Communication

Communication for Older Adults
Most older adults have unique and varied experiences. Decreases in physical and psychological functions may create limitations with respect to societal isolation, so it is essential they develop dynamic assistive and supportive social applications for communication. This literature review is intended to demonstrate the importance of communication in older adults. It includes the following chapters: communication and social relationships, psychological well-being, augmentative and alternative communication, archiving digital story, and digital storytelling. It will review material related to the correlation between verbal communication and the needs of older adults in their later years.

Communication and Social Relationships
“Communication is central to the well-being of older adults” (Dickinson & Hill, 2007, p.626). “Verbal communication ability is closely related to satisfaction of hearing, vision, and speech, using multiple organs such as brain, vocal tract, oral cavity, and ears, all vital for quality of life (QOL) in older adults” (Miura, Kariyasu, Yamasaki, & Sumi, 2004, p.100). It affects social activity, general health status, and cognitive function, and is more related to health status and social activity than oral and hearing functions (Miura et al., 2004). Social relationship is a fundamental need of all humans and is crucial for the well-being of older adults (Williams, Kemper, & Hummert, 2004).
As Rowe and Kahn (1997) define it, successful aging not only includes success in terms of physical function and absence of disease, but also active social participation. Even though formal social support from family is important for older adults, barriers such as mobility problems and distance from family members may make it desirable that friends, acquaintances, and neighbors substitute as informal social support ties (Wright, 1999). Life events such as losing a spouse, retirement, and sickness continually reduce opportunities for communication that may put older individuals at risk of social isolation (Dickinson & Hill, 2007). Moreover, physiological limitations such as “hearing impairment, tooth loss, and declines in short term memory all affect either receptive or expressive aspects of communication” (Miura et al., 2004). However, “social support provides direct benefits of lower levels of stress, morbidity and mortality, and improved psychological well-being” (Wright, 1999, p.34). Furthermore, “the quantity and quality of social relationships have been consistently connected to morbidity and mortality” (Uchino & Kiecolt-Glaser, 1996, p.488). Therefore, isolated individuals are vulnerable and exposed to a higher rate of mortality, and social relationships can play a role in buffering stress on individuals; the most important role of physiological processes is reconciling the effects of social relationships (Cassel, 1976; Uchino et al., 1996). It appears that social isolation and well-being are closely related.

Psychological Well Being

“Maintaining high levels of subjective well-being is considered to be one aspect of successful aging” (Pinquart & Sörensen, 2000). The definition of subjective well-being is the measurement of one’s life with several components such as evaluation of one’s “self-esteem, life satisfaction, happiness” (Pinquart & Sörensen, 2000, p.187). Many researchers have stated that well-being has been characterized by psychological paradigms “such as life satisfaction, depression, psychological well-being, locus of control, and self-efficacy” (Zhang & Umemuro, 2012, p.232). Some old adults are confronted with social isolation, retirement, and minimal or limited contact with friends and family, all of which are primary causes of loss of social environments because of illness, geographical location, (Sum, Mathews, Hughes, & Campbell, 2008) or mobility problems (Webber et al., 2010; Wright, 1999). Aging brings “increasing risk for limitations or losses in health and competence, social networks, and financial means” (Pinquart & Sörensen, 2000, p.187), but older individuals usually do not think negatively about their age. Although they are most concerned about their health, they are optimistic and may not want to change their present lifestyle (Ryff, 1989). Also, older adults do not consider their age as contributing to great unhappiness, dissatisfaction, or low self-esteem (Ryff, 1989).

What are the fundamental factors used to measure well-being for older adults? According to Ryff (1989), older adults defined the ideal person as “being a caring, kind person having good relationships with family and friends” (p.201). Ryff (1989) attempted to determine the most important things for older adults at their present time. Most participants responded that health and family matters such as activities, friendships, and philosophy were the most important factors. In response to another question that asked participants if they could change themselves or their present life in any way, what kinds of changes they would make, most responded that they would change nothing. Moreover, on a question that asked them to describe a mature and well-adjusted person, most participants chose others oriented and accepts change (Ryff, 1989). We can summarize by saying that the most vital principles of well-being for older adults is being others-oriented rather than self-oriented, caring, and having friendships.

