Senior citizens, as they are prominently known in America, make up close to 13% of the general population (Kresevic, 2015). According to research, over the coming decade, the older population in America will change drastically. The reason for concentrated focus and efforts to understand patterns of the older generation is significant as it affects the society both socially and economically. Population forecasts state that between 2012 and 2050, America is going to undergo tremendous adult population increments with adults 65 years and older reaching a record high of 87 million; almost double the forecasts made in 2012. Largely responsible for this increase are the baby boomers who commenced their 65th birthdays in 2011. This generation, born between 1946 and 1964, make up roughly 20% of America’s population. By the time they reach 50, surviving baby boomers will be 85 years of age and above. This situation of older adults and their subsequent projected growth present an immense challenge to programs such as Medicare and Social Security. Moreover, it leaves challenges to policy makers who will need to put them into consideration. This paper discusses functional declines in the elderly with a strong bearing on communication and hospitalized senior citizens.
Influence of Ageism on Communication with Older Adults
Alteration of communicative abilities in senior citizens is a frequently reported and observed conjoint issue; conjoint in the sense that communication involves word formation, articulation, and writing. In a huge survey of more than 12,000 beneficiaries from Medicare who are aged 65 and above, 42% of them reported having hearing ailments. Moreover, of the respondents, 26% had problems in writing and 7% in using a telephone (Yorkston, Bourgeois & Baylor, 2010). Using sampling weights and other statistical procedures, inferences were made concerning the whole population of Medicare and beneficiaries who numbered more than 16 million, and in one way or another, challenges in communication were observed. The study reached a hypothesis that severities of disabilities in communication were highly reliant on the health-ailment continuum and that at the end of the spectrum, senior citizens with well-defined disabilities in communication such as aphasia, dysarthria, and hearing loss were present. The middle of the spectrum represented senior citizens struggling to uphold autonomous function and at the beginning are older adults looking to mitigate communication conditions.
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Interpersonal communication remains to be a critical tool used in linking people to their environments and in overall life adjustments. Consequently, while communication barriers are present in life interactions, these pertinent links become distortions that appositely threaten interpersonal relationships. Especially when it comes to older adults, communication remains to be a problematic issue that needs a constant address and ways to mitigate their negative corollary. In terms of type, co-occurrence, and severity, communication disorders in older adults form an enormous difficulty that varies from other symptoms that limit vision, mobility, cognition or endurance. While communication disorders may affect different people of varied ages, its effects on older adults usually compound in severity and prevalence. Instead of single static events, communication disabilities in older adults are a dynamic process that fluctuates over time. Two broad trajectories of communication disabilities exist where one finds that there are older adults who live without disability and develop secondary ailments such as communication disorders out of primary ailments such as lifestyle diseases or otherwise (Yorkston, Bourgeois & Baylor, 2010). The other trajectory is that of older adults who form communication disabilities out of aging. Regardless of these trajectories, the burden of disorders in communication is inherently cumulative and grows with age resulting in significant implications for the affected individual and health care providers in general.
Typical aging usually leads to communication vicissitudes. The reason for these changes often centers on depression, health and an overall decline in cognition. With age, physiological changes in speech, voice, and hearing are inevitable, especially in hospitalized senior citizens. Moreover, these changes are usually predicted with impartial accuracy through an individual’s speech characteristics such as fluency, loudness, the rate of speak, pitch and voice tremor. Although skills in language are somewhat retained, grammatical judgment, repetition ability, and vocabulary underscore other cases leading to a substantial loss of the capacity to communicate effectively. In addition, the understanding of complex utterances and naming connote disabilities in communication among older adults. In the end, ageism has a profound influence on communication. While these alterations in communication skills may present themselves among the elderly as gradual and subtle processes, the consequences they have on life quality and social roles are alarmingly applicable (Yorkston, Bourgeois & Baylor, 2010).
Effects of Health Literacy on Communication among Senior Citizens
As information concerning health care becomes increasingly complex, the improvement of health literacy is gradually becoming pivotal especially in relation to communication among the elderly. According to Healthy People 2010, America’s agenda on public health, there is an exponential increase in limitations on health literacy, which is now morphing into an issue of national implication. Consequently, health care providers are setting targets and objectives for improvement, particularly when it comes to aging adults. Health literacy refers to the degree in which an individual is capable of accessing, processing, and comprehending basic information on health and its services, which are crucial in making informed and timely decisions (U.S. Department of Health and Human Services, 2009). Therefore, health literacy is pivotal when it comes to proper health-wise functioning, especially, among senior citizens. Moreover, since communication is a pertinent issue as age progresses, prioritization or reprioritization of health literacy can be either a determinant of success or a reason for failure in proper communication.
