Many thanks to the ever-reliable APA Committee on Aging for the tips below.

As the population ages, and as psychologists venture further into integrated healthcare settings, the proportion of older adults in their client caseloads is likely to explode. Is the average healthcare setting designed to accommodate the special needs of older adults with sensory, mobility, cognitive, or other disabilities?

Here’s a checklist of 28 tips that professionals working in behavioral health and other health care settings should consider:

To address hearing loss:

  1. Minimize background noise (e.g., close the office door, forward incoming calls) as individuals with hearing loss have difficulty discriminating between sounds in the environment.

  2. Look at your client when speaking. Many individuals with hearing loss read lips to compensate.

  3. Speak slowly and distinctly. Older adults may process information more slowly than younger adults.

  4. Do not over-articulate or shout as this can distort speech and facial gestures.

  5. Use a lower pitch of voice because the ability to hear high frequency tones is the first and most severe impairment experienced by many older adults with compromised hearing.

  6. Arrange seating to be conducive to conversation. Sit close to your client, face-to-face, at a table rather than on the far side of a desk.

  7. Focus more on written communication to compensate for problems in oral communication. Provide written summaries and follow-up material.

  8. Have auditory amplifiers Many companies sell hand-held amplifiers that connect to headphones for in-office use.

To address vision loss:

  1. Increase lighting.

  2. Reduce the impact of glare from windows and lighting as older adults have increased sensitivity to glare. Have clients face away from a bright window.

  3. Do not use glossy print materials as they are particularly vulnerable to glare.

  4. Format documents in large print (e.g., 14 or 16-point font) and double-spaced as presbyopia (blurred vision at normal reading distance) becomes more prevalent with age.

  5. Give your client adequate time to refocus his or her gaze when shifting between reading and viewing objects at a distance, as visual accommodation can be slowed.

  6. Be mindful of your client’s narrowing field of vision. A client may not be aware of your presence in the room until you are directly in front of him or her.

  7. Have reading glasses and magnifying glasses available on conference tables.

  8. Arrange furnishings so pathways are clear for those with visual or physical limitations.

To address mild cognitive changes:

  1. Conduct practice at a slower pace to allow your client to process and digest information, as information-processing speed may decline with age.

  2. Allow extra time for responses to questions, as “word-finding” can decline with age.

  3. Break information into smaller, manageable segments.

  4. Provide cues to assist recall rather than expecting spontaneous retrieval of information.

  5. Provide summary notes and information sheets to facilitate later recall. Include key points, decisions to be made, and instructions for at-home care.

  6. Confirm or reconfirm your client’s basic goal or problem to be solved.

To address changes in mobility:

  1. Be cognizant of the accessibility of your office for individuals using mobility aids (e.g., scooter, wheelchair). Be able provide guidance to clients about how to best access your office via ramps at building entrances and elevators.

  2. Ensure that your office is easy to navigate for a client who uses mobility aids.

  3. Ensure that there is an accessible restroom in close proximity to your office.

  4. When interacting with clients who use a scooter or wheelchair, sit at the same level as them.

  5. Do not push a wheelchair or touch mobility aids without asking.

  6. Do not assume that a client needs assistance with mobility issues – ask before you help.

Relevant resources:

APA Office on Aging

APA Office on Disability Issues

Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists

Assessment of Older Adults with Diminished Capacity: A Handbook for Lawyers