How Caregivers Can Help Older Adults with Health Literacy
Health literacy is an individual's ability “to find, understand, and use information and services to inform health-related decisions and actions for themselves and others”1 (Centers for Disease Control and Prevention). It is an important skill that can prevent health problems and improve health management. However, many older adults do not have necessary skills to interact effectively with health information. The health effects of aging also create barriers for older adults when it comes to understanding health information and messaging. This is why caregivers play a crucial role in improving health literacy for older adults so they can understand their health status and make better health decisions.
While older adults are a group that can benefit from health literacy, they also experience many barriers to building this skill due to aging. These barriers include aging mental state, decreased cognitive abilities, lack of prior knowledge of health information, limited literacy, as well as a smaller social support system.2
Most health materials are written at high reading levels and not well formatted nor presented in a way that is easy to understand. Health information that is readily available is often posted on social media or blogs made for younger audiences. This makes health materials harder to digest for older adults due to their cognitive and vision issues. Furthermore, older adults experience a “digital divide,” where they feel disconnected from society because of their lack of knowledge to use technology, where much of health information is published.2 The combination of older adults being embarrassed with their lack of familiarity with computers and internet, in addition to e-health tools being difficult to use, puts older adults at a disadvantage to leverage health literacy to improve their health.
Improving health literacy for older adults
The ability for older adults to understand health information depends on their ability to process, recall, and apply spoken or printed information.3 Because of the barriers they face, older adults need assistance from caregivers in order for them to better understand health messages and information.
Below are tips for caregivers to communicate health information to older adults in an age-friendly way:
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Keep information focused. Information is best digested one detail at a time. For example, when explaining medication instructions, just focus on the step-by-step process of actually taking the medication. Explain specifics, such as the time the medication needs to be taken, how often, or if they need to eat beforehand. Do not mix in additional information about side-effects, symptoms, etc. when explaining the procedure first.
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Repeat as needed. Not just older adults, but all people benefit from repetition when it comes to memory and retaining information. Also let residents know they can ask you questions as often as they like. This creates a safe environment for the older adult not to feel shame about details they do not remember.
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Use face-to-face communication and make the information personally relevant. Due to the “digital divide” many older adults experience, face-to-face communication can be more effective. Nutritional information may be hard to understand, so using analogies and storytelling to make information personally relevant goes a long way. For example, a physician may prescribe a specific diet to an older adult. Oftentimes, people perceive “dieting” as a negative experience because they are not able to enjoy the foods they love. However, if caregivers explain how adopting a healthy, balanced diet allows them to live a longer life to have more time with their grandkids, older adults can better relate to that personal message as motivation for health behavior change.
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Highlight short-term benefits of taking action now. Understanding short-term benefits allow people to comprehend how taking action now immediately benefits them. For example, people often think quitting smoking is a long, drawn out process. However, immediate benefits of quitting include enhanced taste and smell, more time for hobbies and loved ones, as well as more money saved. Help older adults explore the short-term benefits they can reap from taking action to improve their health.
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Provide sufficient follow up for each resident. Following up with residents can be used as a measure of long term information retention. If the resident forgets critical health information, first ask to see what they remember. If they were able to recall information, commend them for remembering, then fill in the gaps by teaching them the information once again.
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Allow time for processing information. Everyone processes information at a different pace, especially if the information is not in their native language. Be patient and never rush an older adult as they are learning. Caregivers can use the “teach-back” method and have residents teach the caregiver what they just learned to allow for deeper information processing.
Health literacy in the context of language preferences and cultural health beliefs
Other considerations for health literacy are language preferences and understanding cultural health beliefs. Non-native English speakers have unique challenges with health literacy and are often unable to comprehend highly technical English language. Additionally, health beliefs shared among communities play a critical role in how health information is perceived, and whether it is accepted. This is where caregivers, especially those who share the same culture as residents, can be most effective in helping older adults understand health information.
Lupe Flores, Director of Engagement and Impact at the Chicano Federation, a non-profit organization that works with Spanish-speaking communities, shared how the cultural health belief of “Familismo” is a protective factor for Latinos. Familismo is described as the “ the importance of strong family loyalty, closeness, and getting along with and contributing to the wellbeing of the nuclear family, extended family, and kinship networks.4” Not only is it important to consider these cultural beliefs to empathize with residents, but cultural understanding helps caregivers best frame a health message that personally relates to older adults. It is even better when caregivers can speak the native language of residents to convey these messages and information.
The Latino cultural belief of “simpatía,” which is described as “social interactions characterized by warmth and emotional positivity,5” can be an approach caregivers use to relate to residents. Lupe explained how “simpatía ties in with core Latino values that the community holds in general.” Simpatía was especially useful during health messaging of the COVID-19 vaccination effort. When the Chicano Federation was promoting the vaccines to the San Diego Latino community, which had low vaccination rates, Lupe described how health messaging was crucial to break down barriers for Latinos who perceived the vaccine negatively. Specifically, health messaging that revolved around getting the vaccine to protect their family, neighbors, and loved ones were more effective than individual messages about protecting themselves. Caregivers can learn from this example using a cultural health belief in order to best explain health information to Latino residents.
The challenges experienced by older adults when it comes to health literacy are large and significant. Although older adults experience physical and mental barriers due to aging, they can still benefit from health literacy. Caregivers who implement simple tips, cultural understanding, and empathy can greatly enhance health literacy for their residents. As a result, older adults can be empowered to seek and understand health information themselves, improving their physical, mental, and overall health.
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