OET Rx (Student Pre-Class)

Lesson 16: Communicating with a Patient's Carer

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Course Progress

Overall Progress Lesson 16 of 100

16%

Part 1: Lesson Objectives

By the end of this lesson, you will be able to:

Navigate the three-way communication between yourself, the patient, and their carer.
Respect patient confidentiality while involving the carer appropriately.
Provide clear instructions and empathetic support to the carer.
Address situations where the patient's and carer's opinions may differ.

Lesson Video

Coming Soon

This video will be available for the offline course version.

Part 2: Vocabulary & Examples

Study the words, their pronunciations, Persian translations, and example sentences to understand how they are used in context.

General Vocabulary

guarantee /ˌɡærənˈtiː/:

تضمین

While I cannot guarantee a full recovery, I can assure you that we will provide the best possible care, with full support for you as the carer.

guard (v.) /ɡɑːd/:

محافظت کردن

As a doctor, I must guard my patient's confidentiality, so I need their permission before I can discuss their case with you.

guess (v.) /ɡes/:

حدس زدن

I would prefer not to guess the prognosis; instead, let's focus on the facts we have and the plan for the next steps.

guide (v.) /ɡaɪd/:

راهنمایی کردن

My role is to guide both you and your mother through this difficult decision-making process.

guilty /ˈɡɪlti/:

گناهکار

Many carers feel guilty if they take a break, but it's essential for them to avoid burnout.

habit /ˈhæbɪt/:

عادت

We need to help the patient establish a new habit of taking his medication at the same time every day, and your role as carer is key to this.

half /hɑːf/:

نیمه

I understand that you handle the practical half of his care, while he makes the decisions about his own health.

handle (v.) /ˈhændl/:

مدیریت کردن

Can you tell me how you handle his medication schedule at home?

happen /ˈhæpən/:

اتفاق افتادن

I need to explain what will happen next so that both you and the patient are fully prepared.

happy /ˈhæpi/:

خوشحال

Mr. Jones, are you happy for me to discuss your test results with your wife present in the room?

hard /hɑːd/:

سخت

I know it is hard to see a loved one unwell, and I want to acknowledge the difficult role you have as a carer.

hardly /ˈhɑːdli/:

به سختی

The patient can hardly speak for himself, which is why your role as his advocate is so important.

harm (n.) /hɑːm/:

آسیب

Our primary duty is to prevent harm, which means ensuring the patient receives the correct dose of medication.

health /helθ/:

سلامت

The patient's overall health depends on a partnership between our clinical team, the patient, and you, his dedicated carer.

healthy /ˈhelθi/:

سالم

It's vital that you, the carer, also remain healthy, as you are under a great deal of stress.

hear /hɪər/:

شنیدن

It is important that I hear from the patient himself about his symptoms, even if you are the one who notices them most.

hearing /ˈhɪərɪŋ/:

شنوایی

The patient's poor hearing makes communication difficult, so your assistance in ensuring he understands is invaluable.

heart /hɑːt/:

قلب

At the heart of this discussion is the patient's right to make his own decisions.

heavy /ˈhevi/:

سنگین

I understand that the responsibility of being the sole carer can be a heavy burden.

Medical Vocabulary

Advocate (n.) /ˈædvəkət/:

حامی

As his carer, you are his most important advocate, and we value your input highly.

Burnout (carer) /ˈbɜːrnaʊt/:

فرسودگی

It is critical to discuss respite care options to prevent carer burnout, which can compromise the health of both the carer and the patient.

Capacity (mental) /kəˈpæsəti/:

ظرفیت ذهنی

Although he is physically frail, the patient still has full mental capacity to make his own treatment decisions.

Carer / Caregiver /ˈkeərər/ /ˈkerˌɡɪvər/:

مراقب

As the primary carer, you will need to be trained on how to manage the new feeding tube.

Next of Kin /nekst əv kɪn/:

نزدیک‌ترین خویشاوند

We have you listed as your mother's next of kin, but I still require her direct permission to discuss these results with you.

