Working with Elderly Clients

Golden tips to create meaningful and effective working relationships.

Posted Mar 03, 2020

Nashua Volquez. Pexels open access.
with grace.
Source: Nashua Volquez. Pexels open access.

Although elders face a different set of challenges than younger clients, working with elderly clients can be incredibly rewarding. With the right perspective and planning, you can create meaningful and effective therapeutic relationships. 

After years of working with older clients, I speak from experience when I say that working with the elderly is like working with any client. They are looking for the same things as any other client—professionalism, honesty, and clear communication, for some examples. And of course, you must maintain high ethical standards when working with the elderly as you would with any client. In order to maintain high ethical standards and work effectively with an elderly clientele, some additional steps may be needed in your work. Here are some challenges, solutions, and tips regarding working with the elderly, based on my research and experience. 

What Are the Challenges?

When working with an elderly client, it’s common enough to run into issues like hearing or visual impairments or slower cognitive function. Don’t worry—these things won’t prevent you from working with the client effectively. Accommodating common age-related changes may require minor changes to your office or therapy session.

Below are some of the common challenges experienced in working with the elderly, as well as ways to work together and manage the issue.

Hearing Impairment

Hearing impairment is a common challenge faced among the elderly. According to the National Institute on Deafness and Other Communication Disorders, approximately one in three Americans between the ages of 65 and 74 has hearing loss, and nearly half of American adults older than 75 have hearing difficulties.

Although hearing impairment can impact your client’s ability to communicate, there are ways that you can accommodate your hearing-impaired clients to ensure effective communication. If you suspect that your client has a hearing impairment, don’t be afraid to ask about specifics, such as which side they have the most trouble hearing on, and adapt accordingly. 

Speak slowly and try to keep a quiet meeting space with little ambient noise or echo. Many hearing-impaired individuals rely on lip-reading to understand what is being spoken to them, so it’s always a good idea to sit face-to-face with your client. 

Visual Impairment

According to the American Academy of Family Physicians, approximately one in three people 65 years of age and older has some form of vision-reducing eye disease. As with hearing impairment, there are a few ways that you can accommodate your vision-impaired clients to ensure that they have no issues absorbing important information. 

To accommodate your vision-impaired clients, keep large print versions of documents handy. It can also help to keep a magnifying glass on hand and ensure good lighting during meetings. 

It’s especially important to understanding that, at times, seniors may try to mask these issues. They may be embarrassed to admit that they have trouble seeing or hearing, so handling the issue with compassion is key. 

If you bring up the issue of sensory impairment proactively and have solutions ready, it will likely ease your client’s embarrassment. If he or she feels at ease and understood, he or she will be more willing to engage, which will ultimately lead to a better therapeutic relationship.

Cognitive Function

Studies show that age is linked to cognitive decline, and as the life expectancy of Americans continues to rise, there is a growing population of elderly people living with age-related cognitive changes. Because of this, it’s important to be proactive when working with elderly clients to ensure that they fully understand what is being communicated to them. Law topics can be difficult to understand for most laypeople, and this can be even harder for those who have issues with cognitive function. 

If you recognize signs of cognitive decline in your client, be sure to avoid complicated technical terms or legal jargon when communicating with them. Use familiar words, and take your time in speaking and reviewing documents together. To prevent your client from feeling overwhelmed, you may need to break up longer meetings into shorter, more manageable chunks and approach only one topic at a time.

One important note, however, is that you should avoid pathologizing the client’s age. That is, there are many age-related changes that are normative, or natural, and just a part of aging. Non-normative changes, such as significant memory loss or depression should be a red flag for referral.

Instead, if you encounter normative changes in aging, simply acknowledge there is a challenge and find a work-around with your client and/or their family members and caregivers.

What Are the Solutions?

Working with elderly clients can present just as many challenges as working with any other client, but it can be incredibly rewarding work that has the very real potential to change lives. That’s why it’s important to focus on the solutions rather than simply dwelling on the challenges you may face. The following solutions can help you and your client work through any challenges you may face, resulting in better relationships and more successful cases.

Get to Know Your Client

Taking some time to get to know your client as an individual can make all the difference when working with elderly clients. Seniors may be less socialized to therapy (although that is changing) and may be unsure of how to interact in session. So it may take additional time to build rapport and session norms.  

Have Good Clinical Sense

Working with the elderly requires having good clinical sense. This means having an open mind when you first meet the client and not immediately assuming that they will have a certain issue simply due to their age. However, as you begin to notice challenges that your client may face, you should adapt to better serve the client.

To make sure your client feels comfortable asking questions, be sure to ask, “What questions do you have?” when providing information. After asking, pause for long enough that they have a chance to think. Giving your client the opportunity to express their thoughts, feelings, and concerns can help them regain control in a time when they may feel powerless.

In Summary

All clients are different and present their own unique set of challenges. Developing a successful framework for working with elderly clients helps them and also your practice. Keeping in mind the principles laid out in this article will lead to more meaningful and effective relationships.