Do words really matter? A focus on communication and aging

My passion for research on aging and communication probably stems from seeing family members and their care partners struggle to understand directives from health professionals about disease diagnosis and treatment. The strong and brilliant women I admired during my childhood seemed lost and grasping for any and all information they could find to help them cope with cancer recurrences or onset of dementia. They scoured pamphlets in specialists’ waiting rooms; surfed credible and questionable sites on the early World Wide Web; and sought second and third opinions as they sent their medical records and CT scans from office to office.

Early research on communication and aging focused on interpersonal communication. Ryan et al. conceptualized the Communication Predicament Model on Aging that acknowledged how conversations based on aging stereotypes could limit older adults’ opportunities for productive communication (Ryan et al., 1995). This type of stereotype-guided communication in a medical encounter could have dire implications for health outcomes, including inadequate diagnosis, inappropriate treatment, and reduced compliance, especially among vulnerable older populations (E.B. Ryan et al., 2006). Doty’s early work on assertiveness (Doty, 1987) examined how assertive communication could increase self-esteem and the higher likelihood of successful interactions. Research involving sample scenarios between providers and older adults indicated that assertive seniors (compared with those using passive or aggressive communication styles) were evaluated by individuals of all ages as most competent and likely to be satisfied with future health-care encounters (E.B. Ryan et al., 2006).

Explorations into the volume and scope of health-focused articles published in newspapers and magazines, including those intended for adults over age 50, revealed that the information was written in technical language often requiring high school to college education, content was often quite limited and without cues to action, and the messaging did not always indicate clearly that high-risk groups may need to seek preventive care earlier than the general population (e.g., D.B. Friedman & Hoffman-Goetz, 2003a; Rose et al., 2013). Risk and protective factors published also were not always commensurate with the state of the science on the medical issue being discussed (Mathews et al., 2009). With exponential growth of online health content for older adults, communication studies began examining static website information (D.B. Friedman & Kao, 2008; Olscamp et al., 2019) as well as content of more interactive and social platforms (e.g., D.B. Friedman et al., 2016, 2011; Tang et al., 2017), blogs (Kannaley et al., 2019), and apps (Choi et al., 2018). These Web 2.0 type resources, while available with a click of a button, are often written at an even higher reading grade level than printed information and not necessarily tailored to those who need it most.

Meeting people where they are with health information is critical. As Kreuter et al. (1999) wrote so eloquently in a seminal paper: “One size does not fit all.” Continuing to explore how older communities would like to and need to receive information and who needs to be involved in information receipt and sharing (e.g., family, important others) is key for achieving effective messaging (e.g., Bergeron et al., 2018; D.B. Friedman & Hoffman-Goetz, 2003b; D.B. Friedman et al., 2012; D.B. Friedman & Kao, 2008; Friedman et al., 2009).

This issue of the Journal of Women & Aging features a special selection of articles focused on Communication and Aging: Challenges and Opportunities for Older Women. The articles in this issue were selected because they provide empirical research on a variety of populations and settings, and they each contain innovative communication-focused research questions. The special issue begins with a collection of three qualitative articles. In their in-depth analysis, Logan Marg and colleagues present findings from a focus group of women over 50 living with HIV and identify through the women’s voices the importance of social support as a source of resilience and the need for tailored communication and interventions to improve their quality of life. Lené Levy-Storms and LinChen’s research with dyads describes emotional connections between largely women caregivers and women care recipients with a dementia diagnosis living in nursing homes. They examine how interpersonal communication between caregivers and patients convey enacted emotional support. Janiece Taylor et al.’s research on pain among older, low-income women reveals that communication with health-care providers can play a major role in decision making surrounding pain management and provides implications for future intervention development.

The final four papers in the issue explore and use technology in different ways. Rachel Douglas and Anne Barrett conducted a comprehensive analysis of online travel articles focused on solo travel advice, and they present differences in online article focus based on the age of the female traveler. Emily Franzosa and Emma Tsui also conducted an in-depth content analysis. They examine how the largest U.S. home care and home health providers are marketing their services online through family-like relationships. Using a mixed methods approach, Magdalena Leszko examines the role of online support groups for older Polish women who are caring for spouses with Alzheimer’s disease. Julia Upton et al.’s intervention study assesses the benefits of an innovative technology-based program on the well-being of long-term care residents.

It has been exciting to read the ever-expanding body of work focused on aging and communication. Let’s continue to explore how we can communicate most effectively in a world in which information—both accurate and misleading—is at our fingertips, options for sharing information via technology are evolving rapidly, and our diverse older adult populations who are living in a variety of settings have unique information source preferences and needs. Clear, accurate, and culturally appropriate communication about health may not lead directly to changes in behavior or improved health outcomes, but we owe it to our aging communities and their families to try our very best.

I dedicate this special issue to the wonderful contributing authors and the scientists out there who are advancing greatly the field of communication and aging and to my mother, my grandmother, my mother-in-law, and all older adults in our families and communities who are deserving of information. Knowledge can be powerful.

Order of special issue articles

1. Logan Marg: “‘We Are Becoming Older Women and Then We Have Two Stigmas’: Voicing Women’s Biopsychosocial Health Issues as They Age with HIV”

2. Lené Levy-Storms: “Communicating Emotional Support: Family Caregivers’ Visits with Residents Living with Dementia in Nursing Homes”

3. Janiece Taylor: “Pain in Low-Income Older Women With Disabilities: A Qualitative Descriptive Study”

4. Anne Barrett: “Footloose and Fancy-Free: A Comparison of Online Travel Advice for Older and Younger Women”

5. Emily Franzosa: “Professional, Friend, or Family?: How Home Care Companies Sell Emotional Care”

6. Magdalena Leszko: “The Role of Online Communication Among Spousal Caregivers of Individuals With Alzheimer’s Disease”

7. Julia Ann Upton: “The Use of It’s Never Too Late Technology (iN2L) in Enhancing Well-Being Among the Elderly in a Residential Setting”

Disclosure statement

No potential conflict of interest was reported by the author.