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Effective Communication With Older Adults

By: Rivka Kulik




Communication, as individuals age, can be a challenging experience. Caregivers may find communicating with older adults a test of patience and a cause for frustration. Please realize older adults may also be impatient and frustrated. Understanding what could hamper conversations of aging adults, and showing them empathy can alleviate ill feelings on both sides.


Challenges may be related to loss of hearing or vision as well as speech or language disorders that can impair communication. Communication may be caused by diminishing memory and cognitive abilities. Even those without dementia often forget more and understand less. In addition, dementia can lead to aphasia, which affects the ability to speak, read, write or listen.


Often, the cause of communication breakdown has an emotional component. An older individual may feel negatively about having to rely on other people, often on those whom she had taken care of and to whom she had dispensed advice. The adjustment to role reversal might lower self-esteem. The once self-reliant giver is now dependent on others.


In general, but particularly if the person has a hearing issue, make sure you speak loudly and clearly. Face the person. Make eye contact. Don’t block your mouth. Minimize background noise. Use nonverbal cues and gestures along with your speech.


Use active listening skills and make sure the conversation is two-sided. Use simple language and stay on topic. Allow an appropriate amount of time for the conversation and give it and the person your full attention.


Do not hurry nor interrupt the person. Keep your voice calm. If you are in a stressed state of mind, hold off certain conversations until you can have more patience.


Try assistive ideas. Keep markers and pads handy. Write things down when spoken speech might not be comprehended and have the older adult write back to you. With more complex cases, see if health care providers can prescribe and/or supply an augmentative and alternative communication device. Picture boards are tools that utilize pictures to help boost communication to show daily routine pictures, and many picture boards can be individualized to the person's needs and background.


Ensure when speaking to a person that you are in his/her line of vision. If someone has a visual impairment, make sure there is enough light in the room. Ensure he/she is wearing glasses, if needed. Show paperwork/documentation in large print or provide a magnifying glass.


For those with dementia or any cognitive issues, speak naturally and in a normal tone. Use easy words. If the individual forgets a word, provide one and ask if that is what he meant. If you see the person does not understand, rephrase the statement or question. Avoid open ended questions. Never question why the person can't remember or say, “You already said that.”


When you are speaking on the phone, the person does not see your facial expressions, gestures or other non-verbal cues. When possible, speak via video instead, and make sure your hands are visible.


Be careful not to come across as bossy. Don’t order. Suggest and remind. Don’t bring up past hurts. Leave your emotions aside when dealing with technical issues.


Beware of how you may trigger each other. It may be easy to take it personally if you argue. But it is usually not the caregiver whom the person is upset with, but the situation. The caregiver becomes an easy target. Assure your loved older adult of your love for him/her. Assure that you will continue to care and help.


Remember, a smile goes a long way. And a touch can be grounding, comforting and affirming, even when the words fail.


For more information on improving communication with your loved senior:

Assistive Devices for People with Hearing, Voice, Speech, or Language Disorders

Tips for Improving Communication with Older Patients