Communicating with Older Adults, Families, and Healthcare Teams

Intended Learning Outcomes

• Communicate effectively with older adults, families and healthcare teams, demonstrating empathy
• Understanding geriatric-specific communication concerns

Who are Older Adults?

• Between 60 – 75 years = young old
• Between 75 – 85 years = old
• 85+ years = older adults having frailty

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Aging…

• Impact of the accumulation of a wide variety of molecular and cellular damage over time leads to a gradual decrease in physical and mental capacity, a growing risk of disease and ultimately death (WHO,2014)
• These changes are neither linear nor consistent, only loosely associated with a person’s age in years.
• Beyond biological changes, it is often associated with other life transitions:
• Retirement
• Relocation to more appropriate housing
• Death of friends and partners

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Effective Communication in Geriatric Care

• Build trust and rapport
• Improves adherence to physiotherapy
• Enhances interdisciplinary collaboration

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• Comprehensive geriatric assessment (CGA) is a multidimensional interdisciplinary assessment for evaluating the medical, psychological, physical functions and socioeconomic problems to detect unidentified and potentially reversible problems and develop a coordinated and integrated management plan for treatment and long-term care plan.

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Image source: https://www.physio-pedia.com/images/7/7b/CGA_Image_2.jpg?20200915154948

Why is it Difficult?

• Hearing impairments
• Speech/language deficits (e.g. Aphasia)
• Cognitive decline (e.g. Dementia)

Tips For Communicating With Older Patients

• Allow extra time for older patients
• Minimize visual and auditory distractions
• Sit face to face with the patient
• Maintain eye contact
• Listen without interrupting the patient
• Speak slowly, clearly and loudly
• Use short, simple words and sentences
• Stick to one topic at a time

Tips For Communicating With Older Patients Cont..

• Simplify and write down your instructions.
• Use charts, models and pictures to illustrate your message.
• Frequently summarize the most important points.
• Give the patient a chance to ask questions.

Image source: https://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcTQ20kDuethIjIN8Kl6qDgZPKT7_0Uyl0aiP2EayjTwE0ZLp8t4

Tips For Communicating With Older Patients Cont..

• Schedule older patients earlier in the day
• Greet them as they arrive at the practice
• Seat them in a quiet, comfortable area
• Make signs, forms and brochures easy to read
• Be prepared to escort elderly patients from room to room
• Check on them if they’ve been waiting in the exam room
• Use touch to keep the patient relaxed and focused
• Say goodbye, to end the visit on a positive note

Educating Families and Caregivers

• Clarify physiotherapy goals and expected outcomes
• Emphasize the role of caregivers in rehabilitation
• Use lay terms and analogies
• Address concerns and expectations empathetically

Communicating Prognosis and Planning

• Be honest but compassionate
• Avoid jargon; focus on functional improvements
• Involve family members in goal setting

Interdisciplinary Communication

• Collaborate with health care professionals
• Shared decision making and shared goals
• Trust and mutual respect
• Technology (Telehealth)
• Examples: Geriatric evaluation units, Acute care of the elderly units, Palliative care

Things To Avoid Doing

• Criticizing, blaming or raising your voice at them.
• Talking too much, too rapidly, too loudly (Silence and pauses are ok).
• Showing any form of hostility towards them.
• Assuming things about them or their situation.
• Being sarcastic or making jokes about their condition.
• Patronizing them or saying anything condescending. 

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Miscommunication?

Thank you!