Communicating with Older Adults: An Update

I have been studying how to unlock the communication code of older adults for the last twenty-three years. My first breakthrough came early on with developmental psychology, a model based on age-specific tasks that are easy to understand, easy to use, and highly effective. As a result, the two tasks of the final phase of life, control and legacy, have earned their way into the vernacular of how to communicate with older adults.

However, in the last few years I have discovered two additional elements that combine with the developmental tasks of older adults to complicate rapport. Understanding what they are and how to engage them preserves effective communication in even the most trying circumstances.

One of these elements is the invasion of dilemmas in the second half of life. Dilemmas resist heroic attempts to keep everything together. Like an unruly Rubik’s Cube, alignment in one caregiver area seems to trigger chaos in another. Just when driving issues calm down, sibling conflict erupts over money. Just when housing accommodations get better, a parent falls and winds up in the hospital. In the face of this steady stream of dilemmas, the natural instinct is to work harder in search of the illusive mix that will stabilize this disruptive phenomenon. Ironically, upping the work ethic on dilemmas only seems to give birth to new ones, a sorcerer’s apprentice law of dilemma management that runs caregivers ragged. Now what?

The first rule of dilemma management is to reset expectations. There are no final, elegant solutions, just the dance with complexity. Unlike problems, win-win is not part of dilemma management, which is usually a messy process that requires patience and smaller bursts of sustainability. All of this argues for a different orientation, softer reins, and deeper acceptance. In the end, the predictable dilemmas of aging require a different skill set that is not intuitive but essential for everyone’s well being.

The other element is the deep-seated ambivalence older adults have to unwanted advice. This goes beyond the collision between developmental stages, though that is part of it. There are different psychological forces at work here, present at all ages, but markedly enhanced in the final phase of life. We are talking about ambivalence to change.

Choosing to engage ambivalence head, to tell older adults what and how to change, only intensifies and prolongs resistance. Like dilemmas, overcoming ambivalence to change requires a different set of skills. Instead of provoking resistance, we need to soften ambivalence and make room for the possibility of change. This is not an intuitive strategy or skill, but it can be learned with patience and practice.