Interviewing, advising, and advocating for older adult clients with diligence and consideration is an essential skill for lawyers practicing in the areas of estates, guardianship and elder law. Effective techniques for accommodating these clients are especially important given the discrimination they may face as a result of their advanced age. The Seniors First BC training guide suggests that:
- 41% of older adults report be treated as if invisible;
- 38% of older adults report being treated as if they have nothing to contribute; and
- 27% of older adults report that others assume they are incompetent.
While each client is different, with individual needs and goals, there are several tips and techniques that lawyers and other professionals can use to improve the quality of services provided to older adult clients. The tips provided in this blog may also be useful for family members and individuals acting under a Power of Attorney when engaging in estate, financial, and personal care planning in consultation with elderly persons.
SENIORS FIRST BC
The Seniors First BC Website offers an array of tips for professionals for accommodating older persons. Of particular importance for legal and financial professionals are the recommendations with respect to the meeting environment and the conduct of the meeting:
Before the Meeting
- Ask if the client has any hearing or vision impairment
- Provide a list of documents or information for the client to bring to the meeting
- Where appropriate, ask if the client wants to bring a family member, support worker or friend
- Politely inquire as to whether the client has transportation to and from the meeting
The Meeting Space
- Make the room as distraction-free as possible in terms of background noise and clutter
- Ensure there is sufficient lighting
- Provide documents in large font on pale blue or yellow paper, where possible
- Have reading glasses or magnifying glasses available
- Ensure that the paths to the meeting space are clear of any obstacles and wide enough to accommodate a walker or wheelchair
During the Meeting
- Make sure to look at the client when you are speaking, as many hearing impaired individuals read lips
- If the client has brought in a family member, support worker or friend, ensure that you are not talking to them rather than the client
- Take note of your body language, as a person’s ability to read body language is maintained for a long time even where cognition may be impaired
- If possible, sit beside the client rather than across from them
THE AMERICAN BAR ASSOCIATION AND AMERICAN PSYCHIATRIC ASSOCIATION
The American Bar Association’s 2005 Handbook for Lawyers, a collaboration with the American Psychological Association, is designed as a comprehensive guide for lawyers working with older adult clients where capacity is at issue. In particular, two techniques outlined in the handbook, and summarized below, are particularly useful for interviewing and taking instructions from older adult clients.
I: Interviewing where Capacity May be at Issue (p. 29)
- Begin the interview with simple questions requiring brief responses to assess client understanding and optimal pace, as reaction time is often slower among older adults, particularly for more complex tasks;
- Conduct business at a slower pace to allow the client to process and digest information, as information-processing speed declines with age;
- Allow extra time for responses to questions, as “word-finding” can decline with age;
- Break information into smaller, manageable segments;
- Discuss one issue at a time, as divided attention between two simultaneous tasks, as well as the ability to shift attention rapidly, shows age-related decline;
- Provide cues to assist recall rather than expecting spontaneous retrieval of information;
- Repeat, paraphrase, summarize, and check periodically for accuracy of communication and comprehension;
- If information is not understood, incompletely understood, or misunderstood, provide corrected feedback and check again for comprehension;
- Provide summary notes and information sheets to facilitate later recall. Include key points, decisions to be made, and documents to bring to next meeting;
- Schedule appointments for times of the day when the client is at peak performance. Peak performance periods change with age and for many older adults mornings are often best;
- Provide time for rest and bathroom breaks;
- Schedule multiple, shorter appointments rather than one lengthy appointment, as older adults may tire more easily than younger adults; and
- Whenever possible, conduct business in the client’s residence.
II: Fostering Engagement in Decision-Making Processes: Gradual Feedback Counselling (p. 30)
- Confirm or reconfirm the basic goal or problem to be solved;
- Get feedback to ensure that the client agrees with the lawyer’s assessment of the issue;
- Listen for the most important values that the client expresses. Restate those values to confirm with the client;
- Describe the best option for attaining the client’s goal (as the lawyer sees it) and ask for the client’s feeling about that option. Explain each relevant option and get the client’s feedback; and
- Give the client any feedback that may be helpful (e.g. respectfully pointing out any inconsistencies in the client’s wishes or expressing concern over any course of action that seems harmful) and gauge the client’s reaction.
Given the discrimination that seniors and older adults may face when engaging in estate, financial, and personal care planning, it is essential that lawyers and other professionals develop policies based on best practices for working with older adults in these scenarios. This is especially relevant given the Statistics Canada prediction that almost one in four Canadians will be over the age of 65 by 2030. With the tips and techniques outlines above, older adults can be accommodated in ways that empower them to participate meaningfully in decision-making processes.