Honoring our Residents: Avoiding Elderspeak

As people who work every day with elders, we may think we never engage in behavior that older people may find offensive. We may even say something with the best of intentions only to have it taken as an insult. One of the most common ways that younger people unintentionally offend older people is through “elderspeak.” Elderspeak is a style of speech that often mimics baby talk that many people use when speaking with older adults. Elderspeak is characterized by:

• Short, simplified sentences with limited, simple vocabulary
• Slower speech
• Higher-pitched voice and an over-caring tone
• Substituting “we” for “you”—as in “Don’t we look nice this morning?”
• Describing the person as “cute” or “adorable”
• Addressing a senior with endearments like “honey,” “sweetie” or “dearie” instead of by name
• Referring to an older adult as “young man” or “young lady”

Most people who engage in elderspeak most likely are well-meaning and have no idea that they’re being offensive. We have an instinct to show kindness to and protect people whom we judge to be vulnerable. But in reality, most older people find elderspeak demeaning and patronizing. Dr. Kristine Williams of the University of Kansas Medical Center conducted a study where she videotaped and then observed interactions between nursing home staff and residents. She found residents who were spoken to as if they were children became irritated and acted out by grimacing, screaming and/or refusing to do what was being asked of them.  She discovered that the initial damage caused by elderspeak could begin a downward spiral in their self-esteem, often leading to depression and an increase of dependent behavior. Studies also show that senior patients spoken to in this manner are less likely to follow a healthcare provider’s orders.

This may well be because beneath its sweet surface, elderspeak is controlling and contains some not-so-nice underlying judgments. Singsong baby talk implies that a person is childish. Calling a senior “young man” or “young lady” contains an implication that the person should be flattered to be considered “young,” rather than the less-desirable “old.” Calling a senior “cute” or “adorable” when they’re doing something the speaker considers to be in the domain of younger people also is infantilizing. Consider that small children taunt each other with baby talk, which usually infuriates the other child because baby talk is an expression of the speaker’s perceived superior power.

It’s true that communication may need to change if a person has challenges such as hearing loss or Alzheimer’s disease. You might need to adjust your speech as needed—for example, speaking more slowly, facing the person, and repeating or rephrasing if necessary. But don’t assume the person needs you to adjust your speech; wait to see if they really need help. And remember: the helpful changes don’t include baby talk. Speak to seniors with the same respect you would want to receive.

 Elderspeak Is a Part of Ageism

Whether our beliefs and feelings about older people are conscious or unconscious, using elderspeak is part of ageism, a prejudice against people based on their age. It’s particularly dangerous given its acceptability in society. How many times during this election season have you heard someone say “So-and-so is too old to be president”? Todd Nelson, Ph.D., professor of psychology at California State University, Stanislaus, says that “ageism remains one of the most institutionalized forms of prejudice today.”

The negative impact of ageism has been well-documented. Stress, depression and a higher risk of heart disease result when seniors internalize negative messages from the media and from people around them. Older people who feel they are a burden to others see their lives as less valuable, increasing their risk of isolation and depression. Ageism can cause a damaging cycle: marginalization leads to low self-esteem, which in turn accelerates withdrawal and physical decline. A study from Yale showed that negative beliefs about aging may be linked to brain changes related to Alzheimer’s disease – specifically, people who had more negative thoughts about aging had a significantly greater number of amyloid plaques and neurofibrillary tangles, two conditions associated with Alzheimer’s. Another Yale study showed that positive attitudes about aging could extend one’s life by 7-1/2 years – a greater lifespan gain than from low cholesterol, low blood pressure, maintaining a healthy weight, or even being a nonsmoker! And, finally, research by the Yale School of Public Health shows that younger people also are damaged by these negative beliefs. The study found a striking link between ageism in early life and poor health later on.

Honoring our Residents

By being conscious of our thoughts about growing older and how we speak to our residents, we can help ensure that we are treating them with the respect they deserve.

“Sometimes we call our residents names like mama and sweetie and although it comes from a place of genuinely caring about them, it can be hurtful and disrespectful even if it wasn’t our intent. Research has shown that older adults with dementia who are spoken to in this manner are more likely to disregard instructions and have a very negative reaction. At Kline Galland, we are very aware that our residents deserve the respect of being treated as adults with their incredible amount of life accomplishments and wisdom.” – Liliya Babadzhanova, Kline Galland Home Administrator