Small talk gets easier. I have a couple go-to topics. Grandkids, pets, sports seem to be good go-to topics. What did you have for breakfast/lunch/dinner and how was it is also good.
You are a nurse, so a little Assessment with your small talk is ok (do you usually sleep in a chair, do your legs hurt when you walk, do you get dizzy or lightheaded when you stand up -- yeah, I work on the cardiac floor
How's the poop is always a good topic. (I'm not kidding).
You'd be amazed at how many elderly patients deny pain until you probe. For example, I had a patient who fell on her tailbone. I started with how painful a bruised tailbone is (explaining a I did it once). For the first time, she admitted 9/10 pain. Every other assessment was 0/10. Sometimes, you need to "allow" them to have pain.
You can ask if they are sleeping ok and if they usually take anything to help them sleep at home if they are not (and then get it ordered).
If they are voiding frequently, ask if that's their norm, if it burns when they void, etc to see if they have any S/S of a UTI.
Basically, just ask them questions about themselves. Everyone likes to talk about themselves. Think of things to ask that relate to their diagnosis (e.g., small bowel obstruction: passing gas? Burping?). You'll see things over and over, so the list relevant questions will get easier. Look up your patients' diagnoses in your old textbooks to see what you can be asking. Hang in there!