The use of visual methods to support communication with older adults with cognitive impairment: A scoping review.
Annie T Chen, Andrew K Teng, Jillian Zhao and 2 others
PMID 35605551WHAT IT FOUND
Photos, pictograms, Talking Mats, and web-based decision aids were used to help older adults with cognitive impairment express preferences, understand information, and take part in decisions.
Some studies reported better understanding or communication, but retention and expressing choices sometimes did not improve.
Key findings
01Visual methods were used mainly for two purposes: eliciting older adults' everyday needs, feelings, and preferences, and supporting health-related understanding, communication, or decision-making.
02Visual aids helped some people understand or communicate better, but the evidence was mixed: one study found no difference in communication, and another found low information retention despite increased understanding.
03Decision aids sometimes improved values clarification or some decisional capacities, but they did not improve expressing a choice, and many observations came from caregivers rather than people with cognitive impairment.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
Only 11 articles were included, and they used very different methods, visual tools, outcomes, and samples. The search was limited to English articles from 2000 onward and to keywords about visualization, comprehension, understanding, and decision-making, so related tools or outcomes may have been missed. Study quality was not rated, so the reader cannot tell how reliable the included studies were. Most studies had small or heterogeneous samples, and some included people without cognitive impairment. Many health decision-aid findings relied on caregiver or stakeholder feedback rather than direct feedback from people with cognitive impairment. The populations were mostly White or Western, so cultural differences in symbols and images may limit use with other patients. Some studies had no control comparison, so any benefit cannot be clearly attributed to the visual tool.
Declared interests
The authors declared no conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not read this as proof that visual tools improve patient outcomes. The review included only 11 heterogeneous studies, did not rate their quality, and found mixed effects: some aids improved understanding or communication, but retention was sometimes low and expressing choices did not improve.