Communicating With Elderly

COLEGIO SAN AGUSTIN-BACOLOD COLLEGE OF
HEALTH AND ALLIED PROFESSIONS

B.S. Aquino Drive, Bacolod City
CCOLEGIO SAN AGUSTIN-BACOLOD COLLEGE OF
NCM 114
GERONTOLOGY
NURSING
Communicating with Older adults

• Information sharing
• Priority areas for information sharing relate to trust and

respect, involvement and information needs and
expectations, facilitators and barriers included prior
health care experience and trusting relationship.
• Knowledge translation is done through effective
strategies that improve information sharing and care
continuity to older adults by those that involve active
facilitation of an on-going partnership that respects the
knowledge of those involved.
Formal or Therapeutic
Communication
Communication – giving
or receiving of information
• - it is important for everyone
• - basis for relationship
Components of
Sender Message
Communication:
Receiver Feedback/Response Medium/Channel
Nonverbal – body
language, written
Verbal-spoken
words, pictures,
language
diagrams,
photographs
Communication with Older persons are influenced by:
Social, Cultural, Educational Background
Emotional state
Language
Illness
Physical state
Interest
Therapeutic Communication
-refers to healing or curative dialogue between people.
-It is a collection of techniques that prioritize the physical,

mental and emotional well-being of patients
-Nurses use open-ended statements and questions , repeat

information or use silence to prompt patients to work
through problems on their own
Therapeutic Communication Technique

• Using Silence – it gives both the nurse and the
patient an opportunity to think through and
process what comes next in the conversation.
• Accepting – it is necessary to acknowledge what
patient say and affirm that they have been heard
• Giving recognition – acknowledges a patient
behavior and highlights it without giving an overt
compliment
• Active listening – use verbal and nonverbal cues such as

nodding and saying “I see” can encourage patients to
continue talking
• Offering self – it shows we value patients and that

someone is willing to give them time and attention,
offering to stay for lunch, simply sit with the patients will
boost their mood
Very useful in patients

with dementia,
Non-Verbal
Alzheimer’s and those
Communication
with difficulty in
communicating verbally
Those with difficulty

using word to describe
something
Ways to Communicate Non-verbally
Make eye contact- showing the person you are paying attention
Re-introduce yourself with a handshake
Give them space
Level with them – if they are setting, try to set next to them
Do not cross your hand- it indicates that you are not open to them
❑Make a gesture – give visual cues

❑Use therapeutic touch – it conveys warmth
and support
❑Smile – conveys acceptance
• Barriers to Communication
• Communication with older adults relies on senses such
as hearing, vision, physical and cognitive processes
• Any significant changes or distortion of one or more

senses can cause significant challenge for effective
communication
• Categories of Normal and Abnormal Barriers to

Communication
1. Internal barriers – reduction in sensory and cognition
abilities as people age
- there is the gradual decrease in brain mass and
neuronal function
- short term memory is limited
- long term memory is preserved
A. Cognitive Issues On Communication
Dysarthria – refers to muscle weakness, difficulty of
the mouth speech movement
Aphasia – language impairment due to brain damage
Anomia – naming impairment
Brocas’s aphasia – comprehension is intact, speech is slow, choppy,

effortful and lack proper grammatical matter such as ed for the past tense
Global aphasia – limited spoken language, may use single words that are
not always understood, spoken and written information is impaired
Wernicke’s aphasia – fluent speech with unintelligible content

• - use real or nonsense word, but the string of words has no clear meaning
• - comprehension of spoken and written word is impaired
• Interventions for those with Cognitive and Language Barriers
Strategy Definition Example

Recognition Acknowledge the person, “Come along Mrs. Jones,
know the person’s name your dinner is being served”.
Affirm uniqueness
Negotiation Consult the person regarding “ That was a nice bit of fresh
preferences, desires, needs air. I’m ready for my dinner,
would you like to join me?”
Validation Acknowledge the person’s “Mrs. Jones, it sounds like
emotions, feelings and you would like to wait for
respond your bath?”
Facilitation and Collaboration Work together, involve the “What is it your looking for
person Mrs. Smith? Can I help you?
Enable the person to do what “
he or she otherwise would
not be able to do by
providing the missing part
• Make use of pictures, drawings, concrete

symbols, gestures and facial expression to
aid in communication
• Avoid questions that incorporate
confrontation naming such questions are :
who is this?, what’s her name?
B. Vision Changes
a. Presbyopia – difficulty seeing at close
range
b. Increase sensitivity to light and glare
c. Glaucoma
Interventions
-Contrasting warm and cool colors should be used when

