Communication Changes in Older Adults

communication can be

written, oral, or nonverbal

effective communication with elderly requires adaptations to

physiological, social and psychological changes

auditory impairment in older adults

gradual, difficulty with voice and volume modulation

presbycusis

age related hearing loss preventing sound transmission to brain

presbycusis can be due to

stiffness of ear structures, nerve degeneration

presbycusis will present with

loss of high frequency sounds, loss of sound localization, distortion of received message, impairment of speech discrimination

conductive hearing loss

impairment to mechanics of sounds transmission to get it into the ear, treated with hearing aids

pathological hearing changes

can be conductive or sensorineural (from drugs, tumors, or disease processes)

many older adults need but dont have or use hearing aids because of

cost, stigma, putting battery in is difficult

age related changes to vision

loss of visual acuity and accommodation, yellowing of lens, weakness of ocular muscle, less tear production, droopy eyelids from loss of skin elasticity

presbyopia

loss of accomodation to focus quickly (cannot be prevented, not a disease)

presbyopia caused by

decline in ciliary muscle efficicency causing loss of lens elasticity ("short arm syndrome")

treatment of presbyopia

reading glasses for close up, bifocals if distance is an issue too

monovision

one eye is corrected for distance and the other eye is corrected for near

pathological vision problems

glaucoma, cataracts, macular degeneration, diabetic retinopathy

glaucoma

high intraocular pressure, peripheral vision loss

cataract

degenerative opacity of lens of the eye, causing cloudy vision (treatable)

macular degeneration

pigmentary changes from small hemmorrhages causing middle loss of vision

diabetic retinopathy

damage to small blood vessels in retina causing degeneration and scarring, bilateral blind spots (hard to treat)

speech changes with age

rigidity of cartilaginous structures decreasing respiratory efficiency, atrophy of vocal cords/hoarseness or variable pitches in voice, changes in oral face structure, decreased rate of communication (reaction time)

pathologic speech changes

dyarthria, aphasia

dysphagia

damage to muscles affecting ability to speak (motor degeneration)

aphasia

result of damage to L hemisphere of brain - difficulty with communication/language

brocas aphasia

can understand but not produce language

wernicke's aphasia

difficulty with understanding others and self, but can produce speech

global aphasia

receptive and expressive issues

facial expression with age

changes in elasticity and affects on expressive communication (do not assume mood)

touch changes with age

dermis is thinner, less elastic and vascular - much more frail and easy to bruise

smell with age

less acute

taste with age

80% of taste buds may atrophy

sleep with age

changes begin in 4th decade of life (earlier for women) (increased time sleeping, amount of wakeups, changes in stages of sleeping)

strategies for effective commincation

touch as a sense of caring, reminiscence for increased communication, humor to decrease anxiety