Communication with the Older Adult

An important element in effectively developing an awareness of oral prevention is communication skills. Communication with the older adult can be a rewarding, enriching experience, especially when certain principles of adult learning are used.

Communication is a two-way process. Many times questions of a patient's history, family, or likes/dislikes are appreciated. Being a patient listener is a critical skill to develop for communicating with any individual, regardless of age–and can be particularly important in dealing with the older adult. Remember that he or she is a person first and a patient second. Individuality should be explored and nurtured. In that way treatment can be more easily customized. Inquiring about past hobbies or areas of interest can open the door for the older adult to share part of his or her life. Though difficult to always remember, effort must be made to realize–especially with frail patients–they have not always been as they appear now.

Commonly an older person may be accompanied to a health provider's office by another adult, such as an adult child, spouse, friend, or home duty nurse. Even if this “caregiver” answers questions that were directed to the patient, it is essential the health provider continue to direct inquiries and comments to the patient. Failing to do so is to treat the patient as an object. It is natural to converse with the person who is closer to one's age or who is seemingly more responsive, but it is the professional's responsibility to demonstrate throughout the interview that s/he knows who the patient is and that the patient is the focus of the clinical efforts.

Addressing an older adult by his or her surname, such as Mr. or Mrs. Doe, provides an atmosphere of respect. If the patient prefers to be called by a first name or nickname, it is best to let him/her initiate that change. A useful approach is for this preference to be noted on the patient's chart. It is not appropropriate to engage in a conversational style that experts refer to as "elder speak," or infantilizing language used in a misguided attempt to put a patient at ease. Well-intended comments like, "hello young lady" when greeting an 80-year-old patient, using a high-pitched sing-song voice as if speaking to a child, or speaking excessively loudly or slowly convey the message that you view your patient as a child rather than an equal.

Significant loss of hearing ability, which is seen in approximately 25% of older patients, or difficulty hearing higher pitched sounds (presbycusis) can be compensated for by:

  • Lowering the pitch of the speaking voice and speaking more slowly and distinctly - not by talking louder.
  • Allowing the person to observe your lips while speaking.
  • Minimizing the music level or other background noise within earshot of the treatment area.

It is always helpful to maintain eye contact when communicating with a hearing impaired older patient. Exaggerating hand movements and facial movements can help convey messages. Allowing time for the patient to respond will increase communication.

Communication with visually impaired persons can be helped by making word pictures to help the patient visualize the spoken word. Large print materials are also available for patient education.