Communication and Aging

When communicating with older patients, physicians are asked to make a connection with them on a professional, physical and emotional level. Once this important connection has been made, physicians can begin to communicate necessary information and instructions to their patients with matters concerning their health and wellbeing.

One of the biggest problems faced by physicians when treating and conversing with older patients is that they have a wider range of life experiences and cultural backgrounds. This can often influence their perception of illness. It may also have an impact on their adherence to medical regimes and the ability to communicate effectively with health care professionals.

It is to be expected that the normal aging process will impede communication between physician and patient. This may involve a patient's sensory loss, decline in memory, slower processing of information, lessening of power, influence over their own lives, retirement from work, as well as separation from family and friends. This is usually in addition to any medical ailments, which may also affect their ability to communicate and understand information being relayed to them.

Studies have shown that older patients desire a greater amount of information from their physicians than that of younger patients. Due to their increased need for information, older patients require additional time from their physicians, making effective communication paramount to any doctor-patient relationship. Researchers have discovered that the first 60 seconds of a physician-patient meeting are the most important period of time in an older patient's medical visit. The most common complaint among older patients is that doctors don't listen, underlying the need for good listening skills as a key tool of communication.

Many older patients suffer from vision and hearing loss. In these cases it is important for physicians to sit face-to-face with the patient, as they may have to rely on lip reading. Additionally, sitting in front of them may also reduce distractions. Eye contact is one of the most direct and powerful forms of non-verbal communication. This takes on greater significance when relaying information or listening to older patients. Maintaining eye contact creates a comfortable and positive atmosphere, which usually results in patients providing additional information to their physicians.

Older patients tend to learn at a much slower pace than that of younger patients. The rate at which a physician provides information can greatly affect the amount of details that an older patient can take in, learn and commit to memory. Doctors are advised to avoid rushing through their instructions and to speak clearly and loudly. Simplifying information and speaking in a manner that can be easily understood is one of the best methods for ensuring that older patients follow a doctor's instructions. Physicians should avoid using medical jargon and technical terms that may prove difficult to understand.

Information or instructions written in a basic and easy-to-follow format are easier for the majority of older patients to understand. Writing offers a more permanent form of communication than its spoken counterpart and provides the opportunity for the patient to review the notes of their medical appointment in a less stressful environment such as their own home or care home. An excellent tool physicians apply to relate to older patients is the use of an information sheet that summarizes the most important points of the visit and explains what the patient needs to do at home. Visual aids can also help patients understand their condition and treatment to a greater degree.

The National Council on Patient Information and Education recommends that physicians allow a nurse or pharmacist to repeat instructions for taking medication. The council advises that doctors combine written and oral instructions. They stipulate that if patients require a second or third explanation of this information, they may become frustrated and disregard it altogether. The council advises that an effective technique to try at that point is to rephrase the message or make it shorter and simpler, which creates greater clarity.

It is important for patients to be provided with the opportunity to ask questions and express themselves. This allows patients to verbalize any apprehensions they may have and an excellent opportunity for doctors to determine whether their patient has completely understood the information and instructions they have been given. Health care professionals will need to experiment with their methods in order to find out which communication strategies work best for them, their staff and each patient, according to their medical and communication needs.

Communication and Aging: Selected full-text books and articles

Communication and Aging By Jon F. Nussbaum; Loretta L. Pecchioni; James D. Robinson; Teresa L. Thompson Lawrence Erlbaum Associates, 2000 (2nd edition)
Handbook of Communication and Aging Research By Jon F. Nussbaum; Justine Coupland Lawrence Erlbaum Associates, 2004 (2nd edition)
Cross-Cultural Communication and Aging in the United States By Hana S. Noor Al-Deen Lawrence Erlbaum Associates, 1997
Aging, Communication, and Health: Linking Research and Practice for Successful Aging By Mary Lee Hummert; Jon F. Nussbaum Lawrence Erlbaum Associates, 2001
Message Production: Advances in Communication Theory By John O. Greene Lawrence Erlbaum Associates, 1997
Librarian's tip: Chap. 6 "New Directions in Research on Aging and Message Production"
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