An older man is walking outside with a cane. A health professional is walking beside him, in an attitude of listening; photo source: Administration on Aging, DHHS Learning Activities

Communication Competency

Communicate effectively, respectfully, and compassionately with older adults and their families/caregivers.

Develop your Communication Competency by completing some or all of these learning activities. Choose the ones that are the most useful to develop the knowledge and skills you need to demonstrate your Communication Competency. You might want to explore them all, to see what resources are here for sharing with others in your work setting or community. Introductory Video for the Communication Competency

If you prefer, you can read a transcript of the video.

Overview of Learning Activities:  Learning Activities for the Communication Competency are divided into two major areas of focus:

Sensory Changes in Older Adults

Sensory changes experienced by older adults are either normal aging changes experienced by everyone (e.g., presbyopia) or pathophysiological processes (e.g., macular degeneration) that occur with increased frequency as people age. These sensory changes can have a big impact on an older adult's life in many areas, including communication.

Print a Reference Sheet

Print Senses and Aging and use it as a reference as you proceed. Read the material about sensory changes in a gerontological nursing or other textbook. Write your notes on the reference sheet. Keep communication issues in mind as you read.

Complete a Crossword Puzzle Picture of a crossword puzzle

Have fun with the Sensory Changes in Older Adults Crossword Puzzle.

Picture of the letters http: Explore Internet Resources for Adults with Impaired Vision

Note: The internet links provided here were active at the time these materials were prepared. If a link is no longer active, try searching for the same or similar content using the name of the organization or the title provided.

Visit at least two of the following websites and become familiar with some of the resources available to support communication for older adults who have impaired vision.

Council of Citizens with Low Vision International

Click on Helpful Resources to learn more about Braille, education, technology, and blindness. 

Center for the Partially Sighted

In the left column, two links are useful for building your communication competency:

  • Click on Low Vision Library to learn about low vision. 
  • Click on Helpful Resources to download a catalog of low vision products that could be useful for persons with partial vision impairment.

Lighthouse International

Drawing of a lighthouse  

Take time to explore the many informational sections of this site. Click on Vision Resources, then Educational Publications, and choose these links:

  • Age-Related Vision Loss
  • Getting the Facts -- for Free
  • Research Publications

Macular Degeneration Foundation, Inc.

Read the Table of Contents. Then direct your attention to the following chapters, plus additional topics that interest you:

  • Chapter 2, Adult Macular Degeneration
  • Chapter 3, Pictorials (Great illustrations!)
  • Chapter 11, Newsletter (Note the archived copies.)

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Communication Tips and Strategies

Watch a Presentation

See what tips for communication with older adults you can glean from this presentation Unlocking Communication.

Picture of two compact discs Explore a TNEEL Module

Obtain the TNEEL CD, a highly recommended resource that has learning activities pertinent to your learning about older adults. These Older Adult Focus materials refer to the TNEEL materials several times. Information about how to obtain this inexpensive but valuable resource is available at

TNEEL stands for Toolkit on Nursing Excellence at End of Life Transition. You need the following instructions to use the TNEEL CD, so take notes or print this page before you leave these Older Adult Focus materials.

Using the TNEEL CD, go to the Connections section and explore the module on Communication. These directions focus on areas that will be useful in working with older adults, but feel free to explore further if you wish. Here are specific directions:

Put the TNEEL CD into your computer's CD drive. 

You are now at the Connections section. Click on Communication. The left column provides a series of links.

Now click on Case Studies in the left column. Work through the following two case studies, clicking on the audio and video clips that provide examples of effective, less effective, inappropriate, and family-oriented responses.

Last, click on Learning Activities in the left column, and work through Activity 1. View both video clips. Which video clip represents an interaction that would be difficult for you? Why?
Read Some Articles about Communication with Older Adults Picture of two journal articles     

Read at least two of these articles.

Communication Themes

Tuohy, D. (2003). Student nurse-older person communication. Nurse Education Today, 23(1), 19-26.

  • Pay particular attention to the four themes in the findings of this study!

A Unique Communication Strategy

Wikstrom, B. (2003). Health professionals' experience of paintings as a conversation instrument: a communication strategy at a nursing home in Sweden. Applied Nursing Research, 16(3), 184-188.

  • Focus on the Results and Discussion sections of this article.
Picture of a painting of a windmill and a green field

Touch as a Form of Communication

Sansone, P., & Schmitt, L. (2000). Providing tender touch massage to elderly nursing home residents: a demonstration project. Geriatric Nursing, 21(6), 303-308.

  • How did the residents respond to the use of tender touch massage?

Providing Nursing Care

Happ, M.B., Baumann, B.M., Sawicki, J., Tate, J.A., George, E.L., & Barnato, A.E. (2010). SPEACS-2: Intensive care unit “communication rounds” with speech language pathology. Geriatric Nursing, 31(3), 170-177.

  • What are your thoughts about the SPEACS-2 Communication Care Plan?
  • Could this care plan be useful in your clinical setting?

Kee, C.C., & Miller, V. (1999). Perioperative care of the older adult with auditory and visual changes. Association of Perioperative Registered Nurses, 70 (6), 1011-1021.

  • Table 1 is a useful resource. Could you post the table somewhere in your clinical setting?
  • If you want to print this article, you can avoid printing the CE exam by printing only pages 1-10.

Find Tips for Patient Education Brochures

If you will be involved in revising or creating patient education brochures or other written materials for older adults, you need to consider sensory changes of aging in your design. Here are two resources for you to use and share with others:

Presentation to Watch

Color, Contrast, Size, and Style: Hints for Designing Patient Education Brochures

Providence Center on Aging
Picture of the letters http:
  • This website has an excellent PDF document Creating Publications for the Elderly. You can find it by clicking the Improving Care tab and then clicking Developing Resources for the Elderly. Or, use the site search function to find it.
  • You might want to bookmark this website. It has many other resources you may find useful in developing other competencies for working with older adults.

Note: The internet link provided here was active at the time these materials were prepared. If the link is no longer active, try searching for the same or similar content using the name of the organization or the title provided.

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After you have completed some or all of these Learning Activities, proceed to the Competency Demonstration.

Developed by C. Van Son; Revised 2010