This assignment discusses the obstacles and methods of communicating effectively with confused people by reflecting on my experience communicating with a confused elderly patient. Specifically, and as part of this assignment, I reflect on two methods of effective communication with confused older patients; one verbal (reality orientation) and one non-verbal (touch). During my first internship I was asked to assist in the care of Elsie (pseudonym), an 86 year old lady admitted to hospital with a hip fracture and a urinary tract infection (UTI). Elsie suffered from frequent periodic episodes of confusion; however this was not due to a diagnosed cognitive disorder. Manos and Braun (2006) and Keenan (2011a) state that elderly patients with a bone fracture or urinary tract infection often present with confusion; which is a disorder of brain function (Manos and Braun, 2006). Older adults are more prone to confusion when they are ill because, with increasing age, the size of the kidneys and renal blood flow decrease causing a reduction in the renal threshold (Keenan, 2011b). When Elsie was in a confused state I found it difficult to interpret what Elsie was trying to communicate with me because her answers to my questions didn't make sense. When communicating with Elsie I consciously used the SOLER (Sit Square-on, Open posture, Lean forward, Eye contact, Relax) active listening model (Egan, 2010) that I had been taught at University. I used this to show Elsie that I was listening and to help me try to understand what Elsie was communicating. I felt frustrated because even though I used SOLER, slowed down my normal pace of communication, and repeated what I was saying, Elsie's responses still didn't make sense. The National Health Service (NHS, 2...... middle of paper ...... suffers from the patient's personal space. I should therefore use a calm and reassuring voice with the use of touch. I find it comforting to know that Oliver and Redfern (1991) say that the use of touch is a skill that can be acquired and learned. Reflecting on my communication experience with Elsie I have learned two communication techniques (reality orientation and use of touch) that will help me. communicate more effectively with a confused elderly patient I have realized that I need to learn more about using expressive touch in communication and using other verbal and nonverbal techniques that can help communicate with confused elderly patients, such as the effective use of. paralinguistic communication This will give me more confidence in communicating with confused elderly patients because I will have additional strategies to bring to the situation.