Communication difficulties: Still getting your point across

Key points:

• There are a range of health issues that may contribute to a person losing their ability to communicate, but that does not mean that they cannot do so
• There are many tips to help facilitate effective communication and aids that can assist in the process
• Even if you experience communication difficulties, you have a right to try out new communication styles in your community and with those who may care for you

Communication impairments include difficulty with speaking and understanding, as well as difficulty reading and writing.

If you are an older person and face communication difficulties, it can become very frustrating for you, your carers, family and friends if you are unable to communicate effectively as you once did.

You may feel upset if you are not able to hear or understand what others are saying, or if you are experiencing trouble expressing yourself.

Similarly, caregivers may be frustrated by not being able to communicate with you adequately or not being able to understand what you are saying.

Not all communication problems can be solved completely, and you and the people you communicate with may have to accept that communication is different now, but that does not mean you cannot use other methods to communicate.

Senior Aged Care Advisor at Speech Pathology Australia, Kym Torresi, says speech pathologists often assess what supports a person needs to be able to communicate well and effectively.

Ms Torresi says if given the opportunity and the right tools, an older person can communicate.

So what are communication difficulties, and how can you overcome them?

Common communication problems

Communication disorders are more common in older people because they have a higher likelihood of living with health conditions that can often affect hearing, speech and comprehension.

Some of the most typical communication problems include hearing loss, reduced vision, stuttering, weakened facial muscles, swallowing issues, and inability to write.

The health problems that can interfere with regular communication range from physical issues that are due to ageing – like hearing loss – to neurological problems that affect the brain and muscles.

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

Other reasons that may be contributing to your communication difficulties can include loud background noise when trying to converse with someone, difficulty understanding regional and ethnic accents, as well as dry mouth or poorly fitting dentures which can affect clarity of speech.

You may also experience communication problems if it is caused by structural or neurological damage from strokes, brain lesions (such as tumours), and diseases such as Alzheimer’s and Parkinson’s disease.

Whatever the cause, communication problems can lead older people to feel defeated, withdraw from society and become isolated, which often causes further loss of communication abilities.

While these disorders tend to cause permanent impairments, there are strategies that can help you and your caregivers try and overcome communication problems.

Depending on the severity of the condition, communication can be boosted with certain technological devices, therapies, and general communication measures tailored to your abilities.

How to enhance communication

When it comes to regaining or enhancing your communication with others, you should follow the guidance of your healthcare professionals like doctors, audiologists, speech therapists and physical therapists.

Often these professionals can suggest communication aids to help you, such as hearing aids, speech and language therapy, single hand sign language, and non-verbal communication strategies.

What you can do depends on what the primary problem is, what is causing it, and how severe it is. Depending on the cause, the solutions will be different.

For example, while ordering a coffee may be easy for some, for people with communication difficulties, it may be a struggle. But instead of carers and family stepping in to communicate for them, Ms Torresi emphasises the importance of older people maintaining a level of independence.

“That person might have a picture card that says ‘can I have a cappuccino, please?’ which means they can go up and order a coffee independently,” she says.

“Often care staff feel it’s much easier for them to do things instead… it seems like a small thing for the carer, but it’s often a massive thing for an older person to get that chance back for a little bit of independence at a time when they’re often having a lot of things done for them.”

Many people have more than one communication problem, and everyone is unique. What works for one person might not work for another. If possible, seek help from a qualified speech pathologist before developing or stopping a plan.

Ways to help get your point across

Speech Pathology Australia recommends a number of different methods for communicating, including:

• Talking face-to-face and maintaining eye contact

For the best chance of effective verbal communication between you and someone else, you should aim to face the person directly so you can see their mouth and facial expressions while they speak. If you are laying down or in a mobility bed, gain the attention of someone who can help you sit up in order to better engage with the other person.

• Communicating in a quiet, well-lighted area

If you have communication difficulties and do need to engage with someone, your setting plays a big role in establishing effective communication between both people.

If you can, ensure that the lighting is bright enough for you to see clearly, but not too bright that it interferes with your vision.

Naturally, other sounds in the room may distract you or the other person from communicating with you and may cause you to mishear or misunderstand the other person.

The fewer distractions the better, so turn off the television or radio to cut out some of the background noise. When picking where to communicate, try and avoid talking in noisy or distracting places like restaurants or cars.

• Using assistive equipment

If you are an older person who needs to wear glasses and hearing aids, it is important to wear them while communicating. It is equally important to ensure your eye prescription is up to date and that your hearing aids are in working order so these aids can assist you properly.

Some other “low vision aids” such as a large lighted magnifying glass may assist your ability to read when regular eye glasses are not sufficient. There are also programmable hearing aids and television and telephone amplifiers that can help you hear in specific situations.

Ms Torresi says, “[Effective communication] may be as simple as cue cards or laminated images on paper that are customised to the person, or using electronic communication devices such as mobile phone apps.”

• Using writing, pictures, and gestures to supplement speech

For people who have difficulty speaking, sometimes gestures, including nods and hand signals, or pictures of, for example, family members or particular foods, can help. Written diaries or memory books and pictures can also be aids for those who struggle with verbal communication.

• Don’t beat yourself up

We all have bad days. If you are struggling to communicate with your carer, loved ones or anyone out in the community, ensure to have patience with yourself. It is often better to have an enjoyable time conversing than having a perfect conversation.

Often the most important part of the message is emotional, and this is conveyed through the sound of your voice and your facial expression. Don’t rely on just one mode or think that just because someone doesn’t understand what you have said completely, that they cannot get your meaning.

Don’t run away from communication

When older people are having problems communicating, sometimes other people tend to avoid talking to them for fear of an awkward or difficult encounter. This can lead to further loss of communication skills and social isolation.

But ‘practice makes perfect’ and you should try to engage in communicating with others whenever you can, even if you feel anxious or apprehensive about it.

Interacting with people will help prevent isolation and depression, and also gives you an opportunity to trial what the best alternate form of communication could be for you.

“It’s quite common for friends to fall away because of the fear-factor surrounding communicating with the older person because they feel awkward in themselves,” says Ms Torresi.

“But what happens then is older people with communication difficulties tend to become quite socially isolated, which often impacts their mental health and thus their quality of life.”

A speech pathologist can often help you stay connected with the people around you by helping them understand your communication difficulties and the best way to communicate with you.

If you can feel yourself becoming frustrated with yourself or the conversation, take a break. This gives you and the person you are engaging with a rest, and also gives you a chance to regroup your thoughts and to think of a better way to communicate.

A speech pathologist can prescribe exercises to change and improve speech habits, as well as build your motor skills and confidence around communicating.

What communication alternatives work best for you? Let us know in the comments below.

Related content:

The role of speech pathology in aged care

How to empower older people

Having someone act on your behalf