Mental Health Concerns and The Older Adult
150
● If using printed materials, 14-point font is suggested. Recommendations for accommodating cognitive impairments include the fol- lowing (NIA, 2017): ● Be patient and allow for ample time to reduce feeling rushed. ● Ensure you have the client’s attention prior to starting. ● Orient and reorient the client as needed throughout the interaction. ● Use a familiar setting for the interview if possible. ● Include family, friends, or caregivers with client consent. ● Avoid medical jargon and rephrase to understandable wording. ● Present one question or direction at a time. ● Choose open-ended (e.g., “How does that make you feel?” or “What do you think might have contributed to this feeling?”) or closed-ended questions (e.g., “Did you get any sleep last night?” or “Have you been feeling sad and down lately?”) based on the client’s ability to answer (closed-ended questions are often easier if cognitive deficits are present). ● Consider following up with the client within the week to assess for understanding and allow for questions. ● Encourage cognitively stimulating activities, exercise, and a healthy diet. Hearing, visual, or cognitive impair- ments that are clinically prohibitive to communication will require the healthcare worker to utilize more extensive variations in technique, and possibly require profes- sional assistance or assistive devices. If professional assistance and assistive de- vices are required, the healthcare worker can collaborate with experts, such as case
management, to mitigate communication barriers for the older adult client. A brief review of verbal and nonverbal communication with older adult consider- ations can benefit the healthcare worker. Nonverbal communication is gestures, expressions, and body language (Boyd, 2017). It encompasses more of the inter- action than verbal communication. The psychiatric older adult client can be dif- ficult to interpret if disabilities or cultur - al differences are present. Using under- standable language to verbally validate nonverbal observations can help clear any perceived deficiency in the informa - tion exchange. Ten techniques can be used to improve the psychiatric interview with the older adult: acceptance, confrontation, doubt, interpretation, observation, open-ended statements, reflection, silence, and vali - dation (Boyd, 2017). Acceptance is a ther- apeutic way to encourage information ex- change in an open manner and is useful for establishing trust and building rapport (Boyd, 2017). The healthcare worker can practice this by saying things such as “It is ok to tell me about it—I would like to hear how it made you feel.” Confronta- tion is used with discretion when trying to confront reality for the older adult (Boyd, 2017). The healthcare worker can use confrontation gently to address inconsis- tencies; however, it has the potential to divide the therapeutic relationship and cause discourse in communication. Doubt is also used cautiously when a health- care worker is certain the older adult is incorrect about factual information. The healthcare worker should assess for the presence of cognitive deficiencies if mis - information in the older adult’s communi- cation is apparent.
Powered by FlippingBook