I ka olelo ke ola, ika olelo ka make.
In the word there is life; in the word there is death.
Ancient Hawaiian Saying (Charcot, 1983)
Introduction
Words are potent. Within the sprawling aging services network, millions of providers interact with millions of older adults on a regular basis. During these professional interactions, each enters into a dance of words and gesturesâa dance that conveys information (Dossey, 2011). This dance transmits meaningâmeaning that can encourage or discourage, reassure or frighten. The purpose of this book is to encourage providers to use words purposefullyâmindful of their power to help or harm the older adult.
Older adults (individuals age 65 or older) are the fastest growing segment of the population in the United States and globally (U.S. Bureau of the Census, 2011). This increaseâdue in part to the generation of baby boomers born between 1946 and 1964âis expected to continue until 2030 and significantly impact most aspects of society and the related network of service providers.
Growing numbers of older adults are voicing dissatisfaction with service providers (Greene & Burleson, 2003). The main reasons cited are the poor quality of the provider/older adult relationships and unsatisfactory interpersonal communication. Unsatisfactory communication can impact the quality of services rendered as well as service outcomes.
Ineffective, unsatisfactory communication has many causes. This chapter introduces five major causes that will be the focus of much discussion throughout this book:
1. Underdeveloped provider communication skills.
2. Lack of provider commitment to a person-centered service delivery approach.
3. Inappropriate use of professional jargon by providers.
4. Ageist attitudes and language by the provider.
5. Impediments to effective communication stemming from cultural differences and from age-related physical, social, and psychological changes in the older adult.
This book argues for a person-centered, respect-based, Plain Language approach to communicating with older adults. It explains how providers can communicate more effectively, more respectfully, and less stressfully.
Providing services to older adults can be rewarding, yet stressful (Tamparo & Lindh, 2008). Communication between providers and older adults is often perceived as demanding and challenging (Hart, 2010). Improved communication can deepen rapport, increase mutual respect and understanding, enhance accurate exchange of information, improve compliance with provider recommendations, positively impact outcomes, and often save time while lowering frustration and stress for the provider and the older adult.
A Message to Service Providers
Do older adults (individuals aged 65 or older) comprise a significant percentage of your patient, client, or customer base? Is communicating with older adults a regular and frequent part of your work? Are older adults one of the target groups for your practice, agency, or program?
Are you an educator helping students to prepare for a career that includes working with older adults? If you answered âyesâ to any of the preceding questions, this book was written for you.
Every Older Adult Has a History and a StoryâHere Is Francesâs
The medication aide at the assisted living facilityâa thirty-something woman with two years of professional experienceâglared at Frances and impatiently demanded she sit down and take her to prescribed medications. Eighty-eight-year-old Frances, a relatively new resident at the facility, complied and choked back her tears just long enough to return to the privacy of her apartment where she sat and cried off and on for the next hour.
As a pioneering nurse practitioner with a Ph.D., Frances had served thousands of patients during her long medical career. She helped establish intensive care units around the United States, taught in university nursing programs, served as keynote speaker for several national professional association meetings, and was the recipient of various prestigious professional awards.
A published poet and author of seven nursing-related text books and 112 professional journal articles, Frances completed over 45 medical mission trips to Central and South America since she retired. Today, she was being ordered where to sit and told what to do by a near-total stranger who was young enough to be her granddaughterâa stranger who knew next to nothing of her lifetime of professional achievements.
Frances finished describing her many accomplishments. She wiped away her tears, looked directly into my eyes and said, âTim, Iâd trade it allâall of itâfor some old-fashioned human kindness, a little courtesy and respectâ (personal conversation, 2013).
Unfortunately, Francesâs experience is not atypical. Her example showcases a major problem in the United Statesâthe problem of disrespect often shown to older adults in a service-delivery system that is more frequently provider centered than person centered. During my experience as a home health and hospice medical social worker, I observed dozens of similar cases and situations where a patient, client, or resident was treated disrespectfully, interactions where each individual wanted only what Frances had wantedâa precious minute or two of anotherâs attention, given with kindness and respect.
The Older Adult Wants What Every Person Wants
Ideallyâin an atmosphere of person-centered servicesâthe older adultâs interests and needs remain central. Whether the older adults served by providers are called patients, clients, residents, customers, or consumers, they areâunderneath all labelsâunique individuals, each with a special story, a specific past, current conditions, and future aspirations.
The providerâs task is simple (yet frequently challenging): Keep the needs of the older adult as the central focus of service and see, hear, and interact with the individual as a unique person and not as a âpatient,â âclient,â or âcustomer.â Drench, Noonan, Sharby, and Ventura (2012) suggest that before taking action, the provider ask, âWhat are the clientâs needs and how will this help him or her?â (p. 5).
In every encounter, olde...