Inadequate literacy on health matters is often linked to numerous health disparities, increased dependence on health facilities and safety issues in health care such as medication and medical errors. When it comes to communication, health literacy acts as a double-edged sword whereby on one hand communication materials on health matters may be too complex for aged individuals to understand and interpret. On the contrary, by virtue of being health illiterate, elderly individuals may unintentionally communicate inaccurate information leading to discrepancies in the treating process (U.S. Department of Health and Human Services, 2009). By virtue of the fact that health literacy needs individuals to have and apply skills in critical thinking, in senior citizens who have communication disabilities, health literacy is a challenge. Conversely, aging adults who are adept in communication and possess sound health literacy often experience minimal health complications; subsequently visiting health facilities less often. Overall, health literacy affects communication in that; older adults can plan effectively and take the necessary steps to subdue communication complications before they can reach an acute level.
Communication Decline in Hospitalized Older Adults
Within older adult populations, 36% to 50% account for admissions in hospitals with 44% of them experiencing hospital charges (Kresevic, 2015). Hospitalization in itself is a dramatic occurrence whether one is old or young. Moreover, a hospital is a harbor of many incidental dangers stemming from restraint injuries, drug events and many more. Such shocks are typically lethal for elderly individuals and can cause great repercussions such as impeding rational communication. As a result, hospitalized senior citizens usually follow an uneven trajectory and many never regain efficient communication, mobility and other significant functionalities crucial to proper social integration. Therefore, as prime respondents in medical situations, nurses are required to aid in the preventing patients from leaving health facilities worse than they came in.
One attribute that austerely affects communication in hospitalized individuals is the occurrence and frequency of delirium. Considered the hallmark of acute illnesses, delirium is basically acute confusion that may be temporary or long term depending on the ailment, severity and its persistence. Presently, 25% to 60% of hospitalized older adults are normally affected by delirium in America (Kresevic, 2015). Moreover, this condition costs the health care industry close to $8 billion dollars. In terms of pathophysiology, delirium usually manifests in alterations to neurotransmitters. Processes leading to this condition include infection, imbalance of electrolytes, hypoxia, pain, constipation among others. These processes and pathophysiology events profoundly affect communication leading to disorders in overall functionality. Inasmuch as delirium is a pertinent issue, there are ways to mitigate and eventually overcome it through careful analysis and identification of the cause and the alteration of certain restraints and medications.
Ways to Communicate Effectively with Older Adults
Communication is one of the fundamental basis of any functional societal; therefore, finding ways to interact effectively is paramount not only for health success but also for the overall well-being of every individual. In nursing, an integrally humanistic science, the six Cs of Roach are highly pivotal. Through compassion, competence, confidence, conscience, commitment, and comportment, health care individuals approach communication in a wholesome scale leading to positive results. Moreover, understanding is significant when it comes to interacting with older persons who have a disability in communication. Confidence and commitment will enable a health practitioner approach numerous challenged aging individuals, but understanding and compassion will produce noteworthy results. Having a conscience also allows the health practitioner to attain empathy, leading to communication quality. In addition, having the right comportment or attitude facilitates consistency and the characteristic ethic of not giving up.
While senior citizens continue to increase unequivocally, the work of health practitioners is becoming complex. Overall, there is a need for the establishment of efficient communication, especially among hospitalized adults, and the reinforcement of proper comportments. It is an undeniable fact that older adults experience tremendous functional declines. As a result, health literacy needs to be a priority, and the implementation of mitigation strategies needs to be the focus of health practitioners globally.
References
Kresevic, D. M. (2015). Reducing functional decline in hospitalized older patients. The essence of nursing, 8-10
U.S. Department of Health and Human Services. (2009). Improving Health Literacy for Older Adults (pp. 1-2). Centers for Disease Control and prevention.
Yorkston, K., Bourgeois, M., & Baylor, C. (2010). Communication and Aging. Physical Medicine And Rehabilitation Clinics Of North America , 21 (2), 309-319. http://dx.doi.org/10.1016/j.pmr.2009.12.01
