Caregiver Guide: Communication Problems

Understanding the Problem

Communication is the act or process of using words, sounds, signs, or behaviors to express ideas, thoughts, feelings, etc., to someone else.
Communication problems can be frustrating for the older person and his or her caregiver. The older person may become upset because of not being able to hear or understand what others are saying, or because of having trouble expressing thoughts. Equally important, the caregiver may be frustrated by not being able to get messages across to the older person or because of not understanding what the older person is saying. Communication impairments include difficulty with speaking and understanding as well as difficulty reading and writing.
Communication is the way to connect with the world, but it doesn’t have to be verbal – our pets don’t talk and they let us know what they want! It can help for caregivers to be creative in the ways they communicate.

Causes of communication problems

Some communication problems are temporary and reversible such as those brought on by medicines, infections, or depression. Some medicines can cause confusion or fatigue, which can make it hard to understand others and to express oneself clearly. Changing the medicine dosage, or the medicine itself, often can eliminate these problems.

Other reasons are background noise in the environment (like in a clinic waiting room), difficulty understanding regional and ethnic accents. For the older adult, dry mouth or poorly fitting dentures can affect clarity of speech.

Other communication problems are caused by structural or neurological damage from strokes, brain lesions (such as tumors), and diseases such as Alzheimer's and Parkinson's. While these disorders tend to cause permanent impairments, there are many strategies that can help the patient and the caregiver cope with-and even overcome-specific communication problems.

Whatever the cause, communication problems can lead older people to withdraw and become isolated, which often causes further loss of communication ability.

Identifying and solving communication disorders

As with most changes that take place with aging, communication problems are likely to develop slowly and subtly. People usually seek medical treatment when their problems interfere with their ability to do things they usually do and are important to them, such as talk on the telephone and understand or remember what they read in a letter. What is a communication problem for one person may not be for another. For example, vision problems that make reading and writing difficult may create frustration for those who have spent much of their recreation time reading magazines and corresponding by mail. On the other hand, for people who have not spent much time reading and writing, the same difficulty may not be as important.

There are two important principles to remember:

Communication is a two-way street

The speaker and hearer both play a role in causing communication problems, and both can alter their behaviors to resolve them. Conversation is a cooperative effort and all parties are responsible for improving it. It is never just one person's responsibility.

Communication problems may require adjusting to new limitations and possibly reduced expectations

Not all communication problems can be solved completely. Therefore, you and the older person may have to accept that communication is different now. For example, poor hearing may make it impossible to carry on a conversation unless the room is quiet and the person is wearing a hearing aid. That does not mean that you have to give up conversation. It just means that you have to make sure that the older person brings to the conversation not only his or her natural wit and special ways of expression, but also hearing aids.

Your goals are to:

  • Call for professional help when needed
  • Inform (and educate) others about the problems and the best ways to communicate with the older person
  • Obtain communication aids/devices when necessary
  • Maximize communication by using appropriate speech styles
  • Encourage the older person to do exercises to improve communication

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