Communicating with older adults who have a hearing or speech impairment problem or who suffer from dementia can be a big challenge and awkward for most if not all of us. The following are some tips offered by Lisa Petsche, Geriatric social worker, Ontario, in a recent article in Priest magazine. Lisa writes:

Setting the Stage-

Some General Advice

Choose a quiet area to minimize distractions.

Ensure you have the person's full attention before initiating conversation. Sit close by, facing them.

Show interest by maintaining eye contact and leaning forward. Be conscious of your facial expression and other body language.

Be prepared for multiple forms of communication, such as gesturing, pointing to an alphabet, word or picture board, drawing and writing.

Hearing Impairment

Pick a location with good acoustics-rooms with carpeting and curtains are better than those with lots of hard surfaces.

Sit with your face to the light and be careful not to cover it with your hands.

Ask if one ear is better than the other, and speak to that side.

Lean in when it's your turn to speak.

Use a loud voice, but avoid shouting. Speak slowly and clearly, but don't exaggerate.

Keep your voice low-pitched.

Be succinct about expressing yourself, and use short sentences.

Read the person's non-verbal expressions, since some hearing-impaired people are hesitant to ask others to repeat themselves. If it looks as if they didn't pick up what you said, rephrase it.

Speech Impairment

Defective speech due to impairment of the tongue or other key muscles is known as dysarthria. It involves difficulty pronouncing words; however, language abilities may otherwise be intact. Follow these tips to help with communication:

Encourage them to slow down, if necessary, in order to pronounce each syllable.

Be patient and remain calm, allowing extra time for the person to get their words out. Don't interrupt or try to finish sentences unless they become really frustrated.

Be attuned to non-verbal language that can give clues to the factual or emotional content of the message.

Summarize the message to check if you heard it right.

Ask them to repeat the message if you could not make it out. Don't pretend that you understood.

Ask questions that require a Yes or No answer so they can simply nod or shake their head.

Don't correct every error.

If the person is able to write, have a notepad and pen handy as a backup.

Mental Impairment (Dementia)

When someone is cognitively impaired, traditional types of conversation may not be possible. However, contact is still important, providing them with much-needed validation in addition to spiritual support. Here's how to go about it:

Approach slowly, establish eye contact, then address the person by name.

Always identify yourself by name. Don't be deterred if the person does not remember you from one contact to the next-it doesn't diminish the value of your involvement.

Keep your voice low-pitched to convey calmness and reassurance.

Use simple words and short sentences, speaking slowly and distinctly.

Keep questions to a minimum and avoid open-ended ones, especially those that begin with Why, or How.

Allow plenty of time for response to a question before repeating it or changing the subject

Nod your head and smile if appropriate, to indicate understanding.

Avoid debating facts. Focus instead on feelings or use distraction if the person becomes argumentative.

Respond to the person's mood when their words don't make sense-for example, "It sounds like you're feeling sad."

Stick to topics with which the person is familiar. Avoid complex or abstract subjects.

Be direct. Avoid clichés and limit the use of pronouns such as it, she and they.

Try using different words when your message is not getting across.

Don't feel you have to fill every minute together with conversation. Remember that your very presence is therapeutic.

Final Thoughts

Watch for signs of frustration or fatigue that signal you should bring the visit to a close.

Don't forget that humor is a valuable tool which can help reduce awkwardness and frustration.

Above all, persist with your efforts. Remind yourself that with each contact, your comfort level will increase.