10 Strategies for Communicating Effectively With Senior Care Residents

Laura M. Cascella, MA, CPHRM

The question of how to communicate effectively has persisted in healthcare for years. Communication has long been recognized as a complex process that is prone to errors, oversights, and misunderstandings. In terms of patient safety and malpractice risk, the implications of inadequate or poor communication are substantial.

An analysis of almost 124,000 medical professional liability cases filed over a 10-year period shows that communication issues, which were found in all care settings, were one of the top contributing factors in malpractice claims.¹ Another analysis found that 37 percent of all high-severity cases involved a communication failure.²

Although communication is a challenge in all facets of healthcare — from small medical practices to large healthcare systems — senior care organizations face unique communication hurdles due to their resident populations. Healthcare providers and staff members who work in senior care facilities may face communication obstacles as a result of residents’ physical and cognitive impairments, limited health literacy, vision and hearing deficiencies, cultural and generational beliefs, and other factors.

Although a one-size-fits-all remedy for communication problems does not exist, healthcare providers and staff in senior care organizations can implement some basic strategies to improve communication with residents. Below are 10 recommendations that senior care leaders and staff members can adapt for their facilities:

1. Ask residents how they would prefer that you address them. Some residents might prefer their first names or nicknames, while others want to use titles (e.g., “Mr.,” “Mrs.,” “Ms.,” etc.) and surnames. Making an assumption about how to address a resident might lead to feelings of disrespect, especially in relation to cultural or generational differences.
2. Be aware that older adults might have difficulty hearing. To address hearing impairments, speak in a clear voice and do not rush what you're saying. Avoid shouting, as it may distort your language and make you more difficult to understand. Face the individual and make eye contact while speaking so they can see your mouth movements and watch for visual cues.
3. Avoid distractions and background noise as much as possible. Interruptions and competing noises (such as music, voices, computers, fans, etc.) can hinder effective communication and comprehension.
4. Be aware that older adults might have difficulty seeing. To address vision impairments, make sure that common spaces and residents’ living spaces have adequate lighting. Encourage residents to use their eyeglasses (if applicable), and provide printed material in large type. If a resident has severe vision impairment, consider alternative ways to provide information, such as through audio recording.
5. Don't interrupt or rush residents during communication. Interruptions might imply lack of respect for the individual or general disinterest in what the resident is trying to communicate.
6. Avoid language that implies ageist stereotypes or might be viewed as disrespectful or patronizing. Even though these statements might be unintentional, they can negatively affect your ability to communicate well with residents. Carefully consider your wording and whether it is appropriate for the individual and the situation.
7. Acknowledge residents' emotions and respond with empathy and understanding. Older adults face many challenges associated with aging, and they may experience a range of emotions, such as fear, anger, uncertainty, anxiety, apathy, and more. Acknowledging these emotions and showing compassion, empathy, and understanding can facilitate communication and adherence to care plans.
8. Avoid medical jargon and technical language. Limited health literacy is a problem in all age groups, including older adults. About 70 percent of adults older than 60 have difficulty using print materials, and 80 percent have difficulty using documents such as forms or charts.³ Using plain language, clear descriptions of medical terms, and visual aids can help overcome health literacy barriers. Additionally, writing down key points and having residents explain their understanding of important information in their own words can improve comprehension.
9. Consider residents' culture beliefs and values when communicating. Although it is impossible to understand the fine details and nuances of every culture, developing a general understanding of residents’ beliefs and norms can assist with effective communication. Ask residents open-ended questions, actively listen, and gauge their preferences.
10. Ask politely instead of telling or assuming. Loss of autonomy and independence are very difficult for many older adults, particularly those who have moved from their homes into senior care facilities. Even slight variations in language that imply choice rather than a directive can help older adults maintain a sense of control over their daily lives and activities. Further, by asking instead of telling, providers and staff members can prevent the perception that they are condescending or patronizing to residents.⁴

In summary, healthcare providers and staff members who work in senior care organizations face unique communication challenges in caring for the aging population. These challenges call for strategies that promote respect and empathy, address physical and cognitive impairments, and help preserve residents’ dignity and autonomy as much as possible.

For information about communicating with senior care residents who have dementia, see MedPro’s article The Human Factor: Person-Centered Strategies for Senior Care Residents Who Have Dementia.

Endnotes

---

¹ CRICO Strategies. (2018). Medical malpractice in America: A 10-year assessment with insights. Retrieved from www.candello.com/Insights/Candello-Reports/MedMal-in-America

² CRICO Strategies. (2015). Malpractice risks in communication failures: 2015 annual benchmarking report. Retrieved from www.candello.com/Insights/Candello-Reports/Communications-Report

³ The Centers for Disease Control and Prevention. (2020, July 16). Health literacy: Older adults. Retrieved from www.cdc.gov/healthliteracy/developmaterials/audiences/olderadults/index.html

⁴ Ni, P. (2014, November). How to communicate effectively with older adults. Psychology Today. Retrieved from www.psychologytoday.com/us/blog/communication-success/201411/how-communicate-effectively-older-adults; International Council on Active Aging. (n.d.). ICAA's guidelines for effective communication with older adults. Retrieved from www.icaa.cc/business/whitepapers/communicationguidelines.pdf; Department of Health and Human Services, National Institute on Aging. (n.d.). Talking with your older patients. Retrieved from www.nia.nih.gov/health/talking-your-older-patients; Lubinski, R. (2010, March). Communicating effectively with elders and their families. The ASHA Leader, 15, 12–15. Retrieved from https://leader.pubs.asha.org/doi/full/10.1044/leader.FTR2.15032010.12; The Gerontological Society of America. (2012). Communicating with older adults: An evidence-based review of what really works. Retrieved from https://secure.geron.org/cvweb/cgi-bin/msascartdll.dll/ProductInfo?productcd=1947_Comm-Adults

---

Prevention & Education Center home