Some older people have conditions that can impair their capacity to communicate, for example, stroke, COPD, dementia and hearing impairments.

There are also less obvious symptoms and conditions that can affect communication with our patients particularly when they are unwell. These include:

  • pain
  • frailty
  • mobility impairments
  • self-care impairments
  • under-nutrition
  • dehydration
  • delirium
  • depression
  • low mood
  • anxiety
  • sleep deprivation
  • medication effects and side-effects
  • polypharmacy
  • hearing impairments
  • vision impairments
  • acquired brain injury.

We can use our communication skills to assess what is affecting the person’s ability to receive or give information and to show that we are interested and care.

‘The people who do come in and treat you as a person, with a family, with a history, with… a life. You respond to so much better. There’s… a link, a communication that takes place.’ (patient)

We can also use communication skills to solve problems by asking the patient about their needs, concerns and their condition.

There is increasing interest in the role health literacy plays in determining outcomes for older patients. Health literacy is a person’s ability to seek, understand and use health information and services1.

‘...he said you got SOBOE…I had to go look it up to see what…he was talking about.’ (patient)

Only 40 per cent of adults can understand health messages in the form they are usually presented2. Questions we can ask to help assess our patients’ health literacy include:

  • Can you tell me why you are in hospital?
  • Can you tell me about what medications you are taking and why?
  • Is this an accurate understanding? If not, what appears to be the cause of the misunderstanding? (for example, insufficient explanation/language/cognition)

If we understand our patients’ health literacy and our own abilities to meet their needs we can better tailor our communication and our care to meet their needs.


1. Deakin University, 'Ophelia: Optimising Health Literacy to Improve Health and Equality'), 2015 [Accessed 17 February 2015].

2. Australian Commission on Safety and Quality in Health Care, National Statement on Health Literacy, 2014. [Accessed 17 February 2015].