“Hello sweetie,” I recently overheard a 30-something nurse say to an elderly assisted living resident. “Time to take our little pill, dear.” I cringed.
Another time at a shopping mall, a cosmetics saleswoman loudly over-enunciated every syllable to my then 83-year-old mom. “Now are you sure you can see the different shades of lipstick in my hands, hon?” she asked.
“I’m in Macy’s, not France,” my mom replied laughing, not in a mean way, but she got her point across. Don’t talk down to me. The saleswoman probably didn’t realize she was speaking like a cartoon version of a tourist screaming a question at a foreigner, assuming that if she was loud enough, she’d break through the language barrier.
I wish I could say these were isolated incidents, but I’ve witnessed similar interactions far too often. Somewhere between patronizing and over-simplifying our speech patterns lies what’s known as elderspeak, a way of talking to our elders as if they were toddlers.
Why do we use elderspeak?
All of us wrestle with cultural stereotypes about hard of hearing, confused older people. We grew up with them, and habits become hard to break. Our challenge is to confront the stereotypes before we project them onto our elderly loved ones and insult or demean them.
I’ve never attempted elderspeak on my parents, and I’m glad I didn’t. My father, who passed away in 2007 at 80, was a brilliant man with multiple educational degrees who didn’t suffer fools gladly. His desire for plainspeak from others continued long after mini-strokes and Parkinson’s disease made it challenging for him to speak at all. He could still understand what you were saying and was acutely aware if anyone skirted around an issue or talked down to him.
My mother, who’s 89 with some cognitive decline, still tells it like it is and can’t stand being patronized or allowing anyone speak about her in hushed tones, as if she can’t comprehend what’s going on. Short-term memory loss in no way keeps her from understanding when someone uses elderspeak with her. Her dignity and awareness of others’ behaviors and attitudes are firmly intact.
How common is elderspeak?
It happens all the time, even to the well-intentioned. You’re interacting with an older person and before you know it, your voice modulates to singsong and you adopt overly simple wording and a patronizing tone toward an adult who just happens to be a few decades your senior.
Elderspeak can be so routine in social settings and senior living communities that you might not even realize you do it. But it’s still unwarranted.
In their guide, Communicating with Older Adults: An Evidence-Based Review of What Really Works, The Gerontological Society of America (GSA) writes, “As a general rule, older adults maintain their existing vocabulary or continue to improve it. They have no greater problem understanding complicated words than do members of other age groups, so there is no need to simplify the words you use.”
The Harmful Effects of Elderspeak
Elderspeak Communication: Impact on Dementia Care, a study reported in the American Journal of Alzheimer's Disease & Other Dementias, found that elderspeak isn’t just an annoyance; using it has a serious negative impact on the health and longevity of seniors. It may trigger resistance to care and even depression in seniors. Communication training programs have been shown to reduce elderspeak in professional settings (e.g. nursing homes and assisted living communities), and this raised awareness can only help in personal interactions, too.
In another GSA study, Overcoming Elderspeak: A Qualitative Study of Three Alternatives, caregivers had great success with their carees through three approaches that sidestepped elderspeak:
- Spiritual blessings that didn’t require a response
- Making jokes to elicit laughter
- Telling stories to engage connection through common experiences
In addition to fostering a stereotype that old people are slow and confused, using elderspeak can make an older adult feel dependent and can set up a power imbalance. It’s easy for a senior to assume that someone using elderspeak feels smarter, more powerful and in control than the senior.
“[Health care workers] don’t realize the implications that it’s also giving messages to older adults that they’re incompetent,” Kristine Williams, a nurse gerontologist and associate professor at the University of Kansas School of Nursing, told The New York Times. “If you know you’re losing your cognitive abilities and trying to maintain your personhood, and someone talks to you like a baby, it’s upsetting to you.”
How to Avoid Elderspeak
In "Communicating with Older Adults," the GSA emphasizes the following two tips for improving interactions with older adults:
- Recognize the tendency to stereotype older adults, then conduct your own assessment.
- Avoid speech that might be seen as patronizing to an older person.
In addition to these tips, GSA also recommends that you follow other other guidelines to avoid using elderspeak, including:
- Don’t limit your wording or reduce your rate of speech. In many cases, there’s no reason to oversimplify how you say something or how quickly you say it.
- If your loved one is hard of hearing, break down sentences into shorter bites rather than longer run-ons that might be hard to follow.
- Include seniors in all conversations happening around them; never exclude them if they are also in the room with you and other family members or medical staff.
Most importantly, as you consider what to say and how you say it, make sure your tone is respectful -- adult to adult. You wouldn’t want anything less if you were in their shoes.