Communicating with the Elder Client

An essential component of client management is ensuring that communications with the client are understood by the client. When communicating with elder clients it is often necessary to adjust communications to accommodate diminished hearing or vision. In general, simply increasing volume is not a good answer because it increases the volume of the sounds a person can hear as well as those he or she
cannot. As stated above this is one problem with the use of hearing aids. If a client is having difficulty distinguishing speech or other desired sound from background or other undesired sound, simply increasing the volume of all sound will not help, and may make the problem worse. Finally, shouting and other means of raising volume can lead to confidentiality problems. It increases the chance that the conversation will be overheard by other persons. This is especially true when we must meet our client outside of the office—in their home, a hospital, nursing home, or other assisted living facility.

If the solution implemented to accommodate the loss of hearing is increased volume, then we must also adopt some means of maintaining confidentiality. Sound-proofing rooms is quite expensive but provides the additional benefit of screening out distractions. Certainly we should consider rugs (well secured so as not to create a tripping hazard) and wall décor that deaden sound. However, we can take simpler steps such as conducting conferences in rooms detached from waiting rooms and other high traffic locations. In addition, we can follow the
lead of therapists and use “white noise”machines outside of conference rooms.

Fortunately, simply raising the volume is not the only and often is not the best way to accommodate our clients’ diminished hearing. Gerontologists inform us that there are ways to communicate that compensate for much loss of hearing. Many of the techniques are helpful in ensuring understanding of our communications with any client. Those methods include:

• Face the person and maintain eye contact. This minimizes distractions and provides non-verbal clues as to what is being said as well as directing the sound at the listener.
• Sit somewhat close to and at eye level with the listener. Large, fancy conference tables are nice, but it may be better to sit next to the listener rather than across the table. Placing the client at the end of the long side of the table and sitting at the closest point on the short side allows closeness without the need to turn uncomfortably to the side to maintain eye contract. Watch the client’s body language for signs that you are too close for their comfort.
• Do not cover your mouth or face with your hands or objects such as papers while speaking. This muffles and deflects the sounds and creates an unnecessary distraction.
• Speak slowly and clearly but not in an exaggerated way.
• Minimize distractions, especially background noises. Again, sound proofing a room can be excessively expensive, but distractions can be minimized by holding conversations away from high-traffic areas, using “white noise” machines, and décor that deadens sound. Sometimes it is as simple as remembering to close the door. “White noise” machines can be purchased in sizes that fit in a briefcase and brought to out-of-office meetings with the client.
• Speak in a lower tone of voice. This is not as counter-intuitive as it may seem. We are not talking about lowering volume but tone of voice, thus conveying our words in frequencies within the listener’s ability to receive. Speak as you normally would in terms of cadence and modulation.
• Especially important information should be repeated often and in different ways. If the client fails to catch the point due to sound distortion, distraction, background noise or the like when it is stated one way, they may understand the same point when it stated a different way.
• Speak from a checklist or agenda so that points are made in a clear, systematic way. Provide the client with a written checklist of the topics covered and/or specific information conveyed such as items they must bring with them to the next meeting.

I suggest you literally put yourself in the place of the client. Sit in your conference room at different times of day and listen to the background noise. Do this not from the seat you normally take, but the seat or seats normally assigned to clients. Sit outside your conference room and listen for indications that conversations can be overheard. Conduct conversations with earplugs that
deaden, but do not eliminate sound. Ask the other person to try the techniques listed above in various ways and settings to see how they work from the perspective of the listener with diminished hearing capacity. Accommodating our clients’ diminished hearing capacity is generally not difficult if we make ourselves aware of it and implement reasonable steps in response to it. It helps not only the client but the entire legal team. Effective and efficient communication among the members of the team is essential in order for any
member of the team to be able to perform at his or her best.

(Excerpted from The Empowered Paralegal: Working with the Elder Client scheduled for publication by Carolina Academic Press in September, 2010. Internal footnotes omitted.)

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