Why exaggerated lip movements by a newly licensed nurse undermine communication with older adults

How to talk with grace and clarity when older adults are in the room

Let me level with you: effective communication isn’t a fancy add-on in nursing. It’s the core of trust, comfort, and good care—especially with older adults who bring a lifetime of stories, worries, and sometimes hearing challenges into the room. In the Nurse’s Touch world of professional communication, the way you speak and listen matters as much as the care you provide. Here’s a practical look at one key behavior that a newly licensed nurse should avoid, and why the other common behaviors—spoken clearly, open-ended questions, and steady eye contact—are the ones that truly build connection.

The quick takeaway: what behavior requires intervention?

If you’re ever unsure about what to do in a moment with an older client, think about lip movements. The behavior that clearly requires intervention is using exaggerated lip movements. It sounds minor, but it can feel patronizing or confusing. Imagine you’re trying to understand a story while someone’s lips are doing a loud, showy dance—if you find yourself nodding or glazing over, you’re not alone. That kind of nonverbal cue can trip up someone who may already be adapting to hearing changes or cognitive shifts. It’s not just unhelpful; it can erode trust faster than you expect.

Now, let’s compare what helps versus what hurts, because there’s a fine line between effective communication and something that rings false. The good news is that the other three behaviors in the question—speaking slowly and clearly, asking open-ended questions, and maintaining eye contact—are all powerful tools when interacting with older adults.

Speaking slowly and clearly: a simple, effective approach

Why does pace matter? For many older adults, hearing is just one piece of the picture. Age-related changes in cognition, attention, and processing speed can make rapid speech feel like a jumble of sounds. Slower, deliberate speech gives your words time to land, reduces the chance of mishearing a critical detail, and lowers the barrier to understanding. It’s not about talking to them like a child or talking at a museum docent level; it’s about giving them a fair shot at grasping what you’re communicating and feeling respected in the process.

But here’s a helpful caveat: “slow” doesn’t mean “monotone.” You want a natural cadence, expressive voice, and genuine warmth. Use short sentences when the situation allows, sprinkle in a little emphasis to highlight key points, and pause after important questions so clients have space to reflect and respond. A calm, steady pace also helps you listen more effectively, which brings us to the next vital behavior.

Asking open-ended questions: invite stories, not yes/no answers

Older adults bring a lifetime of experience to the table. When you ask open-ended questions—things like, “What concerns you most today?” or “How would you describe what helps you feel comfortable here?”—you invite them to tell you what matters most. Open-ended questions show respect for their autonomy and expertise about their own bodies and routines. They also let you gather richer information about symptoms, daily habits, and personal goals.

This isn’t about interrogating someone; it’s about co-creating a plan that fits their life. And yes, you’ll still need to confirm details to avoid miscommunication. A quick follow-up like, “So you mean X and Y work best for you, is that right?” helps anchor understanding without turning the conversation into a quiz.

Maintaining eye contact: the quiet signal of respect

Eye contact matters in every age group, but for older clients it carries extra weight. It’s a nonverbal pledge that you’re present, listening, and invested in their comfort. You don’t have to stare them into a trance, just aim for a natural level of engagement—steady, attentive, and warm. Pair eye contact with an attentive posture, a nod here and there, and a gentle facial expression. These cues reduce anxiety and help people feel seen, not dismissed.

The misstep you should avoid: exaggerated lip movements

Now, back to the main point. Why do exaggerated lip movements come off as problematic? It’s not just about optics; it’s about how communication lands. When lips move in a dramatic, almost theatrical way, it can be hard to tell what’s essential and what’s just performative. For someone with hearing loss, this can create a momentary mismatch between what’s heard and what’s understood. For someone with cognitive challenges, it can introduce confusion or suspicion that the care team is not taking them seriously.

The goal is clarity, not theater. You want words that are clear, a pace that allows processing, and a demeanor that feels respectful and human. In practice, this means a few everyday choices: facial expressions that match your message, a mouth that forms sounds naturally (not stretched or exaggerated), and a voice that’s calm and precise. If you ever feel tempted to “emphasize” with lip movement alone, pause and check in with the client. A quick question can turn a moment of misinterpretation into a moment of understanding.

What real care looks like in daily interactions

Let me paint a picture you can carry into every shift. You walk into a room where Mrs. Alvarez, in her late eighties, sits with a favorite shawl and a TV playing softly. She’s partially deaf and a bit anxious about a new medication. You greet her with a warm smile, lean in slightly to be at a respectful talking distance, and make eye contact. You speak in clear, natural sentences, avoiding medical jargon you’d use with a colleague. You pause after each point, inviting her to weigh in with her experiences.

