Communicating with Older Adults

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Communicatingwith Older Adults

• By Wendi MacKinnon

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What is Communication?

• Communication is the act or reciprocal process
  of imparting or interchanging thoughts,
  attitudes, emotions, opinions, or information by
  speech, writing, or signs (Antai-Otong,
  2006, p.2).

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Facing our Future
Older Adults are living longer and experience new
challenges associated with aging. These
challenges include dealing with significant
losses such as the loss of a spouse or companion
as well as friends, the loss of their home as
they can no longer maintain the upkeep, the loss
of independence as daily activites become harder
to complete.

• Communication can become more difficult in the
  aging process
• As life expectancy rises more and more health
  care professionals will be working with the
  elderly
• Deterioration in sensory and perceptual processes
  affect the ability to communication
• Loss of sight leads to an inability to interpret
  outside stimuli contributing to fear and
  uncertainty in the older adult
• Childhood experiences shape an individuals coping
  skills. As an older adult this client may have
  difficulities expressing feelings and
  communicating with health care professinals.
• (Antai-Otong, 2006)

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Barriers to Effective Communication with Older
Adults

• Stereotyping and Elderspeak
• Lack of appreciation for lifelong experiences
• and meaningfulness in life
• Hurried unconcerned approach
• Sense of hopelessness
• Age related changes
• (Loss of hearing and sight)
• Illnesses and diseases contributing to cognitive
  impairment
• (Antai-Otong, 2006)

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Barriers to Communicating
Illnesses and diseases affecting communication

• Dementia
• Alzheimers
• Stroke
• Delirium
• Depression
• (Antai-Otong, 2006, Williams Davis, 2005).

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Communication Strategies

• Use short, simple vocabulary
• Use concrete content
• Use hand gestures
• Listen to the patients historical
• narrative as time permits
• Speak slowly and clearly
• Keep a pleasant voice tone
• Using closed-ended questions
• Recognize intergeneration differences
• Respect patients point of view

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Communication Strategies

• Use tools to aid in communication writing board
• Speak loud but refrain from yelling
• Use short explanations
• Use one step instructions
• Allow time for responses
• Allow additional time for teaching about
• procedures, surgeries and medications

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Communication Strategies

• Be patient and respectful in order to establish a
  meaningful and trusting relationship
• Listen to their stories to identify fears and
  anxieties

• Establish a relationship with family or caregiver
  to obtain additional information regarding health
  status, personal needs, support systems etc.
  (Antai-Otong,
  2006 Sheldon, 2004)

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Communication Strategies

• Paying attention to detail, having patience and
  being respectful will lead to the establishment
  of a meaningful and trusting relationship
• Listen to their stories to possibly uncover
  present experiences, fears and anxieties
• Maintain or establish relationship with family or
  caregiver to obtain additional information
  regarding health status, personal needs, support
  systems etc.
  (Antai-Otong, 2006 Sheldon, 2004)

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Storytelling

• Through storytelling, the familys legacy and
  uniqueness are communicated to the next
  generation. This unique style of communication
  also helps the nurse gain insight into the
  heritage, perspectives, and life experiences of
  diverse cultures. It helps clients from various
  cultures to cope with serious illness.
  Encouraging storytelling conveys respect and
  appreciation of the older adults life
  experiences, health practices, and contributions
  to society. Embracing the distinctiveness of
  older adults is crucial to helping them maintain
  their spirituality and hope through therapeutic
  and healing communication
• (Antai-Otong, 2006, p.89).

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• Strategy
• Simplify your message
• Use common words and short sentences
• Ask one question at a time
• Accept the clients message
• Allow extra time
• If there is no response, try repeating the
  message
• or use different words and gestures
• Break tasks down into simple steps
• Give instructions one step at a time
• Avoid the use of pronouns
• Repeat names so that your message is clear

• Explanation
• Aphasia limits the persons ability to understand
• complex verbal messages
• Persons with dementia may confuse the date or use
  
• one word and mean another. By avoiding
  correcting
• mistakes, the nurse demonstrates supportiveness
• Cognitive impairment slows comprehension, wait
  for a
• response.
• Cognitive impairment interferes with remembering
• multiple steps
• Cognitive impairment interferes with remembering
  the
• word or name to which the pronoun refers

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Maximizing Communication

• Loss of Hearing
• Find out what method your patient prefers
• hearing aid, sign language, writing words down
• Help patient use hearing aids and assess
• effectiveness of aids
• Speak in moderate, even tones
• Stand face to face when talking with the patient
• (Sheldon, 2004)

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Loss of Sight

• Let your patient know you have entered the room
  and introduce yourself
• Describe the surroundings, including furniture
  location and steps or changes in terrain ahead of
  time

• Allow the patient to hold your arm for support
  when ambulating around new environments
• Explain procedures ahead of time
• Describe what you are doing when you are with the
  patient
• Tell the patient when you are leaving the room
• (Sheldon, 2004)

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References

• Antai-Otong, D. (2006). Nurse-client
  communication a life span approach. Sudbury,
  Massachusetts Jones and Bartlett Publishers.
• Sheldon, L. K. (2004). Communication for nurses
  talking with patients. Thorofare, NJ Slack
  Incorporated.
• Williams, C. Davis, C. (2005). Therapeutic
  interaction in nursing. Sudbury, Massachusetts
  Jones and Bartlett Publishers.

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The End