Observed Nonverbal Communication in the Elderly 

When my group was first formed, and the topic of serving the elderly came up in conversation, I wasn’t the most excited. I’ve had a lot of negative experiences, but when I thought of complaining, a 1981 Shel Silverstein poem came to mind.

Said the little boy, 'Sometimes I drop my spoon.'/Said the old man, 'I do that too.'

The little boy whispered, 'I wet my pants.'/'I do that too,' laughed the little old man.

Said the little boy, 'I often cry.'/The old man nodded, 'So do I.'/'But worst of all,' said the boy, 'it seems/Grown-ups don't pay attention to me.'/And he felt the warmth of a wrinkled old hand./'I know what you mean,' said the little old man (95).

Growing up can really be a sobering experience, even in the most innocuous ways. When one realizes that they are no longer the little boy and inching closer and closer to the grown-ups in this poem, it can make them stop and take stock of their life. I didn’t want to grow up in this sense. Being cavalier about other people’s experiences and needs was always something mean adults would do. I also reflected on the fact that a situation like the residents’ would likely be my future being elderly, somewhat lonely, and unable to do things I wanted to. This recognition sparked a commitment to this project as well as a mind searching for ways to be empathetic towards those I worked with. I went into my sessions at the care centers reminding myself that the hours I was giving up would mean so much to them.

Literature Review

The topic of verbal and nonverbal communication among the elderly is understandably most researched in the context of caretakers, families and the patients. The articles that focused more on the social interactions with peers and families were more applicable to this project.

One such study was more elderly-person based. In their Clinical Interventions with Aging article, McDowell and McDowell found sufficient data to support the idea that loss of communication in the elderly population was a “severe social and health issue” (McDowell and McDowell, pg. 159, 1998), especially when it came to hearing loss and the subsequent consequences for the effected people. Changes in communication style and ability, both for oneself and those they interact with can be difficult for anyone. However, cognitive ability, processing speed, and memory are all common among the elderly and make learning more difficult (Herada, et. al, 2013). This means that even though deafness doesn’t automatically sentence a person to a lifetime of loneliness and isolation, as some people might erroneously think. However, a situation where communication becomes significantly more difficult, in an age range where adapting to change is difficult can make communication nearly impossible.

Method

For our service learning project, we decided to serve those outside of our own age demographic. We spent some time volunteering at Golden Skyline Assisted Living. Due to scheduling conflicts and an influx of volunteers, they couldn’t accommodate our group coming there more than twice. Our group decided to outsource and volunteer at supplementary places half of our group helped other homes for the elderly, while the other half helped with young people. This gave us more examples to work with, as well as decreased the “us vs. them” mentality that could arise in a project like this.

Golden Skyline Assisted Living helps elderly people, often those who have disabilities live as independently as possible. On our group outing to Golden Skyline Assisted Living, we were asked to spend our time facilitating games of Cornhole. In our situation, this meant helping gather residents from their rooms, helping them sit and stand, accommodating walkers, and keeping score, all while doing our best to be empathetic and to observe how verbal and nonverbal communication impacted theirs and our experience. While this experience was in some ways challenging, it was full of opportunities to serve as well as observe different kinds of communication.

My other location was helping an elderly couple and their live-in caretakers decorate for Halloween. The couple is somewhat of a pillar of both my community and their own and are renowned for their holiday decorations. It is important to me, the couple, as well as their community that their tradition of decorating for Halloween continues.

Results

One thing I learned was that the elderly need to worry about Maslow’s Hierarchy of Needs significantly more than people I normally associate with. Elderly people have physical needs (the base layer) that come up urgently. These needs, including changing their temperature, eating snacks, staying hydrated, using the bathroom, and the frequency at which they must be met arise quickly, upending efforts to achieve other levels in Maslow’s Hierarchy (Alder and Proctor, 8).

Some of the elderly people I was communicating with had had strokes which affected their ability and desire to communicate enormously. Dawn, a resident at Golden Skyline had a stroke the week before. She wasn’t eager to talk, as verbal communication highlighted her decreased muscle control. She did listen and nod, and engage in some nonverbal communication, including smiling. She salivated on herself after she moved her lips. This broke the tension, and she asked for a tissue, and then was much more open to nonverbal communication.

Barbara, one of the patients who was receiving at-home care, had a mini stroke while we were talking. She had some muscle spasms in her face as well as some aphasia. Though it was an awful experience to witness, watching the shift from having a normal conversation to a near-emergency, and its effect on her verbal and nonverbal communication was interesting.

She started slurring her words, asking for me to put “Slove Stop Sluffing” in the “pigpen.” After the whole ordeal, she told us she wanted her Stove Top Stuffing to be microwaved. Though this started out as verbal communication, it quickly devolved to nonverbal communication, as neither I nor the caretaker could understand the “words” coming out of her mouth. The aphasia, along with her loss of balance and inconsistent facial expressions did have meaning assigned to them previously, however, so they were able to communicate that Barbara may have been having a stroke.

In less exciting examples, some of the residents I worked with were just less willing to talk or to keep the conversation going, due to being tired, hungry, in pain, or just not wanting to.

Nonverbal communication can be somewhat hindered by aging. Though there are some universal nonverbal ways humans communicate, such as facial expressions and some minor forms of body language, it was more difficult to read. Facial expressions were a bit muddled because of sagging in the face, droopy eyelids as well as muscle weakness. For example, when a resident had a slight frown, crossed arms, or started to cry. In a traditional sense, these examples would communicate displeasure, a lack of openness, and sadness, respectively. In the context of each person’s personal situation, these meant they had a stroke and couldn’t lift one side of their mouth anymore, they were cold, and that they had dry eyes.

I quickly learned that clear verbal communication is imperative when working with people who have decreased ability for nonverbal communication. To make sure I was being understood, I would talk more loudly, use reflective listening, and ask for clarification if I thought I misunderstood. For example, at Golden Skyline, I started to move a woman named Marilyn’s walker out of the way. She started making some odd grunts/whimpers. I immediately stopped what I was doing and asked if there was anything she wanted to tell me. By this time, the speed of her verbal communication had caught up with her nonverbal, and she was able to tell me that the brake was still on, making it more difficult to move the walker.

Conclusion

In the grand scheme of things, this service project might not mean very much. But for those I served, a game of Cornhole or one more year of over-the-top decoration could be a highlight of their day, week, or year. This experience also made me more aware of how I communicate, how others communicate with me and how quickly it can shift a relationship. It made me more aware of if I was quick to dismiss someone because I perceived them as too difficult, too old, too inconvenient to communicate with. This exercise made me reconcile where I would fall on Shel Silverstein’s spectrum. I was acting like the “grown-ups” who just didn’t listen. Now I am making a tangible effort to maintain the proverbial little boy and old man who took the time to just listen to the other.   

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