Experimental studies have shown that age-related stereotypes affect older individuals’ well-being and aging processes; people with negative age perception go in a negative direction and people with positive age perception go in a positive direction (Meisner, 2011). Older adults who have positive age perspective exhibit better health conditions, better recovery abilities from illness or diseases, and have longer life spans (Meisner, 2011), meaning that negative age self-perception has negative effects on well-being. One of the elements of well-being was a measurement of maturity, and many older people agreed that those who accept change are mature people (Ryff, 1989). However, according to the Hummert (1998) team study, individuals with negative impressions are more opposed to change than persons with positive impressions.

The Keicho (傾聴) group in Japan exemplifies how people use communication to support emotional care. Keicho means attentive listening and there are many groups of volunteers in Japan that help people living in areas affected by earthquakes or older adults suffering from dementia (Seth, 2012). Keicho Volunteer Morioka is a listening group for older adults based in Morioka, the capital of Iwate Prefecture and was founded in 2006. They visit individuals’ private homes or communities near Morioka to listen to older adults’ stories for an hour or so. It is common for people with dementia who may clearly remember their childhood to easily forget current events not related to frequent and repeated activities. The group members respond by nodding while listening without judgment of the stories, and before leaving the older adults they promise to revisit them. The director of Keijuso (a group home for older adults with dementia), Hideko Yamashita says, “when listening to older people’s stories they relax and heal their mind” (Seth, 2012). The volunteers have several rules while helping older adults, one of which is that they neither ignore the older adults’ beliefs nor sympathize with them they want to avoid hurting their feeling.

As has been shown, interacting with others and having a positive outlook are very significant factors for older adults in their later years. In terms of the meaning of a “fully developed” person, most older adults think that having good relationships with others is definitive of someone who is fully-developed (Ryff, 1989). Despite the importance of interactions and communication with others, mobility problems can cause isolation from others and invite loneliness and depression. Moreover, older adults with positive age stereotypes tend to avoid health failures, and social communication will likely positively increase their confidence and well-being. Hummert proved this prediction in group research by showing that people with a positive age stereotype increased their communication skills more than people with a negative age stereotype (Hummert & Shaner, 1998). A researcher, Berkman, states that the degree “to which these relationships are strong and supportive, and individuals are integrated in their communities, is related to the health of the individuals who live within such social contexts” (Berkman, 1995, p 245).

Augmentative and Alternative Communication
Some older people prefer to write letters to loved ones rather than phone because they think that letters give them more time to consider what they want to say and it is a no-time-limit activity. However, physical function limitations such as poor vision, arthritic hands, and grammar may lead them to use technology such as phones. Moreover, in preparation for emergency situations, some older adults prefer to use a phone for assistance in immediate emergencies (Dickinson & Hill, 2007). Online communication via the Internet is a form of social support that can be called “weak ties” (Wright, 1999). The Internet provides possibilities for older individuals to frequently connect with others whether the relationships are close or not. It has several advantages such as lower expectation of interaction, slight responsibility, and indifference from others in a support network (Wright, 1999).

The most important factor is that computer-based communication systems do not require much time to learn and are easy to use (Dickinson & Hill, 2007). Furthermore, as the cost of technology continues to decline, educational programs for older adults increase in number. As the well-educated older population grows, baby boomers approach the threshold of older adulthood, and the SeniorNet website operates for older adults, thus, vital computer-mediated communication has continued to develop (Wright, 1999). Age-related changes affect older adults’ abilities and they need to use their energy selectively and effectively to achieve the best outcomes (Melenhorst, Rogers, & Caylor, 2001). Internet technology may give them a chance to maintain their social links. The contrary opinion holds that online communication is inherently impersonal and produces superficial and even unfriendly relationships; however, its positive social effects may exceed its negative qualities by overcoming geographical problems (Sum et al., 2008).

The following example is the augmentative and alternative communication method that shows promise in helping older adults interact with younger people. The Brazilian-based language school (Beck, 2014) CAN has developed a virtual speaking exchange program for online relationships with older American adults called Building Bridges in a Virtual World. They use real-time chatting and conversations that are uploaded to a private YouTube page and instructors review the video files. During chatting in real time, students not only learn language from the older adults, but also receive precious gifts of wisdom from them through an understanding of the old adults’ lives. They can share an emotional connection while chatting.

