Communicating with the Elderly

ASM 150Paige Thompson

April 2015

OverviewCommunication is incredibly important to a healthy lifestyle on many levels, and as a member of Activity and Recreation Therapy staff, it will be my job to encourage healthy communication through certain activities, exercises, events and programs.

Key points from Chapter 1“Communication is the cohesive force in every

human culture and the dominant influence in the personal life of every one of us.”

“The form and function of communication vary with the basic personality types and age characteristics of the persons involved.”

The mental facilities of the elderly change as a person ages, especially those that pertain to communication, like senses to memory.

“Communication is the cohesive force in every human culture and the dominant influence in the

personal life of every one of us.”

The elderly tend to withdraw and disengage, but this can be made better through interpersonal communication. Communication is therapeutic and it gives people a kind of strength, linking them to their environment and helping to regulate their own behaviors. It helps humans cope, it helps us maintain alertness, and it helps us establish relationships with people in our lives.

Application in the WorkplaceBecause the elderly tend to withdraw from

others, communication may not be as naturally prevalent in their lives as necessary.

Solution:Morning coffee and social groupsCurrent event discussionsReading and writing groupsOne to one visits

“The form and function of communication vary with the basic personality types and

age characteristics of the persons involved.”

Different personalities prefer to communicate in different ways, and therefore, different communication mediums should be offered. Introverts are imaginative, creative and, sensitive and tend to express their emotions more freely. They prefer reading, writing, and listening to others. Extroverts are more social and prefer the company of others. They choose objective subjects over abstract thoughts, and they prefer to talk and be active.

Application in the WorkplaceBoth groups need and want communication, it’s

just a matter of how.

Solution:Reading groups and Book Clubs

Offers quiet reading and social discussionStory Circle or Reminisce

each resident has the opportunity to share a story or memory, and others can simply listen and enjoy

The mental facilities of the elderly change as a person ages, especially those that pertain to communication, like senses to memory.

Older adults change a lot as they age, both physically and mentally. They can lose their major senses, like sight, smell, hearing, and taste, and lose the ability to move affecting their sense of touch. Their mental abilities decline as well, from memory recall abilities, to the retention of new memories. Because of this, they need a lot of repetition and extra time to absorb and learn new things.

Application in the Workplace

The loss of senses affects the way things must be presented to older adults, and the necessity of repetition and extra time to learn makes repeating instructions often and offering learning groups important.

Solution: Utilize subtitles on movies shown, use a microphone when

speaking to a group, bring simple activities to those bed bound, offer large print for books or hymnals

Offer instruction groups often for things like technology or other hobbies

Repeat instructions for activities even if it is offered frequently

Key points from Chapter 2Family members and friends are an important

part of an older adult’s healthcare, but institutionalized care can make these relationships difficult.

Physical changes in vocal patterns and hearing abilities can add stress to communicating for an elder.

Family members and friends are an important part of an older adult’s healthcare, but institutionalized

care can make these relationships difficult.

Disagreement is common between families of residents and staff, centering on the way to care for the older adult. Family members can feel that they can’t communicate suggestions or complaints without affecting the care given to their loved ones, and many relatives may feel they are bothering staff or that they’ll appear stupid when they ask questions. They often don’t share enough information about their loved one to allow the staff to care for them the best way possible.

Application in the Workplace

Though communication with family can be difficult, including them in activities and offering them support and education can help.

Solution:Family education events Invite family members to everyday activitiesFamily/ Caregiver Appreciation eventsFacility Orientation so family feels comfortable in

the environment

Physical changes in vocal patterns and hearing abilities can add stress to

communicating for an elder.

Aging not only affects articulation, but phonation, pitch and timing as well. Weak speech muscles, dentures, and receding gums can change the way an older person speaks, causing them to lose acuity of diction and making them cut out certain sounds all together. Voice tremors can become more pronounced, stuttering can become an issue, and the speed and rhythm of speech is affected. Presbycusis is also a common problem for the aging, causing a large gap between what is being said and what is being heard.

Application in the Workplace

Simply because someone is losing the ability to speak clearly or hear well should not exclude them from socialization.

Solution: Work with the facility’s speech therapist

include exercises to strengthen speech muscles in daily activities Writing groups and charades

Allow emotions and thoughts to be expressed without the need for verbal communication

Subtitles on movies Whiteboards, pictures, diagrams

Allows the hard of hearing to participate in programs and discussions

Key points from Chapter 3“Perception is basic to interaction.”

“…a close relationship is crucial to the ‘will to live’.”

Interviewing and Interacting Emphatically

“Perception is basic to interaction.”