creating visuals such as calendars, signs and instruction
-larger print papers and books
-being in direct line of sight while speaking
-correct lighting, reading lamps, magnifying devices be

used
C. Hearing Loss - which can affect ADL, relationship, socialization,

psychological health and quality of life
-safety risk for they may not hear alarms and sirens
- people may experience depression, loneliness and decreased
quality of life
Presbycusis- inability to hear higher frequencies
Tinnitus – abnormal sound in one or both ears, similar to internal noise
one hears after being exposed to loud sounds
Interventions for Hearing Loss
Hearing Aids
Personal amplification devices
Use writings, pictures
Make use of noise cancelling headphones

D. Physical Limitations – abilities can

decrease in a short period of time
Dual sensory Impairment – vision loss,
impaired hearing
2. External barriers
• Environmental Noise – different location, noises in the background
• Physical environment – includes lighting, room temperature
• Cultural shift in living environment – home is a key place for
healing without the risk of hospital acquired infection or excessive
noise
Eden Alternative – use a different language, the naming
of living areas with street names
- Words are selected with positive intent

• Language for Improving Communication

with Older Adults
1. Building Trust and Respect
- Verbal strategies that support communication include addressing the
older adult by name , listening and responding on topic , reflecting
on feelings
- Avoiding elder speak
- Pay attention to nonverbal – 55% of communication with the older
adults is from facial expression and body language
Partnering Communication
• Tell the patient your name and your role as you
sit at eye level
• Ask the patient his/her priorities for the day so
you can assist in meeting these goals
• Let the patient know what your practice needs
are during your shift and look at integrating
your needs and the patients need for the day
• Put your name, contact number and partnered
goals on the white board or other visible area
Continue with the 5 P’s
You did partnering already
Ask about the restroom needs – potty
Obtain a pain assessment
Make a positioning adjustment
Check the pump to reduce potential noise distraction

• Address pain or your 1st assessment of the

day or do both soon
• Before leaving, ask if there is anything
he/she needs before you leave to finish
your regular rounds
Communication Enhancement Model
-Provides direction for effective health care provider

communication
-This helps the health worker to make individualized

assessment of the communication skills of each
adult
1. Compensatory strategies – focus on providing

mechanism to assist the person with physical or
neurological impairment
Ex. -adapting to environment using relational
communication and adding technological devices or
memory aids
2. Restorative strategies – rebuilding the patient’s skills
that are currently impaired
Ex. Patient with aphasia – start focusing on saying
common single words
-speech language pathologist

Communicating With Elderly

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COLEGIO SAN AGUSTIN-BACOLOD COLLEGE OF

HEALTH AND ALLIED PROFESSIONS

Communicating with Older adults

• Priority areas for information sharing relate to trust and

Receiver Feedback/Response Medium/Channel

Communication with Older persons are influenced by:

Social, Cultural, Educational Background

-refers to healing or curative dialogue between people.

-It is a collection of techniques that prioritize the physical,

-Nurses use open-ended statements and questions , repeat

Therapeutic Communication Technique

• Active listening – use verbal and nonverbal cues such as

• Offering self – it shows we value patients and that

Very useful in patients

Those with difficulty

Ways to Communicate Non-verbally

Re-introduce yourself with a handshake

Give them space

❑Make a gesture – give visual cues

• Any significant changes or distortion of one or more

• Categories of Normal and Abnormal Barriers to

Aphasia – language impairment due to brain damage

Anomia – naming impairment

Brocas’s aphasia – comprehension is intact, speech is slow, choppy,

Wernicke’s aphasia – fluent speech with unintelligible content

• Interventions for those with Cognitive and Language Barriers

Strategy Definition Example

• Make use of pictures, drawings, concrete

-Contrasting warm and cool colors should be used when

-being in direct line of sight while speaking

-correct lighting, reading lamps, magnifying devices be

C. Hearing Loss - which can affect ADL, relationship, socialization,

Interventions for Hearing Loss

Personal amplification devices

Use writings, pictures

Make use of noise cancelling headphones

D. Physical Limitations – abilities can

- Words are selected with positive intent

• Language for Improving Communication

Continue with the 5 P’s

You did partnering already

Ask about the restroom needs – potty

Obtain a pain assessment

Make a positioning adjustment

Check the pump to reduce potential noise distraction

• Address pain or your 1st assessment of the

Communication Enhancement Model

-Provides direction for effective health care provider

-This helps the health worker to make individualized

1. Compensatory strategies – focus on providing

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