Older adults with communication disabilities and their use of communication support at doctor's visits: a nationally representative study.

ABSTRACT

PURPOSE: Older adults with communication disabilities (CDs) experience barriers to receiving care and face a paucity of accommodations for their disability. Utilizing someone that supports communication with healthcare providers (communication support persons) may be a way that this group self-supports their disability. We examined if this utilization was independently associated with CDs among older adults. We also sought to understand if socioeconomic factors were associated with utilization. METHODS: We used the 2015 National Health and Aging Trends Survey (NHATS) to conduct a cross-sectional analysis of Medicare beneficiaries (n = 5954) with functional hearing, expressive, or cognitive difficulties. We calculated a weighted, population prevalence and an adjusted prevalence ratio (APR) controlling for sociodemographic, health and other disability factors. RESULTS: Among community dwelling older adults, having CDs was associated with higher utilization of a communication support person at medical visits (APR 1.41 [CI 1.27 - 1.57]). Among adults with CDs, Black adults and women had lower levels of utilization as compared to White adults and men, respectively. CONCLUSION: Communication support persons may be a way that older adults with CDs self-support their disability. However, not all older adults with CDs bring someone and variation by social factors could suggest that unmet support needs exist.

Over half of older adults with communication disabilities do not utilize a communication support person at doctors' visits, and utilization differs by race and gender.Rehabilitation professionals should educate their older adult patients with communication disabilities on this practice and collaborate with speech-language pathologists (SLPs) and audiologists (AuDs) on how to accommodate this population's disability.SLPs and AuDs can directly train support persons, other rehabilitation professionals, and physicians on accommodating these patients. For patients who don't bring a support person, SLPs and AuDs can plan alternative communication disability supports to use in healthcare settings, so that all older adults with CDs can equitably access their healthcare.