Humans behave based on their perception of themselves and others. The Tennessee Self-Concept Scale includes 5 ways the elderly view themselves: physical self (physical attributes), moral-ethical self (developed during earlier life), personal self (self-esteem, health), family self (once head of house, now dependent), social self (many become withdrawn). Elders with a healthy self perception display healthier behaviors in everyday interactions.

Application in the Workplace

The elderly can struggle with a positive self image as they age.

Solution: Beauty/Spa/Salon days

Help elderly women feel positively about their physical appearance

Focus on positive elder achievements in movies and programs

ReminisceRemember times when they were in charge of the family

Social groups/ Interest GroupsEncourage interactions and friendships through frequent social

interactions

“…a close relationship is crucial to the ‘will to live’.”Though they tend to withdraw from many social relationships as they age, the elderly are much happier with a confidante; they have a strong need to confide emotions in another individual. Research shows that friends are more important to psychological well-being than family.

Application in the Workplace

Though incredibly important to well-being, developing relationships through new interactions are intimidating and risky for older adults.

Solution:Social/ Interest groups

Offer regular social activities as an opportunity for elders to connect with others with similar interests

New Resident Night/ “Get to Know Me” events/ “Speed Friend-ing” (speed dating method to getting to know someone)Encourage new interactions by getting introductions out

of the way

Interviewing and Interacting Emphatically

Interviewing is important in the healthcare industry to get pertinent information from residents. To do so effectively, conduct interviews in a quiet and private environment, ask open-ended questions, encourage more thorough answers, and use language familiar with the interviewee. Display empathy– too formal or professional and you won’t get the thorough information you’re looking for. Show respect, be reflective and validating, and welcome feedback.

Application in the Workplace

Interviewing is an important skill to master in the care planning process.

Solution:Staff role-playing to practice proper interview

techniquesFrequent One-to-One visits prior to interview to

make sure both parties are comfortable with one another before asking important questions

Key points from Chapter 4“Communication disorders constitute the

nation’s number one handicapping disability.”

“Communication disorders constitute the nation’s number one handicapping disability.”

Several age-related conditions can cause or contribute to poor communication. Natural physiologic changes in hearing, sight, voice, and speech processing take place as a person gets older, even if they had no difficulty communicating before. Among these, declining hearing and sight may be the most obvious, such as macular degeneration or presbycusis, but changes in voice (tremor, pitch, rate of speech) and language impairment caused by cognitive loss, dementia, illness, disease, or accidents causing brain damage, (such as stroke, cancer, or degenerative neurological diseases) as well as conditions like aphasia, agnosia, apraxia or dysarthria may also cause major difficulties.

Application in the Workplace

Illness and disease can cripple an older person’s ability to effectively communicate.

Solution:Work with the facility’s speech therapist

include exercises to strengthen speech muscles in daily activities

Writing groups and charadesAllow emotions and thoughts to be expressed without

the need for verbal communicationOne-to-Ones if group activities are uncomfortable.

Key points from Chapter 5Communication is a two-way street, and you

must be a good listener and recognize the challenges your speaker faces.

Communication is a two-way street, and you must be a good listener and recognize

the challenges your speaker faces.When communicating with the elderly, you must listen, pay attention, maintain eye contact, and display an active posture. You have to find a reason for listening (so you naturally show a real interest in what they are saying), show respect through maintaining personal space, and get on eye level with the person you’re speaking with. Be aware of your own non-verbal communication and body language, as well as keeping an eye on theirs. Slow down your speaking pace, using a nice, relaxed tone, and lower the tone of your voice, but don’t necessarily raise your volume. Develop an ability to rephrase, act out, and simplify what you’re trying to express. Make sure you are in a quiet and comfortable environment. A common age-related barrier is hearing loss (presbycusis), affecting how well older adults hear what you’re saying and how you’re saying it, and vision loss (presbyopia), affecting how they “hear” your nonverbal communication—gestures, facial expressions, and body language, as well as reading written messages and seeing signs and symbols. Possibly the most frustrating communication barrier occurs when the message is heard, understood, and simply ignored. Attitude issues due to a poor relationship between the two communicators can cause this.

Application in the Workplace

As caregivers, we must do our best to make the older adult feel comfortable and respected.

Solution: Frequent one-to-one visits Group conversation activities, including staff Resident council meetings

Offers a safe, comfortable environment for residents to voice concerns

Informal visitsResidents often see staff only as caregivers, but they want

to see us as friends. Not every interaction needs an official purpose; sometimes, we can visit as a friend and simply sit and chat.

ConclusionThough several things can get in the way of healthy, effective, natural communication, many things can be done to ensure that residents of a long term care facility feel at home and get the interaction they need and desire. I, as a staff member of an Activity or Recreation Therapy department, can ease the struggles common in communicating with the elderly and can promote healthy interactions with the residents I care for through thoughtful programming and meaningful activities.