Health Communication

The concept of health communication among and with older adults represents an interface of two complex phenomena. Health is more than the absence of disease; it is a state of optimal physical, mental, emotional, and spiritual well-being. Communication is more then merely sending a message; it is bidirectional and entails an exchange of mutual understanding between a sender and a receiver. With increasing age, both health and communication abilities may be compromised. Thus, effective health communication with the aging population requires sensitivity as to how these two phenomena may change with age. Understanding the way health affects communication among older adults will enhance the effectiveness of strategies for communicating with them.

When individuals attain an optimal state of health, their physical, mental, emotional, and social needs are met. These needs exist on a hierarchy, with the most basic being the need for food and shelter followed by higher level emotional and social needs. Lack of having any of these needs met, including mental stimulation, may cause a failure to thrive. Health needs and risks increase with age, although aging and disease are not synonymous. Over the past century, health risks have shifted from primarily acute infectious diseases to chronic noninfectious diseases. Thus, maintaining met needs and, therefore, optimal health requires ongoing efforts by individuals interacting with their environment to get their needs met. A key mechanism for getting one's needs met is interpersonal communication or face-to-face interactions with a multitude of health care providers, some of whom are family caregivers. Another mechanism includes mass communication (e.g., commercials, newsprint, magazines, brochures) with which society communicates with older adults about their health risks. The success of an elder's interpersonal communication with another person or vice versa and/or mass communication messages depends on an understanding of how elders “decode,” or receive and understand, messages as they age.

The human body has five senses with which to decode or receive interpersonal and mass communication messages, but the acuity of these senses diminish with increasing age and the presence of one or more diseases. These five senses are vision, hearing, touch, smell, and taste. Vision, hearing, and touch are the primary modalities for sensory reception in relation to verbal and nonverbal communication messages. Individuals use their eyes and ears to understand spoken messages (i.e., verbal communication) and body language (i.e., nonverbal communication, including vocal nonverbal communication). Spoken messages also have nonverbal vocal components, including speech rate, tone, and loudness, that can be heard. In fact, more than 80% of what one understands about a message comes from nonverbal communication. Thus, the importance of the five human senses in allowing one to understand nonverbal communication cannot be understated.

Although many sensory deficits could be corrected or improved with aids, many older adults refuse to use them properly or even at all. Thus, achieving effective health communication with older adults who resist [Page 264]using corrective aids to improve their sensory deficits will at most require substantial effort by health care providers and caregivers to compensate for their deficits. Achieving effective health communication with those older adults who do not resist using corrective aids to improve their sensory deficits will at least require a basic understanding of the ever-changing interface of health and communication issues with increasing age.

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