Communication and informed consent in clinical geriatrics

Area of Science:

• Gerontology
• Neurology
• Bioethics

Background:

• Effective communication is essential for obtaining informed consent, particularly from elderly individuals.
• Elderly populations, especially those with senile dementia of the Alzheimer's type (SDAT), face unique communication challenges.
• Sensory impairments and cognitive decline can significantly impede understanding and participation in research.

Purpose of the Study:

• To identify and discuss perceptual and communication impediments in obtaining informed consent from elderly individuals with SDAT.
• To propose strategies for overcoming these barriers to ensure effective communication and valid consent.

Main Methods:

• Review of common auditory and visual constraints affecting communication in the elderly.
• Analysis of speech, language, and vocabulary-related challenges.
• Discussion of specific conditions like presbycusis, presbyopia, cataracts, and glaucoma.

Main Results:

• Auditory impairments (presbycusis) and visual deficits (presbyopia, cataracts, glaucoma) hinder information sharing.
• Speech and language impediments, alongside the use of complex medical jargon ('medicalese'), create significant misunderstandings.
• These barriers can make informed consent processes difficult or impossible without targeted interventions.

Conclusions:

• Overcoming sensory, speech, and language barriers is paramount for ethical informed consent in elderly populations with SDAT.
• Researchers must adapt communication strategies to address individual needs and ensure comprehension.
• Proactive measures to simplify language and accommodate sensory deficits are vital for ethical research participation.