MedEdPORTAL (Feb 2011)
Interviewing a Grandparent Caregiver With Age-Related Hearing Loss
Abstract
Abstract Since the 1980s, the number of children being raised by their grandparents has increased for a variety of reasons. As the number of grandparent caregivers increases, pediatricians are being exposed to family dynamics and situations that reflect this demographic trend. Since the health and dynamics of the entire family often impact the care we offer as pediatricians, understanding how we best can serve families headed by grandparent caregivers will improve the services we offer our patients. In this simulated case, an older adult brings their grandchild to the emergency room due to a clonidine overdose. Pediatric residents are sent to obtain a history from the grandparent, unaware that the historian has hearing impairment. Specifically, in this case we address effective communication with a caregiver who has presbycusis, or age-related hearing loss. This case also addresses safe medication storage, an important issue to stress with older caregivers, because medications ingested by children belong to their grandparents. After the simulation case is complete, the facilitators and learners gather for a feedback session. They discuss the challenges of interviewing someone with hearing impairment and then hear strategies on how to optimize communication with a hearing impaired historian from geriatric and pediatric faculty. Also discussed is how to address medication safety with families, as well as the proper management of clonidine ingestions. In the process of educating residents and medical students about these specific areas, they become more cognizant of modifying their approach to patients and families with grandparent caregivers. Training pediatricians to work with older adults is a novel and needed approach, and one that will become increasingly important as more pediatric patients are cared for by older adults. This case addresses the following ACGME core competencies: patient care, medical knowledge, interpersonal and communication skills, and professionalism.
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