As people age, they face motor, sensory, and cognitive decline that may compromise their performance of activities of daily living and instrumental activities of daily living. Telephone use is an important instrumental activity of daily living for older adults, but many have difficulty in making and receiving calls. Today, there are many features that can be added to the telephone that can help compensate for impairments, but Often these features are not used. To better understand the problems of older adults in using their telephones, we surveyed 609 older adults living in the community who had chronic health conditions. Interviews were conducted face-to-face, by telephone, or by mail. The most common reasons for not using more telephone special features were cost, lack of perceived need, and lack of knowledge of the features. Occupational therapists who work with older adults must understand the importance Of telephones in their lives and offer them information and assistance in finding telephones with features that match their special needs. The findings of this study suggest that a significant number of older adults with chronic health conditions are unaware of low-cost, feature-laden telephones that could make their communications easier or, for some, possible.