Older People & Ageing Well: Accessible Communication and Information in Day-to-Day Care
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Accessible communication in older people’s services is not optional or situational. It underpins consent, safety, dignity, safeguarding and outcomes. Many failures in care delivery — missed medication, refusals, distress, complaints and safeguarding concerns — can be traced back to poor communication rather than poor intent. Ageing brings increased likelihood of hearing loss, sight loss, cognitive fatigue, slower processing and fluctuating understanding, all of which must be actively planned for.
Providers can strengthen their approach by aligning accessible communication with wider person-centred practice and safeguarding frameworks, including Person-Centred Planning in Social Care and Safeguarding in Social Care. This article focuses on what accessible communication looks like in daily delivery and how to evidence it.
What accessible communication means in older people’s services
Accessible communication means adapting how information is shared so the person can understand, retain and use it. In older people’s services this commonly includes:
- Adjusting pace, volume and complexity of language
- Using visual, written or object-based prompts
- Repeating key information at agreed times
- Confirming understanding using teach-back
- Ensuring environmental factors support communication
Accessibility must be personalised. What works for one person may not work for another, and assumptions based on age alone are unsafe.
Operational example 1: Supporting informed consent in domiciliary care
Context: A homecare provider supported an older person with hearing loss and mild cognitive impairment. Staff reported frequent refusals and incomplete care, with records stating “service declined”.
Support approach: The provider completed an accessible communication assessment and introduced a structured consent approach.
Day-to-day delivery detail: Staff checked hearing aids at the start of each visit, reduced background noise, and used short, clear sentences. Care tasks were explained one step at a time using the same wording each visit. Staff used teach-back by asking the person to repeat key points in their own words. Written prompts in large print were left visible in the home, reinforcing daily routines.
How effectiveness is evidenced: The provider tracked refusal rates, reviewed daily notes for evidence of teach-back, and audited consent documentation. Refusals reduced significantly and care completion improved, which was recorded in a service improvement log.
Operational example 2: Accessible information reducing medication errors
Context: In an extra care setting, an older adult repeatedly missed medication doses following changes made by a GP. Letters and instructions were not being understood.
Support approach: The service introduced accessible medication communication as part of the person’s care plan.
Day-to-day delivery detail: Staff rewrote key medication instructions into large-print, plain-English summaries and reviewed them verbally at agreed times. Colour-coded prompts were introduced for different times of day. Staff avoided giving instructions during periods of fatigue and used teach-back to confirm understanding. Changes were communicated to family with consent.
How effectiveness is evidenced: Medication error records were reviewed before and after the intervention, and staff supervision records confirmed competence in accessible communication. Missed doses reduced and GP feedback improved.
Operational example 3: Supporting decision-making during hospital discharge
Context: An older person experienced repeated confusion during hospital discharge, resulting in anxiety and resistance to follow-up care.
Support approach: The provider created an accessible discharge communication plan.
Day-to-day delivery detail: Staff attended discharge meetings where possible, summarised information verbally using consistent language, and provided a one-page accessible summary covering medication, appointments and care changes. Information was reviewed again at home in a calm environment. Staff checked understanding over several days rather than expecting immediate retention.
How effectiveness is evidenced: Follow-up compliance improved, fewer unplanned contacts occurred, and family feedback was positive. The provider documented learning within discharge reviews and updated care plans accordingly.
Commissioner expectation (explicit)
Commissioner expectation: Commissioners expect providers to comply with accessible information requirements and demonstrate how communication needs are identified, planned for and delivered consistently. Evidence should show reduced errors, improved engagement and clear involvement of families or advocates where appropriate.
Regulator / Inspector expectation (explicit)
Regulator / Inspector expectation (CQC): Inspectors expect services to adapt communication to individual needs and to evidence informed consent. They will review care plans, daily records and speak with people to confirm understanding and consistency of practice.
Governance and assurance
Effective governance includes communication assessments, staff training with competence checks, routine audits of daily notes, and review of incidents and complaints for communication-related themes. Accessible communication should be embedded into induction, supervision and quality assurance frameworks.
Key takeaway
Accessible communication is central to safe, respectful and lawful care for older people. When providers can evidence that information is understood — not just provided — they significantly strengthen safeguarding, outcomes and inspection readiness.
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