Background/aim: Older adults commonly need support with their communication. Although, studies have recognised that communication difficulties are exacerbated by health, personal and environmental factors, little research has explored the ways in which these factors may intersect. We aimed to identify combinations of health (e.g., hearing), personal (e.g., language) and environmental (e.g., services) factors that can negatively impact communication for older adults in aged care.

Methods: Using the International Classification of Functioning, Disability and Health as a framework, we conducted a scoping review. We screened peer-reviewed articles published between 2003-2023 and used a thematic approach to synthesise health, personal and environmental barriers from 75 articles. In addition, we analysed interview data collected from aged care recipients (n=21), significant others (n=23), and workforce (n=27), to identify communication barriers.

Findings: Within the literature, we found 37 distinct combinations of communication barriers comprising of health and personal factors (e.g., dementia and linguistically diverse), personal and environmental factors (e.g., culturally diverse and support), health and environmental factors (e.g., hearing loss and health services), health, personal and environmental factors (e.g., cognitive loss and linguistically diverse and relationships). Our preliminary analysis of the interview data further informed types of communication barriers.

Conclusions: Our findings offer greater insight into the complexity and diversity of the communication support needs experienced by older adults. These combinations of factors influencing communication may inform the development of a profiling/identification tool, policy and more targeted modifications for supporting inclusive communication practices in aged care settings.