Golden tips to create meaningful and effective working relationships.
Although our elders face a different set of challenges than younger clients, working with elderly clients can be incredibly rewarding. With the right perspective and planning, you can create meaningful and effective working relationships.
Working With Elderly Clients
After years of working with older clients, I speak from experience when I say that working with the elderly is like working with any client. They are looking for the same things as any other client – professionalism, honesty, and clear communication, for some examples. And of course, you must maintain high ethical standards when working with the elderly as you would with any client.
The American Bar Association’s Commission on Law & Aging, in partnership with the National Center on Law & Elder Rights has assembled a curriculum of rules and trainings for working with elderly clients and others with cognitive impairments. Something they consider among the basics of working with the elderly is that an attorney should be “careful not to let stereotypes associated with aging drive their determination of capacity.” Instead, they should focus on the client’s ability or lack of ability to make decisions, and support the client as needed.
In order to maintain high ethical standards and work effectively with an elderly clientele, some additional steps may be needed in your work. Here are some challenges, solutions, and tips regarding working with the elderly, all based on my research and experience.
What are the challenges?
When working with an elderly client, it’s common enough to run into issues like hearing or visual impairments or slower cognitive function. Don’t worry- these things won’t prevent you from working with the client effectively.
Below are some of the common challenges experienced in working with the elderly, as well as ways to work together and manage the issue.
Hearing Impairment
Hearing impairment is a common challenge faced among the elderly. According to the National Institute on Deafness and Other Communication Disorders, approximately one in three Americans between the ages of 65 and 74 has hearing loss, and nearly half of American adults older than 75 have hearing difficulties.
Although hearing impairment can impact your client’s ability to communicate, there are ways that you can accommodate your hearing impaired clients to ensure effective communication. If you suspect that your client has a hearing impairment, don’t be afraid to ask about specifics, such as which side they have the most trouble hearing on, and adapt accordingly.
Speak slowly and try to keep a quiet meeting space with little ambient noise or echo. Many hearing impaired individuals rely on lip-reading to understand what is being spoken to them, so it’s always a good idea to sit face-to-face with your client.
Visual Impairment
According to the American Academy of Family Physicians, approximately one in three people 65 years of age and older has some form of vision-reducing eye disease. As with hearing impairment, there are a few ways that you can accommodate your vision-impaired clients to ensure that they have no issues absorbing important information.
To accommodate your vision-impaired clients, keep large print versions of documents handy. It can also help to keep a magnifying glass on hand and ensure good lighting during meetings.
It’s especially important to stay patient when communicating with your client. They may be embarrassed to admit that they have trouble seeing or hearing, so handling the issue with compassion is key.
If you bring up the issue of sensory impairment proactively and have solutions ready, it will likely ease your client’s embarrassment. If he or she feels at ease and understood, he or she will be more willing to engage, which will ultimately lead to a better attorney-client relationship.
Cognitive Function
Studies show that age is linked to cognitive decline, and as the life expectancy of Americans continues to rise, there is a growing population of elderly people living with age-related cognitive changes. Because of this, it’s important to be proactive when working with elderly clients to ensure that they fully understand what is being communicated to them. Law topics can be difficult to understand for most laypeople, and this can be even harder for those who have issues with cognitive function.
If you recognize signs of cognitive decline in your client, be sure to avoid complicated technical terms or legal jargon when communicating with them. Use familiar words, and take your time in speaking and reviewing documents together. To prevent your client from feeling overwhelmed, you may need to break up longer meetings into shorter, more manageable chunks and approach only one topic at a time.
Another critical thing to do if you notice potential cognitive decline in a client is to request a formal capacity assessment for the client. For most adults, capacity is presumed – but Mr. Charles Sabatino, Assistant Director of the ABA Commission on Legal Problems of the Elderly, recommends that attorneys consider taking a more proactive approach when working with an elderly client.
One important note, however, is that you should avoid pathologizing the client’s age. That is, there are many age related changes that are normative, or natural and just a part of aging. Non-normative changes, such as significant memory loss or depression should be a red flag for referral.
Instead, if you encounter normative changes in aging, simply acknowledge there is a challenge and find a work-around with your client and/or their family members and caregivers.
What are the solutions?
