Which communication factor is most likely to have impacted an older adult's response to discharge teaching?

• A. Facial expressions; the words did not always match the facial expression
• B. Pacing; speaking rapidly and not clearly
• C. Clarity and brevity; long sentences and filler words
• D. Timing; the client watched television during teaching

Answer: (A)

Nonverbal cues carried by a clinician, especially facial expressions, heavily influence how an older adult interprets and responds to discharge teaching. When the words say one thing but the facial expression conveys doubt, frustration, or inconsistency, the patient may sense insincerity or confusion. This mismatch can erode trust and make the message harder to take in, leading to poorer understanding and lower likelihood of following instructions. For older adults, who may rely more on nonverbal information due to hearing changes or slower processing, congruent facial expressions help convey empathy, clarity, and confidence, making the teaching more effective.

While pacing, clarity, and minimizing distractions are important, they don’t carry the same potential to undermine or enhance trust as the mismatch between spoken message and facial expression. If a clinician speaks clearly but appears uncertain or skeptical through facial cues, the patient may doubt the guidance; conversely, consistent, warm facial cues reinforce the spoken message and support comprehension and adherence.