This chapter reviews the existing communication literature from the field of geriatric psychiatry and cognitive disorders, and attempts to provide practical solutions for common problems that arise in the oncology setting. Dialogues between physicians and elderly patients are often marked by ineffective communication. The most effective method for learning communication skills is observation of ideal and effective communication strategies, followed by rehearsing the skills in role-play, receiving immediate feed-back on performance to permit modification, and then repeating the practice. Prominent issues when dealing with cognitively impaired elderly patients are loss of independence and ethical questions about treatment options. Interventions aimed at improving physician interactions with older patients have yet to be widely explored. Attention given to enhancing clinician-patient communication skills with elderly cancer patients and their families could optimize the health care delivered to older patients, and improve the sensitivity and effectiveness of cancer clinicians in communicating with elderly patients.