Working with elderly clients can present just as many challenges as working with any other client, but it can be incredibly rewarding work that has the very real potential to change lives. That’s why it’s important to focus on the solutions rather than simply dwelling on the challenges you may face. The following solutions can help you and your client work through any challenges you may face, resulting in better relationships and more successful cases.
Get to Know Your Client
Taking some time to get to know your client as an individual can make all the difference when working with elderly clients. Seniors tend to be more socially isolated than younger people – in fact, 43 percent of older adults regularly feel lonely, which is linked to health problems and premature death.
Your client may look forward to your appointment as a chance to socialize, so chit-chatting with them can make them more comfortable and help establish rapport. This will also make it easier to feel out any challenges your client may be facing.
Have Good Clinical Sense
Working with the elderly requires having good clinical sense. This means having an open mind when you first meet the client and not immediately assuming that they will have a certain issue simply due to their age. However, as you begin to notice challenges that your client may face, you should adapt to better serve the client.
Communicate Effectively
Regardless of whether your client experiences cognitive decline, effective communication should always be your top priority. This means feeling out the client to understand and then mirror the way they communicate without dumbing it down. Keep it short and succinct while hitting all of the important points and check in often to make sure they are following.
To make sure your client feels comfortable asking questions, be sure to ask “What questions do you have?” when providing information. After asking, pause for long enough that they have a chance to think. Giving your client the opportunity to express their thoughts, feelings, and concerns can help them regain control in a time when they may feel powerless.
Practice Examples & Tips
We reached out to some of our colleagues to hear their experience-based tips on working with the elderly. Here’s what they had to say.
Shawn Kerendian
Attorney Shawn Kerendian, Managing Partner at Keystone Law Group said,
Too often, elderly persons are mistaken to lack capacity solely on the basis of their age. As with all clients, it is important to begin representation with the consideration that elderly clients are competent and have the agency to convey their own wishes and goals.
While it may be helpful to speak with other family members and loved ones for background information, it is crucial to listen to the elderly clients and spend time communicating directly with them. And to the extent that there may be any deficiencies in memory, communication, or other areas, the attorney should advocate for their client to receive the proper evaluation and services so that their intention can be effectuated.
Theresa Pranata
Theresa M. Pranata, Partner and Chair of the Elder Law, Trusts, and Estates practice at Sullivan, Workman & Dee, agreed with the importance of communication and connection. She added:
The most important way to create meaningful and effective relationships with any client, especially elderly clients, is to establish true connections with them. Elderly clients have a wealth of experience, knowledge, and wisdom, and many of them are interested in sharing their stories. Furthermore, elderly clients may be struggling with health problems, depression, loneliness, or a number of physical and emotional concerns.
Therefore, it is important for professionals to realize that getting to know your clients and their concerns makes you more effective in representing your clients. You must have compassion for your elderly clients as human beings before you can focus on their legal needs.
Tim McNeil
Tim McNeil from The Elder Law Firm in Portland, Oregon doubled down on the importance of building relationships with elderly clients, sharing this advice about empathy and patience:
Treat your elderly clients no differently than your non-elderly clients. Have empathy. Be a patient listener. For my elderly clients, having empathy often means understanding the loss that they have experienced (of independence; of loved ones, etc.). For all of my clients, including my elderly ones, being a patient listener means being willing to wait for the answer to my question, through stories and asides, and not demanding the direct answer that makes my job easier.
Gian Ducic-Montoya
Attorney Gian Ducic-Montoya, a partner at Albertson & Davidson, agreed. She shared about what elderly clients are looking for (hint: it’s not so different from what any client wants!) in her experience, as well as how to meet their needs with patience, empathy, and understanding.
Elderly clients want an advocate who they feel has truly listened to them, understands them, and respects what they have to say. You should start by actively listening to their concerns, then express your understanding and empathy. Empathy allows for a personal connection, which is essential. Many elders want a more personal and informal interaction. Ask about their interests and their past. Speak clearly and slowly so that you are heard. Always ensure your client understands what you have conveyed to them. Patience is key.
As all of the contributors above have notes, elderly clients want the same things as other clients, someone to listen, understand their needs, and help them craft a path forward. Elderly clients may need more time or just need some accommodations in meeting these needs.
In Summary
All clients are different and present their own unique set of challenges. Developing a successful framework for working with elderly clients helps them and also your practice. Keeping in mind the principles laid out in this article will lead to more meaningful and effective relationships.