Helge Garåsen The Trondheim Model - NSDM

6.6 Intermediate care – could the components be precisely described?
In some studies multicomponent care is described as involving several professions in a
holistic approach (multiprofessional team) (168-169). However, some questions remain
unanswered; 1) why do some multicomponent interventions result in a better outcome than
others? 2) why does a team of professionals function better than several professionals
working independently?
The communication process is complex, and older people are a more heterogeneous group
than younger people, and they have often had mixed past experiences having been subject to
several diseases, diagnostic and treatment procedures. Health personnel and older people can
have differing perceptions of; 1) what illness is and 2) what the consequences of illness are.
Unclear communication could cause the whole medical encounter to fall apart (168).
The intermediate care intervention, mainly focusing on communication with the patients, the
social and professional networks, at Søbstad Teaching Nursing Home is described in paper 4.
The physicians and nurses at Søbstad follow some basic communication rules (170):
o Allow extra time, as older people need more time and also want more
information than younger people.
o Avoiding distractions by sitting alone with the patients
o Sit face to face as this gives better patient compliancy.
o Maintain eye contact, as this is a powerful form of nonverbal communication.
o Listen to what the patient has to say.
o Speak clearly, slowly and loudly.
o Use simple and understandable sentences.
o Talk about one topic at a time.
o Simplify and write down any instructions.
o Frequently summarise the most important topics, often together with family
members.
o Give the patients an opportunity to ask questions and express themselves.
o Meet the patients with politeness and respect
o Keep the patient relaxed
o Enable the patients to manage their own situation
74