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Easing communication with elders

As we age, our ability to communicate gets hindered by various afflictions. It is important to recognise and take active steps to ensure effective communication with seniors.

If we think about it, we will realise that much of what we do in our waking hours involves some sort of communication. Lack of proper communication could create complete chaos in our lives.

Generally, senior citizens are prone to deficient communication, as normal aging is often associated with a host of health-related problems. Reduced social interaction, caused by gradual changes in hearing ability and visual acuity, could lead to frustration or depression. However, communication problems that the elderly face on a day-to-day basis are generally underestimated.

Problems faced by seniors
The number of senior citizens in India stands at a ratio of 1:12. Over eight million people are aged above 80, over 25 million above 70 and 77 million above 60. Over 20 million of them are ill and require daily care. Statistics don’t lie, and these tell the tale of millions of aged Indian men and women who experience the agony of dependency after a lifetime of caring for their families.

To compound this agony, a majority of elders experience communication problems due to depleted hearing ability caused by changes to the peripheral sensory organ [cochlea]. Some of them suffer a double whammy due to age-related changes to cognitive skills. The combined loss [partial or total] of hearing and memory retention impacts communication. There are cases where a person cannot follow what is being said and suffers a communication breakdown in noisy surroundings. Reduced vision is another handicap.

Hearing impairment
Obviously, a person with impaired hearing will find it difficult to communicate as he will not be able to clearly hear what the other person is saying. It is the most common sensory impairment in adults above the age of 65. Because of the communication difficulties it creates, loss of hearing can lead to withdrawal from family, friends and society. Hearing loss is a disability that frequently goes unnoticed. The signs exist but have to be recognised.

Speaking louder than necessary in a conversation, constantly asking for words to be repeated, not being able to follow telephonic conversations, straining to hear with one ear, turning the television or radio up louder than usual, complaining that others are mumbling, all these are indications that the person is not able to hear clearly.

Aging makes an elderly person’s voice sometimes sound tremulous, weak, hoarse and higher- or lower-pitched than it was before. This makes it difficult for the listener to follow the speech and could result in the affected person withdrawing into a shell.

Visual problems
A general deterioration of vision is noticed in most elders. This will impact reading of books and newspapers, the popular pastime of most elderly persons.

Progressive disorders
Progressive diseases such as Parkinson's or Alzheimer's strike seniors, especially if they have suffered a stroke. Imagine sitting in front of the television and not being able to understand what you hear and see. Worse still, being unable to say what you want or even remember what you want to say. Alzheimer dementia patients generally experience difficulty in finding the right words to express themselves. Some of them have trouble understanding what others are saying.

Community factors
Elderly people crave for love and tender care. They want to be heard and respected. They want to be visible and play a constructive role in society. But since they are retired, they are often termed as "unproductive", as there is not much financial input expected from them. This gives rise to a social problem. “Who is going to take care of us?" is their constant worry.

How does one tackle such a situation?
Elders, don't despair if you think you have hearing loss. Consult your family doctor and ask for reference to an audiologist. A thorough hearing evaluation is important to determine the type and degree of hearing loss, and what treatment or hearing aid options may be available.

People all over the world have improved their lifestyle by using assistive devices such as hearing aids to improve the volume of sound in the particular pitches they miss hearing. Generally, a binaural system, a hearing aid in each ear, provides better directionality, better clarity and better ability to separate sounds in noise. As regards change in voice texture, this is natural and one should not feel discouraged to talk and communicate.

The Indian scenario was rosy till a few years back, when the joint family system was in vogue. Caring for elders was never a chore then. It was just part of day-to-day life. The advice and opinion of the elders was sought and respected.

However, with the slow disintegration of the joint family, elders are increasingly left to care for themselves or are being forced to ask for help from their children. Depending on their health condition, seniors can devise a few strategies to be independent, especially in decisions regarding readjustment due to disability.

Adult children and youngsters can work wonders by adopting a few strategies in dealing with their beloved parents and grandparents.

* Stand close to them and lean forward. This shows that you are interested in what they are saying.
* Maintain eye contact. This allows them to read your expression.
* Minimise noise in the background. If the music system or television is on, lower the volume so that they do not strain unnecessarily to hear you.
* You can act as an unnoticed watchdog. Make sure that their hearing aids and reading glasses are on when they are conversing.
* Slow down to their pace whenever you can. This makes them receive your message easily.
* If a family member is suffering from Alzheimer’s, learn to be patient. It is not their fault that they are unable to follow you or remember things. Try to communicate with them as often as you can. This will slow down the deterioration process.
* Never patronise. This puts them off and they will withdraw further into their shell.
* Show them you care by occasionally holding their hands or touching them.

Finally, it would be pertinent to note that there is no institution that can replace the family in caring for the old and infirm. They need your love and reassurance. Give it to them wholeheartedly.