentional with their focus on their time spent with patients and being truly present with them in that moment.

More Benefits for Caregivers and Patients

Why is mindfulness important? It can help you avoid burnout and help your patients:

  • Manage chronic pain and medical conditions.
  • Prevent relapse from major depressive disorders.
  • Counteract anxiety and post-traumatic stress disorders.
  • Lower blood pressure if they have grade 1 hypertension.
  • Reduce stress and aid in preventing migraine symptoms.
  • Improve their quality of life.

Caring for patients who are unable to communicate requires special attention and adaptation. Being mindful of your patients’ needs in the present moment is conducive to an understanding, compassionate approach. It means being alert, aware, and involved with your patients and their families.

Mindfulness education is available online through Relias and within most communities. You and your team members can find apps for learning and practicing mindfulness, as well. Training for mindfulness may encompass topics such as:

  • Breathing techniques.
  • Meditative anchors.
  • Appropriate postures.
  • Readjusted thinking.
  • Daily incorporation of mindfulness.

In addition to the noted benefits for you, your staff, and your patients, mindfulness is conducive to the practice of experiencing and expressing empathy. Let’s explore what that means for your team of professional caregivers.

Empathy

One important way for a person to feel heard and cared for is through empathy. Empathy is feeling with someone. It is trying to tap into the feelings of the patient or their family member, to understand what they’re experiencing, and to connect with them there. It is saying, “You are not alone.” Developing empathy is key to building a solid base for the healthcare provider-patient relationship.

Having empathy is very different from having sympathy. Sympathy is feeling for someone. It keeps you somewhat distant from them.

Sympathy can mean having an attitude that says, “Oh, you poor thing.” It says, “I feel for you. But let me be clear, I’m not really going to get into that with you.” As healthcare professionals, sympathy is not what you or your colleagues should aim for.

You may have team members who are quite comfortable with what to say to their patients but are less comfortable with how to “be” with them. Interactions can be especially challenging when trying to detect and respond to nonverbal communication.

You can use the acronym E.M.P.A.T.H.Y. to assess nonverbal behavior through your perception of and response to nonverbal cues from your patients. The letters stand for the following:

E — Eye contact

M — Muscles of facial expression

P — Posture

A — Affect

T — Tone of voice

H — Hearing the whole patient

Y — Your response

Mindfulness and Empathy

Mindfulness plays a significant role in having and expressing empathy.

The practice of mindfulness involves focusing your attention with purpose on the present moment and accepting it without judgment. It is about openly experiencing patients and their situations with a curious attitude and having respect for their feelings. It is also about communicating your own mindfulness to others in a way that shows you understand them.

There are four key mindful communication practices that you can use in an empathetic manner:

  • Know your audience.
  • Ask questions.
  • Discard scripts.
  • Recognize your role.

Know Your Audience

Knowing your audience means realizing that the person you are caring for is in the midst of a complicated process. Your patients are far more complex than what you see on paper or a computer screen.

This goes for families, too. This health experience is probably not what they signed up for. It’s certainly not what the patient wished for. Make space for their uncertainty and anxiety. Pay special attention to gestures, behaviors, sounds, and eye movements from your noncommunicative patients.

Ask Questions

The second mindful communication practice is asking questions. Ask family members about the patient, their likes and dislikes, and maybe even their favorite sports teams, movies, or hobbies. These questions can build connections and help you begin to better understand your patient. You can ask, “How can I best care for your loved one? Tell me more.”

Rest your attention on noticing the clues the patient and the family members give about the care they need. If you listen deeply, persevere, and ask good questions, they will likely show you what to do next.

Discard Scripts

The third mindfulness practice is discarding scripts. This means don’t rely on a predetermined list of things to say and do. Individualize your reactions and responses using a person-centered approach. Really watch and listen for the things that your patient is experiencing and may be trying to tell you. Ask their family members for their impressions.

For example, your patient is 87, semiconscious, and has aphasia following a car accident. You ask his daughter, “What do I need to know about your father to give him the best possible care?”

She tells you that her dad doesn’t seem to understand what is going on and seems fearful.

You then say, “You seem sad. This makes me sad, too. I wish it could be different. I will do my best to be sure that he understands what I am doing for him so that he won’t be afraid. Please don’t hesitate to share anything with me that you think I should know to be able to give your dad my best.”

Recognize Your Role

The last mindful communication practice is recognizing your role. You have the courage to be a healthcare provider, and the person whom you’re caring for is in crisis, injured, or ill and may be recovering or dying. As their symptoms change, they may experience a wide range of disorders of consciousness.

Your role as a caregiver rests on your innate compassion, clarity of focus, deep listening, and connectedness. You should bring your entire professional self into the lives of your patients and their families by being fully present.

Recognize that your role may bring you into becoming an extended part of your patient’s family. Whether you realize it or not, families often look to you to serve as a nurturing part of their team, and they offer a trust to you that should be highly valued. Protect them and their trust.

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Jennifer Burks

Lead SME Writer, Relias

Jennifer W. Burks, M.S.N., R.N., has over 25 years of clinical and teaching experience, and her areas of expertise are critical care and home health. She earned her Bachelor of Science in Nursing from The University of Virginia in 1993 and her Master of Science in Nursing from The University of North Carolina, Greensboro, in 1996. Her professional practice in education is guided by a philosophy borrowed from Florence Nightingale’s Notes on Nursing, “I do not pretend to teach her how, I ask her to teach herself, and for this purpose, I venture to give her some hints.”

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