You ask an open-ended question: “What has helped you hear better at home, for example?” If she mentions she wears a hearing aid but often turns the TV down, you acknowledge this and explore practical steps: “Would you like me to turn the TV off while we chat, or would you prefer I speak a bit louder or slower?” You’re not performing; you’re partnering—co-creating the moment of care. And you’re watching for cues beyond the words: a tense jaw, a frown line between her brows, a tiny nod that signals understanding or confusion. You adjust accordingly.

Raising comfort through environment and small adjustments

Communication is a two-way street, and your environment can either support or undermine clarity. Here are a few practical tweaks you can apply without breaking your stride:

• Lighting and noise: soft lighting and a quiet space help. If the TV or a hallway din intrudes, propose moving to a quieter room, or ask if a hearing aid setting needs adjustment.

• Seating and distance: sit at the client’s eye level when possible. A good rule is to be within arm’s reach but never looming.

• Visual aids: offer written instructions, large-print handouts, or simple pictures to accompany talking points. For some, a short diagram of a medication schedule can be a lifesaver.

• Clear masks: in times when facial expressions matter, clear masks can preserve visible mouth movements and expressions while maintaining safety. They’re not a cure-all, but they can significantly reduce misreadings in conversations.

• Language and culture: be mindful of language barriers and cultural nuances. Acknowledge if an interpreter or a family member is present and respect patient preferences about who speaks on their behalf.

A few pitfalls to watch for—and why they matter

Beyond exaggerated lip movements, there are other habits that can derail a conversation with older adults, even if they are well-intentioned:

• Talking over the client: it robs them of agency and can erase decades of life experience. Let them finish a thought; it’s a sign of respect.

• Using medical shorthand without explanation: a term like “BP” or “QID” might be second nature to you, but it can feel alien to someone you’re trying to care for. When in doubt, explain.

• Assumptions about hearing: every client is different. Some may need quieter rooms; others may benefit from a written summary or a recap at the end. Check in and tailor your approach.

The human element—the heartbeat of communication

There’s a certain art to speaking with older adults that blends science and sentiment. It’s not enough to know the right words; you have to sense when your tone should soften, when your pace should slow, and when to invite a reply with an open question. The Nurse’s Touch approach—centered on thoughtful listening, respectful presence, and clear, patient-centered language—helps families feel confident in the care team and reminds clients that their dignity remains intact in every exchange.

A few quick, ready-to-use tips you can start tomorrow

• Speak at a natural pace, with clear articulation, but avoid sing-song or overly dramatic delivery.

• Use open-ended questions to invite stories, preferences, and concerns.

• Maintain steady eye contact and a relaxed posture to convey attention and warmth.

• Check for understanding with a simple, “Does that make sense?” or “Would you like me to explain that another way?”

• Create a comfortable space: minimize noise, ensure good lighting, and use visual aids when helpful.

• Honor hearing preferences: offer to adjust the room, use a clear mask if needed, and consider a hearing aid-friendly approach.

• Be mindful of nonverbal cues: if you sense confusion or discomfort, slow down, rephrase, and pause to let them lean in.

Why this matters in the bigger picture

Good communication with older adults isn’t just about avoiding a misstep; it’s about building trust, reducing anxiety, and supporting independence. When clients feel heard and respected, they’re more likely to share vital symptoms, adherence barriers, and personal goals. This alignment isn’t a soft fluffy idea; it translates into safer care, fewer misunderstandings, and more collaborative decision-making with families and interdisciplinary teams.

A final thought: consider this as a living skill, not a checklist

You’ll have good days and tough days, and that’s normal. The beauty of effective communication is that it’s adaptable. You’ll learn to adjust your pace for the room, to phrase questions so they invite conversation rather than close it down, and to use nonverbal cues that reinforce your message rather than distract from it. Exaggerated lip movements? Let that be a red flag that signals you to pause, recalibrate, and reset. The goal isn’t perfection; it’s consistent respect, clear information, and a genuine human connection.

If you’re in a clinical setting or studying the broader framework of how nurses engage with older adults, remember this: every interaction is a chance to honor a life lived, to ease a moment of fear, and to practice listening as a form of care. The details matter—pace, questions, eye contact, and the quiet certainty that you’re meeting the person where they are. That’s the essence of Nurse’s Touch—a call to communicate with clarity, compassion, and authenticity, no matter the day’s pace or the room’s noise.

In the end, the one behavior to avoid isn’t a dramatic display. It’s anything that diminishes the client’s sense of agency or makes the conversation feel less real. The rest—clear speech, open questions, and steady presence—can turn ordinary moments into meaningful, comfortable exchanges. And that distinction? It’s where great care begins.