Communication Techniques with Older Adults and People with Disabilities

Communication skills（コミュニケーション技術）· Material

コミュニケーション技術 · Updated 30 October 2026

The コミュニケーション技術 field tests skills you use every minute in kaigo work: building a relationship of mutual trust, adjusting how you speak to each user’s hearing, vision, and language abilities, and then passing information on to the team accurately. The keys that always appear in exam questions are 傾聴 (active listening), 受容 (acceptance), and 共感 (empathy).

The basics: verbal, nonverbal, and empathy

Communication consists of verbal elements （言語的コミュニケーション） and nonverbal elements （非言語的コミュニケーション） such as facial expressions, posture, distance, and tone of voice. In a first meeting with a user, the nonverbal elements often shape their sense of safety more than the actual words, so the two must be in harmony.

The care worker’s basic attitudes are 受容 (accepting users as they are, without judging), 共感 (trying to understand feelings from the user’s point of view — different from 同感, which is merely feeling along with them), and 傾聴 (listening to the end without interrupting). Together, the three build a relationship of mutual trust called ラポール (rapport).

• Nonverbal: expression, posture, tone — they must match your words
• 共感 ≠ 同感: understand from the user’s viewpoint, don’t just get swept along
• 傾聴: listen to the end, don’t interrupt

Adapting to hearing and visual impairments

For older adults with hearing impairment （老人性難聴）, stand on the side of the better ear, face them so your lip movements can be read, and speak slowly in a slightly lower voice using short sentences. Shouting from far away or from behind actually makes words even less clear.

For users with visual impairment, state your name and who you are before touching them, explain the position of food using clock directions (クロックポジション), and when walking together, have the user hold your arm just above the elbow while you walk half a step ahead （誘導歩行）.

• Hearing impairment: stay close, face them, use a low, clear voice
• Visual impairment: introduce yourself first before any physical contact
• クロックポジション for the position of side dishes; 誘導歩行 half a step ahead

Communication in aphasia and dementia

Aphasia （失語症） comes in two types: 運動性失語 (motor aphasia / Broca’s) — comprehension is relatively good but speech is halting; and 感覚性失語 (sensory aphasia / Wernicke’s) — speech is fluent but comprehension is poor, so answers often miss the point. For both, use yes/no questions, short sentences, gestures, and picture cards, and give them time to answer.

With users who have dementia, avoid denying or scolding what they say; accept their feelings, deliver one message at a time, and use short, concrete sentences. Correcting facts head-on only creates anxiety and resistance to care.

• 運動性失語: understands, but speech is halting （前頭葉・ブローカ)
• 感覚性失語: speaks fluently but struggles to understand （側頭葉・ウェルニッケ)
• Dementia: accept their feelings, one message at a time

Team communication: report, record, hand over

Between staff members, 報告・連絡・相談 (ホウレンソウ) applies: report results and incidents, share information that others need to know, and consult before making decisions on your own. Changes in a user’s condition must be passed on immediately, not left until the shift change.

Records （記録） state facts objectively using the 5W1H elements, separating facts from opinions, and form the basis of handovers （申し送り） and case conferences （カンファレンス） that align the whole team’s care plan.

• 報連相: report, inform, consult — don’t decide alone
• 記録: objective, 5W1H, keep facts and opinions separate
• 申し送り and カンファレンス align the team’s direction

Key terms

Frequently tested points

• First, be clear on the difference in 運動性失語: comprehension is good, speech output is poor; 感覚性失語 is the opposite.
• 共感 (empathy) is different from 同感 — exam questions often swap these two terms.
• When guiding a visually impaired person as they walk: the care worker is half a step ahead, not pushing from behind.
• For 老人性難聴, a high voice and shouting actually make words harder to make out.

Independent study material for the Japanese national Certified Care Worker exam (介護福祉士国家試験). Official terms and rules may change — always cross-check with the latest official sources.