This kind of work has been a large part of my job for a long time, and I definitely recognize all of those frustrations. This may be obvious, but the problem is usually not a lack of communication but rather that the designer/client/manager isn't able or willing to think through the design fully. As such, when you seek clarification on something, you're really asking the stakeholder(s) to figure it out for the first time.
I've learned that a good strategy is simply to figure it out for them and hand it back complete. Not only does this eliminate communication overhead, it allows me to pick a solution that strikes a good balance between quality and my own time and effort, as opposed to having to push back against some half-baked, unrealistic idea.
The vast majority of the time, whatever I come up with is accepted either without comment, with minor requests for tweaks, or with elation. In the rare instance that something needs to be redone from scratch, I've at least gotten the ball rolling and given the stakeholder(s) some idea of what's possible.
It's kind of like turning a waterfall process into an iterative one by doing the first iteration yourself.