Regardless of your work setting (aside from institutions that solely treat pediatric patients), you will likely encounter elderly patients throughout your career as a nurse. Although there are best practices for communication across all spans of life, it is also important to consider the particular needs of the geriatric population, especially since medical conversations can be very sensitive for older adults.
Learning a little more about geriatrics can go a long way toward building rapport with your patients. The following tips are here to help promote smooth interactions among nurses and elderly patients:
1. Be aware of the complexity
While any individual at any age could present with multiple comorbidities, keep in mind that older adults are more likely to have a complex medical history compared to younger patients. The patient in that hospital room may have already battled cancer, undergone surgeries, and experienced major bodily changes.
These patients are frequently on numerous medications that can have interactive effects or alter the mood or behavior of the individual. Although nurses cannot control these types of issues, having an awareness of the complexity of the geriatric patient is important when working with this population.
2. Anticipate possible needs
This tip is difficult because it comes with a very fine line. Older adults are more likely to have experienced cognitive decline and hearing or vision loss compared to other populations. These factors could significantly impact both expressive and receptive communication. Geriatric clients may need to hear information several times or be provided with written information in larger print.
While anticipating these needs can be helpful, it is also important to avoid making assumptions when it comes to older clients. Speaking very loudly or providing information in overly simplified terms can be offensive.
How do you find the balance? Read your client’s visual cues. Make eye contact and watch for signals that the patient may not be hearing you or may not be understanding the information you are providing. Be patient and calm in your interactions.
3. Demonstrate empathy
A little bit of empathy can make a huge impact on the nurse-patient relationship, regardless of age. Some topics of discussion that may be particularly sensitive for older adults include end-of-life care, cognitive decline, and loss of independence. While these topics certainly need to be discussed, they should be addressed in a delicate manner.
Consider how you would want a medical professional to speak with your parents or grandparents as they age. I would want my family to be treated with respect and understanding, especially when it comes to sensitive topics.
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4. Listen carefully
This is another one of those tips that could really apply to any population, but it’s worth noting. Sometimes, we get so busy with our own schedules that we forget to slow down and actually listen to our patients.
Who knows their body better than someone who has lived in it for over 60 years? You can learn a lot about your patient by simply listening to what he or she has to say and responding appropriately. Using body language (such as nodding your head and making eye contact) that shows you are listening to the patient can also help build trust.
5. Take note of physical needs
Let’s face it—hospitals, clinics, and doctor’s offices are cold. Elderly patients may have a harder time keeping warm compared to younger patients. If the setting allows for it, be sure to offer your patient a blanket if he or she appears to be cold.
Additional needs may include checking on pain levels more frequently (if the patient is in a hospital setting and has a diagnosis that tends to be painful), assuring adequate hydration, and ensuring restroom needs are addressed.
6. Be mindful of distractions
As noted previously, older adults may be experiencing a decline in hearing, vision, and/or cognition. Although we don’t want to make any assumptions based solely on a patient’s age, we should be aware of possible external factors that may negatively impact communication between the nurse and the patient.
For example, a TV blasting loudly in the background may be distracting and could also impede the patient’s ability to hear the information being provided. This could also occur when machines are beeping in the next room or the hallway is busy with people passing by. Being aware of these potential distractions can help you better anticipate the needs of your patient.
7. Be respectful of the patient’s individualism
Sometimes, family members may overtake their loved ones as they are aging. While this can be malicious, I’ve found that people often do this out of love and the desire to protect their family member. Be sure to consider the needs of the patient, even if he or she has a family spokesperson or power of attorney.
One way to do this is to address both the patient and the family member in conversation, rather than only addressing the power of attorney. Try to read the patient’s body language for any signs of discomfort with or disapproval of the plan of care. Regardless of whether the individual is able to make his or her own decisions, it is important to be respectful and to remember that the patient is an individual.
8. Maintain patience
We already know that elderly clients tend to be complex due to their age and history. Older adults may (or may not) require increased processing time when receiving new information. They may require repetition to fully understand the information.
Regardless of whether your client needs these types of accommodations, maintaining patience and demonstrating a willingness to adapt are both important skills for a nurse to develop.
Many of these tips are applicable to all patient populations, but we have to be sure to see them though a different lens when working with the geriatric population. Working in geriatrics can be incredibly rewarding, especially when you have developed the skills needed to effectively interact with older adults.