Permission /pəˈmɪʃn/:

اجازه

"Mrs. Smith, do I have your permission to share this information with your daughter?"

Power of Attorney (for health) /ˌpaʊər əv əˈtɜːrni/:

وکالتنامه (برای سلامت)

Since the patient lacks capacity, we must consult his wife, who holds the Power of Attorney for his health.

Privacy /ˈprɪvəsi/:

حریم خصوصی

Respecting a patient's privacy is a fundamental duty, even when family members are anxious for information.

Respite Care /ˈrespaɪt ker/:

مراقبت موقت

We can refer you to a social worker to discuss respite care options; taking a short break is not selfish, it's essential.

Third Party /θɜːrd ˈpɑːrti/:

شخص ثالث

A carer is considered a third party, and we cannot disclose patient information to them without explicit consent.

Part 3: Pre-Class Practice Tests

Reading Task (Longer & More Professional):

Excerpt from "The Journal of Geriatric Medicine"

A frequent and complex challenge in geriatric medicine arises when a patient with mild to moderate dementia, who still retains legal capacity, expresses a wish that conflicts with the opinion of their primary carer. For instance, a patient may insist on their desire to continue living alone, a decision their adult child, the carer, deems unsafe. The physician's role in this triad is to guard the patient's autonomy while acknowledging the carer's valid concerns, which are often grounded in an intimate knowledge of the patient's daily struggles. The initial step is to establish the patient's capacity in the context of this specific decision. Does the patient understand the risks of living alone? Can they weigh the pros and cons? This must be done in a private dialogue, separate from the carer, to avoid undue influence. Subsequently, a joint meeting is advised. Here, the physician must act as a mediator, guiding the conversation. The goal is not to force a decision but to explore compromises. Could a personal alarm system or increased home help be a solution? Ultimately, if a patient with capacity makes an unwise but informed decision, their autonomy must be respected. The physician's duty then shifts to documenting this process thoroughly and providing robust support to the carer, who must handle the heavy burden of respecting a decision they believe could lead to harm.

Question: According to the text, what is the doctor's primary obligation if a patient with mental capacity makes a decision that the carer considers unsafe?

To side with the carer as they have more knowledge of the patient's daily life.

To respect the patient's decision while ensuring the carer is supported.

To refer the case immediately to a legal Power of Attorney.

Listening Task (Part C Simulation - Interview):

Scenario: You will hear an interview with a palliative care nurse specialist named Sarah, talking about supporting family caregivers.

0:00

1. According to Sarah, what is a common, unexpressed feeling among carers?

Anger at the patient.

A sense of guilt.

A desire for more medical information.

2. What does Sarah suggest is a practical way to support a carer?

Recommending specific websites for them to read.

Encouraging them to take breaks for themselves.

Teaching them advanced clinical procedures.

Part 4: Answer Key for Pre-Class Work

Reading Answer: b) To respect the patient's decision while ensuring the carer is supported.

Listening Answers: 1. b) A sense of guilt. 2. b) Encouraging them to take breaks for themselves.

Part 5: In-Class Preparation

Be prepared to discuss the vocabulary and practice the following tasks in class.

Speaking Task: OET Role-Play Card (Medicine)

Setting: A GP's office.
Patient: An 80-year-old patient with mild cognitive impairment, who is accompanied by their 50-year-old son (the primary carer). You have determined that the patient's blood sugar is no longer controlled by tablets.
Task: Greet both the patient and their son. Explain that the tablets are no longer effective enough and that you need to start insulin injections. Direct the explanation and the core decision-making question ("How do you feel about that?") primarily to the patient. Acknowledge the son's role by explaining that he will need to be involved in the daily management and training. Address the son's practical questions about storage, timing, etc., after getting the patient's initial consent.

Writing Task:

You are the doctor from the speaking scenario. Write a referral letter to the community diabetic nurse specialist. The letter should request a home visit to provide training on insulin administration. You must clearly state that both the patient and his son (the carer) need to be included in the training session.

Proceed to Lesson 17

OET Rx

In this lesson, you will be able to: