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Communication Tools and Techniques

Responding to Older Adults with Substance Use, Mental Health and Gambling Challenges

On this page:

All people need to be listened to and understood. You can make a difference in an older person's life by spending a few moments talking with the person.

Ways to communicate

When communicating with older adults:

  • Don't use ageist language (e.g., the elderly, the aged, oldsters, senile, feeble); use "seniors," "older people" or "older adults" to indicate the age group.
  • If you think the person may have trouble hearing or seeing you, ask, "Can you hear me clearly?" or "Can you see me clearly?"
  • Remember that 80 per cent of Canadians over 65 may have problems reading (Health Canada, 1999). Many older adults prefer talking about something rather than reading about it.
  • Encourage older adults to talk about their own lives and experiences. When people tell their own stories, it helps them feel more comfortable. It helps you learn about their challenges, strengths, culture, hobbies and interests, and the way they view the world. This information will help you connect with the older person.
  • Don't confront or argue with the older person.
  • You may spend only a short time with an older adult. You may be unable to get to know him or her well, or to understand all the person's care issues. When you see an older adult behaving in ways that indicate a substance use or mental health problem, offer warmth and support, not advice, and report what you see to your supervisor.

Listening

To listen well, you need to:

  • want to hear what the other person is saying
  • want to be helpful
  • accept the other person's feelings
  • make eye contact
  • nod to show you hear, or respond with a few encouraging words
  • see the other person as unique, with his or her own experiences and ways of expressing himself or herself.

Talking about problems and giving information

When talking with an older person who may have a substance use, mental health or gambling challenge, remember:

  • Some times are better to talk about problems than others. If the person is overwhelmed by other concerns, wait for a better time.
  • Some problems may have been going on for a long time. The problems may also be more complicated than they seem. Remember that they don't need to be solved right away, and you don't need to solve them.
  • Anything you hear or see in your close personal contact with older adults is private and confidential. However, it is important to tell your supervisor about any concerns you have about the person's health. In addition, it is your responsibility to report any signs that the person may be a danger to himself or herself or to others, or that the person may be a victim of elder abuse.
  • Before giving information to an older person about a problem, check with your supervisor to see if you are permitted to do this. If you are permitted, ask the older adult if he or she would like this information (e.g., "Would you like to know more about how alcohol and medications can interact and cause problems?").
  • Present information in a neutral, non-dramatic way (e.g., "I've heard that people who are depressed often keep it to themselves, which can make them feel even more depressed. I've also heard that people who tell their doctor about how they are feeling, and ask for treatment, are often able to overcome depression and to enjoy life.").

Setting boundaries

In your work, some older people may act in ways you find surprising, demanding, annoying, upsetting or even frightening. Sometimes the best thing to do is put up with or ignore this behaviour. For example, if the older person you are caring for insists on telling you the same stories over and over, and you find it irritating, consider:

  • Does the person have dementia?
  • Is he or she lonely?
  • Does telling you those same stories over and over give that person pleasure?

Sometimes changing how you think can reduce your irritation and help you to feel more generous toward the person.

But what if the person's behaviour toward you is rude, offensive or threatening? For example, if the person yells, demands, touches you inappropriately or makes racist comments. At these times, you may need to set boundaries to protect your time, dignity or safety.

Even if you feel you can handle the situation, talk with your supervisor to get support and encouragement before doing anything on your own. By doing this, you also protect yourself in case the older person makes a complaint against you. Ask if your supervisor has information about the person's mental or physical health that could help explain the behaviour. Discuss whether any changes can be made to deal with these behaviours (e.g., another staff person might be treated more favourably).

If you know these behaviours are not caused by dementia or another mental health problem, you should not have to tolerate them. Using a calm tone of voice, be clear and direct. Let the person know the impact of his or her behaviour. Say, for example, "When you yell at me, I feel threatened. If you continue, I'll leave."

Specify what behaviour you expect (e.g., "When you speak to me in a calm and quiet tone of voice, I'll be happy to help you."). Be firm, but gentle. If you still have problems, continue to problem-solve with your supervisor or other team members.

Support

You may sometimes feel you cannot give older adults the help they need. Or you may see them behave in ways that seem to only make things worse. This can be frustrating, and you may feel the situation is hopeless. Remember that you can only do so much. You must know the limits of your responsibilities and how to get more help when you need it.

Agencies may have different levels of support for workers and volunteers, but there is always someone to whom you can report your concerns. Your supervisor can then work to get you extra help, if needed.

Co-workers may also have experience or knowledge that can help you find a solution to a problem, or help you deal with it.

You may also wish to get additional training or do extra reading to increase your knowledge. A good place to start is the websites and other resources listed in the next section.

In Responding to Older Adults :

1 The Nature of Aging

2 Substance Use, Mental Health and Gambling Challenges in Older Adults

3 Communication Tools and Techniques
Responding To Older Adults

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