Communicating with elderly patients with sensory impairment

Authors: Sanjay Suman 

Publication date:  26 Feb 2005

Doctors need a special understanding of visual, auditory, and cognitive impairment in elderly people. A few simple measures can make all the difference.

Visual impairment

  • Review clinical notes to pick up conditions such as macular degeneration, glaucoma, and other conditions which can impair vision

  • Stand or sit reasonably close; partially sighted patients can often learn to recognise outlines of individual faces

  • Avoid sudden appearances at the bedside as this may startle your patient

Hearing impairment

  • Avoid the temptation to speak too loudly or directly into your patient's ear

  • Ensure that any hearing aid is switched on and working

  • Speak slowly and clearly while facing the patient to allow them to lip read, as some can

  • Look for ear wax with an otoscope

  • If writing on a pad is the only way to communicate, then write short clear sentences in a legible handwriting

Cognitive impairment

  • Don't assume patients are incapable of effective communication. Many with dementia can understand simple facts, though they may forget this later

  • Enlist the help of a relative or friend

  • Be patient if you need to repeat any information already given. Written information can be left to remind the patient

  • Allow time for patient to respond as their reaction time maybe slow

Speech impairment

• Expressive and receptive dysphasia as a result of stroke can make communication very difficult. Liaise with speech and language therapist for expert advice

Sanjay Suman specialist registrar in medicine for the elderly Norfolk and Norwich University Hospital, Norwich

Cite this as BMJ Careers ; doi: