Background <p>For people with (profound) intellectual and multiple disabilities verbal language is often not the primary means of communication. Communication is closely tied to familiar persons and the interpretation of individual forms of expression. In later life health-related changes, the loss of social relationships and institutional transitions can substantially impair communication.</p> Objective <p>Based on group interviews with professionals this paper examines the significance of communication partners, the professional and institutional prerequisites for successful communication in later life and the institutional embedding of augmentative and alternative communication.</p> Methods <p>In this study seven group interviews were conducted with professionals working in disability support services. Data were analyzed using structured qualitative content analysis.</p> Results <p>Professionals describe social relationships in later life as fragile and communication partners as often confined to institutional settings, which increases the importance of familiar caregivers for successful communication. They further emphasize experiential and specialist knowledge, resources and knowledge transfer across interfaces. Augmentative and alternative communication appears sustainable especially where it is institutionally embedded.</p> Conclusion <p>In later life communicative participation among this group appears less as a&#xa0;matter of individual competence than as an organizational and knowledge-related task: it requires both preserving biographically developed interpretive knowledge and institutionally embedded augmentative and alternative communication.</p>