2.2.3: Active Listening

“Most people do not listen with the intent to understand; they listen with the intent to reply”–Stephen R. Covey

Active listening means what it sounds like.It means that you are fully concentrating on what is being said, rather than passively listening or focusing on your reply. You are actively paying attention or listening to the other person with whom you are speaking. Active listening is an important skill for a HHA/PCA to develop. It demonstrates to their patients that they care and are interested in them. It also allows them to obtain important information about their patient’s health care needs.

Active listening means giving the speaker, or sender of the message, your full attention. It means using all your senses while listening. Active listening means paying attention to the words the speaker is saying and the nonverbal messages that are also being expressed. Active listening means conveying (showing) the other person that you are interested in what they are saying. We demonstrate active listening by not only our spoken words. Unspoken words or our nonverbal messages also demonstrate that we are actively listening. Nonverbal messages, such as use of eye contact, posture, nodding of the head, touch, and facial expressions like smiling convey the powerful message that we are actively listening to the speaker.

How to Be a Good Listener:

Allow the person the opportunity to express his/her ideas completely. Concentrate on what they are saying. Do not interrupt. Avoid finishing their sentences, even if you are in a hurry, if you think you know what they are going to say, if they have told you the same thing before, or if they are having trouble communicating and are taking a long time to respond. If you find it particularly difficult to not interrupt, practice counting to ten when you feel the urge to interrupt.

Restate the message you heard the other person saying to ensure you heard them correctly. This feedback allows the other person to correct any misunderstandings and demonstrates you were listening to and heard them. For instance, you can something like, “I heard you saying that you are not happy with your new diet.”

Provide feedback while you are listening to encourage the person to continue and show you are interested. Leading statements such as, “Go on,” “Mmm–hmm,” “Yes,” and “Tell me more,” encourages the person to continue and demonstrates your interest in what they have to say. Use of body language such as nodding your head helps to encourage the person to continue.

Allow for silence. Silence can be a powerful tool. Silence allows the person a chance to fully explore and express their thoughts. Often, we try to avoid silence because it makes us uncomfortable. Silence is especially important when discussing sensitive or difficult topics. Don’t rush to fill in the silence with meaningless conversation or clichés.

Avoid changing the subject even if the topic makes you uncomfortable. This conveys to the patient that you are not interested in what they are saying. For example, a patient might say, “I am really afraid to die,” do not say something like, “Don‘t think like that. Come on, let‘s do something to cheer you up.” Instead say something like, “You are afraid you are going to die. Tell me what‘s on your mind.”

Use your body language to demonstrate your interest in the other person. Stop other tasks you are doing and put your full attention on the person in front of you. Stand, or better yet, sit, facing them. If appropriate for the culture, make eye contact. If a patient enjoys touch as a means of communication, a HHA/PCA can touch their hand or arm while they are talking. Use facial expressions to convey your interest and attention. Smile as appropriate and appear concerned when a difficult topic is being discussed. Lean forward to convey your interest and avoid crossing your arms over your chest, which closes you off from the other person.

Be aware of cultural differences. Get to know a patient’s culture and what is acceptable. Learn the words and expressions of a patient’s culture to fully understand the message they are trying to convey. When in doubt, ask a patient to explain what a phrase or expression means. Do not assume you understand.

Do not talk to an elderly or disabled person as if they are a child. Talk to them as if you would anyone else. Do not call them names such as “Honey,” “Sweetheart,” or “Dear.” Call the person by the name they wish to be called. Always ask how the person would like to be referred. Some people may find it inappropriate if you call them by their first name. They may prefer to be addressed as “Mr.” or “Mrs.”

Avoid fidgeting during conversation. Do not look at the clock while people are speaking as this conveys that you are in a hurry or bored. Avoid picking at your fingernails or clothing, playing with your hair, doodling, or using your cell phone while the person is speaking. Home Health Aides/Personal Care Aides should give their patient their full attention.

Use empathy. Try to put yourself in another person’s shoes to understand what they are going through. Don’t state, “I understand how you feel” as you cannot know exactly how they feel.

Ensure communication aides such as hearing aids, eyeglasses, and dentures are clean and in good working order. Home Health Aides/Personal Care Aides should provide them to their patient to help them communicate more effectively.

Self Check Activity \(\PageIndex{1}\)

Which of these two scenarios demonstrates active listening?

1. Mrs. Pompi is in her bed and is telling her HHA that she is scared she will never walk again. The HHA is cleaning the room as Mrs. Pompi talks and periodically says, “Mhmmm” and “Okay” during the conversation. The HHA is worried that she will not get all her tasks completed before she has to leave for the day. She looks at the clock on the wall every now and then as she works and Mrs. Pompi talks. Mrs. Pompi says, “I just don’t want to live the rest of my life in this bed. I’m so scared.” The HHA says to her, “Don’t worry about that, honey.I understand how you feel. Everything will be okay. Now, let’s get you washed and dressed.”

2. Mrs. Williams is in her wheelchair doing a crossword puzzle while the HHA makes her bed. Suddenly she looks up from her crossword and says, “I am so frightened that I am going to die. I don’t want to die yet.” The HHA stops what she is doing, pulls a chair next to Mrs. Williams and touches her hand. The HHA says, “You sound scared and worried about dying. Would you like to talk about it?”

Answer

Scenario 2 demonstrates active listening.

Feedback:

The healthcare worker stopped completion of her tasks, positioned herself so she could focus on her patient and so that her patient would know she cared about what she had to say. She also used reflection and an open-ended question, inviting Mrs. Williams to share her thoughts and feelings.