The situation of older Thai family members has changed, resulting in less interaction that could impact family bonds. A sequential explanatory mixed methods design explored communication and relationships within older adults’ families. Using communication patterns and family relationships questionnaires, a survey was administered to 180 older adults in Phetchaburi province. Then, 40 participants were engaged in semi-structured interviews. The quantitative data were analyzed using simple linear regression, and the qualitative data were analyzed using content analysis. The quantitative results revealed that most family communication patterns with high family relationships were pluralistic. Consensual (B =7.13; SE = 3.26; p < .05) and protective communication patterns (B = 1.72; SE = 0.82; p < .05) were associated with family relationships. The qualitative analysis highlighted the contributors to low family communication and relationships, which included a lack of effective communication skills, unresolved conflicts, technology distraction, and poor time management. The management strategies were active listening, being a role model, and having a heart-to-heart conversation. The initiation of relationships among older adults’ families has originated from communication within the family. Thus, healthcare providers, especially community nurses, should create a family interaction program to promote open and positive communication between older adults and their families.