Seeing is understanding: The role of visual strategies to support older adults with cognitive impairment

The Bottom Line

  • Older adults living with cognitive impairments can face difficulties with communication and comprehension.
  • These challenges can negatively impact their ability to fully engage in decision-making and affect their quality of life.
  • Visual supports and communication strategies can help facilitate everyday activities for older adults and decision-making processes, including those about healthcare.

Older adults living with cognitive impairments such as Alzheimer’s disease, brain injury, or intellectual disabilities often face difficulties with communication and comprehension, which can in turn impact other cognitive processes like decision-making and their overall quality of life.1 

Visual methods of communication can be used to facilitate communication about older adults’ needs, feelings and preferences in everyday life. Additionally, in healthcare, visual tools can be employed to help convey complex health information like test results and support decision-making (e.g., treatment options or end-of-life care).1


What the research tells us

An evidence synthesis assessed the use of visual methods to support communication with older adults with cognitive impairment. It found that visual communication methods can help preserve the dignity and identity of older adults with cognitive impairments by promoting active participation in decision-making, respect and understanding individual preferences.1 However, caregivers and health providers need to be trained to use these tools effectively, while maintaining focus on the individual rather than the technology or communication support itself.

Some common types of visual communication methods include:

  • web-based decision aids
  • video-based aids
  • image-based approaches (e.g., pictograms, photos, and charts/diagrams

Overall, visual communication methods have been shown to lead to improvements in understanding, decision-making capacity and clarifying values. They also help older adults with cognitive impairments feel more informed and confident about the decisions they are making.1

Another evidence synthesis found that information communication technology interventions using visual aids may promote more social behaviours, which can in turn lead to improvements in social well-being.2

Supporting everyday life and care-related decision-making through visual supports

Communication challenges brought about by cognitive impairment and age-related changes can be addressed through visual aids to support communication and comprehension. You can help improve your communication with older adults with cognitive impairments by:

  • using physical contact (while respecting their personal space and if it feels appropriate), body language, tone and facial expression to provide context and improve communication
  • having pictures and visual cues as memory aids
  • providing visual prompts such as cue cards, book of pictures of meals, or mood cues to help facilitate communication and day-to-day decision-making.3

While visual communications can help improve understanding, communication, and decision-making, it is important that visual methods do not become overwhelming or reduce the quality of the interaction. Explore the resources below for more information. 


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Author Details

References

  1. Chen AT, Teng AK, Zhao J, Asirot MG, Turner AM. The use of visual methods to support communication with older adults with cognitive impairment: A scoping review. Geriatric Nursing. 2022 Jul 1;46:52-60.
  2. Pinto-Bruno AC, Garcia-Casal JA, Csipke E, et al. ICT-based applications to improve social health and social participation in older adults with dementia. A systematic literature review. Aging and Mental Health. 2016;21(1).
  3. Alzheimer’s Society. Non-verbal communication and dementia. [cited September 2024]. Available from https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/non-verbal-communication-and-dementia

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.