Communicating with the Elderly: 8 Tips to Improve the Conversation

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    No matter where you work, you are likely to encounter elderly patients and residents every day. They require a different approach and communication style from younger clients. Here are 8 tips to make your interactions more effective and enjoyable.

    Communicating with the Elderly: 8 Tips to Improve the Conversation

    One in eight Americans is currently over the age of 65. The number is expected to skyrocket! The Administration on Aging predicts that by 2030, there will be twice as many older people as there were in 2000—over 72 million “senior citizens.” That will mean 1 out of 5 people!

    As the Baby Boomer generation ages, the need for CNAs to help care for them will increase. The Bureau of Labor Statistics reports that the 2014-2024 growth rate for CNA jobs is 18%, much faster than the 7% for most other occupations. Because people live longer, even with chronic conditions and lifestyle-related problems such as obesity and diabetes, they are going to need your assistance and good communication skills for years to come.

    No matter where you work, you are likely to encounter elderly patients and residents every day. They require a different approach and communication style from younger clients.


    Here are 8 tips to make your interactions more effective and enjoyable:


    1. Accept the fact that elderly people need more time
      They process information more slowly and require extra time to answer questions. Don’t rush them or try to finish their sentences. Yes, you are busy, but older people are slower in several ways, including speech. Give them the appreciation and time they deserve.
    2. Avoid distractions by moving to a quiet place
      Choose a spot away from a common sitting area or the clatter of the dining room. Turn off the television or radio. It will be easier for the resident to hear if there is no noise, especially if they have a hearing loss.
    3. Get the resident’s attention before you start to talk
      Address them by name and use good eye contact. Make sure there is good lighting so they can watch your face and expression. Don’t stand above them; put yourself at the same level so it’s easy for them to see you.
    4. Speak clearly and a little slower than normal
      You may need to speak a little louder, but don’t shout. Use simple sentences and ask questions that are answered with a yes or no. Tell them what you’d like to discuss, so they have a frame of reference. Say something like, “I want to ask you about…” or “Can you tell me…?
    5. You may need to repeat yourself
      Often the resident will nod, even if they don’t understand. Ask them to tell you what was said. If they didn’t understand, repeat the statement or question. You may also have to rephrase, or say it in a different way.
    6. Stick with one topic at a time
      Even though you and your friends are able to chat easily about several subjects at a time, elderly people can become confused when the conversation skips around.
    7. Offer choices when possible
      It’s empowering to be able to decide for oneself. Ask, “Do you want to wear the blue sweater or the red shirt?” or “Do you want to shower before lunch or after you eat?” Allow them tell you which they prefer.
    8. Let them reminisce
      Many older people have poor short-term memory, but can happily tell you stories from their childhood. It isn’t easy to find time during a hectic day, but one of the best things you can offer your residents is your attention.


    As a CNA, you’ll likely have patients or residents with hearing loss. Even if they wear a hearing aid, it can be difficult for them to understand you because a hearing aid amplifies all sounds, including background noise. A few pointers for the hearing impaired:

    • Be sure they can see you when you speak. They don’t need to be a lip-reading expert to recognize words by the shape of your mouth. But don’t exaggerate words; this distorts the mouth.
    • Don’t mumble, chew gum, or cover your mouth.
    • Use facial expressions, non-verbal cues, and gestures to get your message across. You may both have a laugh as you display your acting skills.
    • If more than one person is present, talk one at a time. Include the resident in the conversation, too.
    • Be patient and know that they want to understand and be involved. Their intelligence hasn’t changed, so keep including them as much as possible.


    For CNAs who work in nursing homes, assisted living facilities and memory units, residents with dementia and Alzheimer’s disease require additional communication techniques. While many of these are useful for all elderly people, they are necessary when caring for someone with a brain disorder.

    • Maintain a positive attitude, including a pleasant tone of voice and facial expression. Residents with dementia respond the the feelings you convey more than the actual words.
    • Use the resident’s name each time you speak with them. Identify yourself, as well. Also use the proper names for people, places, and objects; avoid saying he, she, it, or they so that the resident can understand.
    • Visual aids should go with your words. When giving a resident a choice, show them the two options. Also, point where objects should go or where you want the resident to sit.
    • Give directions one step at a time. Keep them simple and praise the resident for their accomplishments. Offer gentle reminders of tasks and assist as needed.
    • If the resident’s words make no sense, pay attention to non-verbal cues and the emotions behind what’s being said. It’s fine to suggest words or phrases.


    Humans are social creatures and need to communicate at every age. Just as we adapt our style to talk to a baby, we need to do it for our elderly patients and residents, too. When we’re able to give others an appropriate way to communicate, we also giving them the respect that they deserve.
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    3 Comments

  3. by   amoLucia
    I enjoyed it. Very appropriate for a CNA population.

    This article could be expanded upon to become some type of video for easy CNA inservice by Staff Dev Coord.

    Not all CNAs are nsg school students; many are more mature and in no way ever going back to school. And they've been CNAs for a while. As they matured, the principles for good communication with institutionalized seniors has been lost, forgotten, or never ever formally addressed along the way of their careers.

    So this would be a good program for that population of CNAs.

    A good companion piece would be to remember to physically slow down for the elderly too.

  4. by   knurse10
    I imagine myself as an elder being very irritated reading this article. Or maybe I will appreciate my nurse/cna following tips suggested above. Only time will tell...
  5. by   KsoontobeLNA
    I enjoyed this.

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