Registered Nurses' Association of Ontario

Communication Strategies

The three A’s

The Core Curriculum and Resource Guide from the Ontario Network for the Prevention of Elder Abuse (2008) outlines three A’s to consider when interacting with older adults. The three A’s include
•    active listening and reassurance,
•    ask the older person what he or she wants, and
•    action according to wishes and follow-up.

Caution: Nurses and other health-care providers might need to override the wishes of an older adult if mandatory reporting exists (e.g., abuse by a staff member).

Tips for conducting caring communications

The document Looking Beyond the Hurt: A Service Provider’s Guide to Elder Abuse outlines tips for caring communications that help make it easier to talk about abuse and neglect. Caring communication includes the following:

•    “I” messages (e.g., I am concerned about you…),
•    is specific (e.g., because you missed your last appointment and today I see a bruise on your arm),
•    is sensitive to others’ feelings (e.g., I understand that it’s hard to talk about personal concerns),
•    is non-judgmental and non-threatening (e.g., would you like to talk to me about it?),
•    empowers rather than “rescues” (e.g., do you want to talk about some of the resources you might want to use?),
•    helps to remove any perceived stigma about being abused (e.g., I have often seen people who are not receiving the care that they deserve),
•    is respectful of an older person’s right to make his/her own decision in his/her own time, and
•    is prepared to assist the older person to find the supports and services he/she needs.

Other communication tips-when talking about abuse and neglect

The Elder Abuse Modules from Employment and Social Development Canada (2011) outline communication tips to assist with having a preliminary conversation with an older adult regarding abuse and neglect. These tips include the following:

•    choose an environment where the older adult is comfortable and at ease;
•    do everything possible to ensure that the conversation will not be overheard or interrupted;
•    be mindful of hearing difficulties, language barriers, cultural and religious values;
•    maintain a relaxed, non-judgmental, supportive demeanor;
•    talk less and listen more; allow them to talk at their own pace;
•    notice inconsistencies and discrepancies;
•    take time to allow them to respond;
•    avoid comments that may seem like putting down the alleged or suspected abuser; and
•    offer support, discuss options but do not give advice.

Older Adults
Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches
Point of Care Resources