Communicating With Older Adults (Part 1)

I received a mailing from the Gerontological Society of America the other day. It was entitled “Communicating With Older Adults”. It had a list of 29 tips on how to better connect with seniors. It was really targeted towards medical professionals. But, it had many EXCELLENT suggestions. In the next few posts, I’m going to give you a list of those, in my own words, that I think will be of value to most of my readers. If you’d like to see the original piece, go here.

1. Don’t Be Prejudiced– prejudice literally means to pre-judge. Our brains, in order to not cognitively reinvent the wheel throughout the day, tend to categorize. So, naturally we’ve an “older person” category filled with generalizations. But, the facts are that within the age group regarded as “elder” there is more variability than in any other group. A 95 year old can have the intellectual acuity of a 30 year old. And a 60 year old can have advanced dementia. Try to be tabula rasa (blank slate) when first encountering an elder. Accumulate your “data”. The best way to do this is with simple brief dialogue (IE; the weather, the news, etc…). From this you can quickly discern much (IE; linguistic facility, knowledge of English, cognitive ability, hearing ability, etc…). Use open ended questions (those other than what can be answered with one word answers).
2. Don’t do “elderspeak”- The GSA publication defines this as “characterized by the use of simplified vocabulary (e.g., only using short words), endearing or diminutive terms (e.g., sweetie, cutie), and exaggerated intonation (e.g., unusual stress on certain words,“sing-song” pitch variation)”. This speech may well be based on a desire to show care or sympathy. At the same time though, it is more often than not, “heard” as derisive, dismissive, and disrespectful. There are the ubiquitous “honey” and/or “darling”. These can be radioactive, even when the intention’s quite beneficent. Better (much) is to use the person’s name (ie; Mr. Smith) and offer to do something kind (“Can I get you a cup of coffee?”). Be careful to avoid a high pitch as those with hearing difficulties might not hear this and the words will be clipped. This word clipping merged with cognitive difficulties can lead to extreme confusion. The coup de gras is when, in order to avoid feeling foolish, they just agree with whatever’s been said (ie; “Do you understand?”, “Yes.”). To avoid the latter it’ll be necessary to gently probe whether they really understood? And, if its apparent that they didn’t, I’d shoulder to entire blame for the communication failure. After all…, they didn’t choose to have the disabilities. Its your fault for not acting accordingly.
3. Mind Your (Non-verbal) Behavior– Its not just what you say but how you say it. Consider eye contact, facial expressions, tone of voice, speech rate, speech volume, body positioning, use of space, etc… These things can either or severely damage accurate communication. These things, consciously or subconsciously, can telegraph whether you give a damn about the listener and/or whether they should trust you. So, here are some rules/considerations:

a) Maintain eye contact

b) If you suspect a hearing problem, increase speech volume SLIGHTLY. Why slightly? Because if you go beyond a certain volume, you’re pitch will increase. Hearing deficits can be for sounds that are higher in pitch. Hence, you’ll make the matter worse, not better.

c) Don’t multitask while talking (ie; look at a computer screen, stand up, writing notes). It says they are not important. Even if you say otherwise, the nonverbal cue will take precedence.

4) Minimize Background Noise– Why? Because as people age the hearing loss makes it increasingly difficult to understand and remember speech with background noise (especially multiple conversations). Whereas its true that through added concentration they can possibly overcome this, it comes sat the expense of other mental processes (ie; long term memory of the conversation). Bottom line is to keep the environment quiet. That includes conversations, music, noise, etc…