Communicating with Older Adults

1. Communicatingwith Older Adults By Wendi MacKinnon

2. 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).

3. Facing our Future 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)

4. 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)

5. Barriers to Communicating Dementia Alzheimer�s Stroke Delirium Depression (Antai-Otong, 2006, Williams & Davis, 2005).

6. 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

7. 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

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

9. 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)

10. Storytelling �Through storytelling, the family�s 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 adult�s 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).

11. 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 Use a calming approach Take a break, try again later If you or the client becomes frustrated Try another approach at a later time Explanation Aphasia limits the person�s 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 Conversation can be stressful. A soothing tone and an unhurried approach may prevent the client from feeling overwhelmed. Miscommunication can be trying for both the nurse and the person with dementia. Maintaining a warm and supportive relationship is of utmost importance. (Williams & Davis, 2005, p.79. Table 7.1)

12. 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)

13. Loss of Sight 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)

14. 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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