Communicating With Impaired Elderly Persons

Communication with a mentally or physically impaired person can be a difficult and frustrating task, but good communication skills can prevent catastrophic reactions. In dealing with persons with limited physical or mental abilities, it is important to listen, speak clearly and slowly and use non-verbal communication (body language) to help convey your message. The following article includes tips for communicating with (1) the hearing impaired; (2) the deaf; (3) the visually impaired; (4) aphasics; and (5) those with Alzheimer's Disease and related disorders.

Communicating with the hearing impaired

  1. If the person wears a hearing aid and still has difficulty hearing, check to see if the hearing aid is in the person’s ear. Also check to see that it is turned on, adjusted and has a working battery. If these things are fine and the person still has difficulty hearing, find out when he/she last had a hearing evaluation;
  2. Wait until you are directly in front of the person, you have that individual’s attention and you are close enough to the person before you begin speaking;
  3. Be sure that the individual sees you approach, otherwise your presence may startle the person;
  4. Face the hard-of-hearing person directly and be on the same level with him/her whenever possible;
  5. If you are eating, chewing or smoking while talking, your speech will be more difficult to understand;
  6. Keep your hands away from your face while talking;
  7. Recognize that hard-of-hearing people hear and understand less well when they are tired or ill;
  8. Reduce or eliminate background noise as much as possible when carrying on conversations;
  9. Speak in a normal fashion without shouting. See that the light is not shining in the eyes of the hearing impaired person;
  10. If the person has difficulty understanding something, find a different way of saying the same thing, rather than repeating the original words over and over;
  11. Use simple, short sentences to make your conversation easier to understand;
  12. Write messages if necessary;
  13. Allow ample time to converse with a hearing impaired person. Being in a rush will compound everyone’s stress and create barriers to having a meaningful conversation.

Communicating with the deaf

  1. Communicating with the deaf is similar to communicating with the hearing impaired;
  2. Write messages if the person can read;
  3. Use a pictogram grid or other device with illustrations to facilitate communication;
  4. Be concise with your statements and questions;
  5. Utilize as many other methods of communication as possible to convey your message (i.e. body language);
  6. Spend time with the person, so you are not rushed or under pressure.

Communicating with the visually impaired

  1. If you are entering a room with someone who is visually impaired, describe the room layout, other people who are in the room, and what is happening;
  2. Tell the person if you are leaving. Let him/her know if others will remain in the room or if he/she will be alone;
  3. Use whatever vision remains;
  4. Allow the person to take your arm for guidance;
  5. When you speak, let the person know whom you are addressing;
  6. Ask how you may help: increasing the light, reading the menu, describing where things are, or in some other way;
  7. Call out the person’s name before touching. Touching lets a person know that you are listening;
  8. Allow the person to touch you;
  9. Treat him/her like a sighted person as much as possible;
  10. Use the words "see" and "look" normally;
  11. Legal blindness is not necessarily total blindness. Use large movement, wide gestures and contrasting colors;
  12. Explain what you are doing as you are doing it, for example, looking for something or putting the wheelchair away;
  13. Describe walks in routine places. Use sound and smell clues;
  14. Encourage familiarity and independence whenever possible;
  15. Leave things where they are unless the person asks you to move something.

Communicating with aphasics

Aphasia is a total or partial loss of the power to use or understand words. It is often the result of a stroke or other brain damage. Expressive aphasics are able to understand what you say; receptive aphasics are not. Some victims may have a bit of both kinds of the impediment. For expressive aphasics, trying to speak in like having a word "on the tip of your tongue" and not being able to call it forth. Some suggestions for communicating with individuals who have aphasia follow:

  1. Be patient and allow plenty of time to communicate with a person with aphasia;
  2. Be honest with the individual. Let him/her know if you can’t quite understand what he/she is telling you;
  3. Ask the person how best to communicate. What techniques or devices can be used to aid communication;
  4. Allow the aphasic to try to complete his/her thoughts, to struggle with words. Avoid being too quick to guess what the person is trying to express;
  5. Encourage the person to write the word he/she is trying to express and read it aloud;
  6. Use gestures or pointing to objects if helpful in supplying words or adding meaning;
  7. A pictogram grid is sometimes used. These are useful to "fill in" answers to requests such as "I need" or "I want." The person merely points to the appropriate picture;
  8. Use touch to aid in concentration, to establish another avenue of communication and to offer reassurance and encouragement.

Communicating with persons with Alzheimer’s Disease or related disorders

  1. Always approach the person from the front, or within his/her line of vision – no surprise appearances;
  2. Speak in a normal tone of voice and greet the person as you would anyone else;
  3. Face the person as you talk to him/her;
  4. Minimize hand movements that approach the other person;
  5. Avoid a setting with a lot of sensory stimulation, like a big room where many people may be sitting or talking, a high-traffic area or a very noisy place;
  6. Maintain eye contact and smile. A frown will convey negative feeling s to a person;
  7. Be respectful of the person’s personal space and observant of his/her reaction as you move closer. Maintain a distance of one to one and a half feet initially;
  8. If a person is a pacer, walk with him/her, in step with him/her while you talk;
  9. Use distraction if a situation looks like it may get out of hand. A couple of examples are: if the person is about to hit someone of if he/she is trying to leave the home/facility.
  10. Use a low-pitched, slow speaking voice which older adults hear best;
  11. Ask only one question at a time. More than one question will increase confusion;
  12. Repeat key words if the person does not understand the first time around;
  13. Nod and smile only if what the person said is understood.
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