Communication Skills for Working With Elders Second Edition Barbara Bender Dreher, PhD, is Professor Emerita of Communica- tion and former director of the speech and hearing curriculum at Wright State University in Dayton, Ohio. She holds the Certificate of Clinical Competence from the American Speech, Language and Hearing Association and presents many workshops for professionals in health care and human services. She has served on national and state committees on the communication disorders of adults and was a founding member of the Ohio Research Council on Aging. After acting as a consultant with the Greene County Health Department, she founded the first support group for stroke victims in southern Ohio. While serving as a family caregiver she built an extensive record of professional and semi-professional publications. Communication Skills for Working With Elders Second Edition Barbara Bender Dreher, PhD SPRINGERS PUBLISHING COMPANY NEW YORK Copyright © 2001 by Springer Publishing Company, Inc. All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Springer Publishing Company, Inc. Springer Publishing Company, Inc. 11 West 42nd Street New York, NY 10036 Cover design by Susan Hauley Acquisitions Editor: Helvi Gold Production Editor: Jeanne W. Libby 07 08 / 6 5 Library of Congress Catologing-in-Publication Data Dreher, Barabara Bender. Communication skills for working with elders / Barabara Bender Dreher.—2nd ed. p. cm. Includes bibliographical references and index. ISBN 0-8261-1405-9 1. Social work and the aged. 2. Communication in social work. 3. Communicative disorders in old age. 4. Interpersonal communication. I. Title. HV1451.D75 2001 362.6—dc21 00-067051 CIP Printed in the United States of America by Berryville Graphics. Contents Introduction ix Chapter 1 Bridges to Understanding 1 Two-Way Nature of Communication Functions of Communication Need and Desire for Communication as a Variable of Personality Form of Communication as a Variable of Personality Theories of Aging Changing Mental Functioning of the Elderly Social Expectations and Realities Exercises Chapter 2 How Aging Affects Communication 25 Social Changes That Affect Communication Physical Changes That Affect Communication Delicate Balance in Voice and Articulation Changes in Hearing Exercises Chapter 3 Interacting With the Elderly 43 How the Elderly Perceive Themselves Initiating and Maintaining Relationships Interviewing Interacting Empathically Gaining Compliance Exercises v vi Contents Chapter 4 How Illness Affects Communication Skills 60 Case Study of an Aphasic Effects of Stroke Case Study of a Dysarthric Effects of Medical Conditions Case Study of a Laryngectomee Effects of Surgery Family's Reaction Anxiety and Depression Therapeutic Relationship Exercises Chapter 5 Exchanging Messages Despite Barriers 86 Modifying Your Reception Modifying Your Vocal Production Special Adaptations for the Intellectually Impaired Modifying Your Language Telephoning Touching Exercises Chapter 6 Decision Making With the Elderly 105 Timing and Tact Exploring Alternatives Charting Pros and Cons Mobilizing From Past Strengths Exercises Chapter 7 Group Involvement 114 Values of Group Communication Kinds of Groups Procedures in Groups Functional Roles Maintaining Good Participation Suggested Topics for Discussion Exercises Chapter 8 Promoting Self-Expressionn 129 Factors in Motivation Establishing a Conducive Environment Advantages of the Life Review Audio/Video Taping for Posterity Contents vii Writing for Posterity Exercises Chapter 9 Computers and the Oldest Generation 140 Predictors of Computer Use by the Aged Barriers Benefits Exercises Chapter 10 Preserving Morale 150 Happiness is ... A Personal Perception Keeping Attitudes Flexible Cognitive Restructuring Imaging Innovative Approaches Building Morale With Hospitality Preserving Morale by Honoring Exercises Index 163 163 This page intentionally left blank Introduction The elderly make up the fastest growing segment of our population, and there is increasing national interest in their well-being. The upcoming generation of baby boomers will be choosy consumers— discriminating and demanding. Historically, most resources have gone into meeting the older person's basic needs for health, housing, economic security, and compensatory services. Now there is growing recognition that the served population wants more than satisfaction with bread and butter issues. They want a better quality of life. They want "happiness." The pursuit of happiness is the birthright of every American, regardless of age. But the full flowering of a personality can be impeded by diminished sensory acuity, muscular strength, and intel- lectual agility. Professionals are needed to assist the individual in the kind of meaningful activities that maintain integrity, preserve wisdom, and enhance personal relations. Communication is the key to a happy psychosocial adjustment. It is more than talking and listening, or reading and writing. It is a tool for the kind of social interaction that can aid understanding and overcome loneliness. It is the code for formulating our thoughts and analyzing our emotions. Human happiness depends on the quality of the messages we send to others and the quality of messages we send to ourselves. The goal of this book is to overcome the barrier of silence often suffered by the elderly and to enhance the quality of their lives. The barriers may be physical—an ill-fitting hearing aid or surgical IX