Archiving Digital Story
Many older adults use media and websites not only to gather information, but also to share their own medical stories, to rate doctors and facilities, and to join support groups. A virtual life story is a storage service archiving a biography and family history documents, reminiscences, and recordings of special events as a sharing space for family members and a source for caregivers who care for older adults with dementia (Emily Study, 2014). According to the report of ABHOW (American Baptist Homes of the West) memory care consultants (Emily Study, 2014), understanding residents’ unique life stories aids caregivers to successfully care for memory-impaired patients, especially through enhancing engagement. According to the Rush Alzheimer’s Disease Center in Chicago (Study, 2014), engagement supports against feelings of isolation from society that can easily lead to dementia and cognitive impairment. The following examples delineate the websites people use to store their stories on the Internet.

LifeBio (http://www.lifebio.com) was developed in 2006, based in Marysville, Ohio, and founded by CEO Beth Sander. LifeBio focuses on a family-oriented community with the aim of making connections between older adults and their family members such as grandparents and grandchildren through the sharing of life stories. It allows people to visit the website and create a written autobiography or biography of a loved one, as well as assist in publishing a book containing the uploaded stories. It has joined with 100 communities and provides web and phone based training to help them use a tablet and websites. Older adults’ biographies can be gifted to their family members and children when they leave them as a memorable keepsake that shares their memories through written stories on the website and remains as a book they published.

Senior Correspondent (http://www.seniorcorrespondent.com/) is an in-depth reporting community from veteran journalists and commentators who provide written storytelling of their experiences related to U.S. and world news, politics, technology, arts, work,
health, and more. It provides services through the online magazine, mobile apps, and social media. Older journalists and commentators deliver their viewpoints along with their experiences and current issues. This communications firm was founded in 1999 by Signal Hill and continuously helps organizations generate stories.

Digital Storytelling with Voice
Digital storytelling uses ‘voice’ as a vital means for telling a story. A teller’s emotion conveyed in a story expresses the teller’s personal characteristics that add to the feeling and meaning of the story. In terms of voice incorporating individual’s characteristics, each story includes unique features that make differences compared to more limited services. There are several services that use technology to create digital storytelling for people in general or for specific target audiences. The following examples are the websites including voice function to help people collect stories with ease.

In 1993, StoryCenter (http://www.storycenter.org) began helping individuals share their stories by developing professional development tools, educational methods, and a mobilized community. Their service is based on public workshops that train people from organizations in the workshop to help them plan storywork projects, curriculum development, storytelling, and facilitation for their organizations. They provide videos of the storytelling completed during the workshop.

Web of Stories (http://www.webofstories.com/) provides a chance to hear the life stories of famous people. The goal of this site is to interview people and archive stories about some who have significantly influenced the world. They talk about their life stories and achievements, so audiences can hear famous people’s personal stories in their own words. It also provides an application to support mobile devices or tablets. This archive stores historical stories of famous people and users can search videos by storyteller or themes.

StoryCorp.me (https://storycorps.me/)’s primary goal is interview people. To gather stories around the world, the company moved to many locations to interview a wide variety of people in many countries to gain insight into their wisdom and humanity. Thanks to the development of technology, they now provide a mobile application to help people produce and listen to interviews. The tool provides features such as interview questions and editing resources, focusing on experience rather than interaction. Anyone can upload their story; however, there is a process to get a confirmation from the StoryCenter to publish their story to the public. Their stories are archived at the American Folklife Center in the Library of Congress.

My Story (http://www.mystoryapp.org) provides a simple method of storytelling and a bookmaking application for kids. Students can create a story using drawing tools and their voices. They can add clips provided by the application to their voices to create a new story. Teachers can invite students to do classroom authors and multiple stories can be created under each author. Students can share their stories via YouTube.

Pixntell.com (http://www.pixntell.com) is an application for making a story using pictures from a user’s library or camera to add photos and videos. After ordering the photos, they can record their voice to make a story. Users can share their videos via social media or email.