[Editor's Note: Originally posted at The Generation Above Me]
About a year after I started volunteering at a skilled nursing home, I observed a set of new teenaged volunteers who came to help with a craft at the monthly meeting of the Red Hat Society. I heard several of the volunteers speak slowly and loudly, using a sing-song voice. In response, I saw many of the residents roll their eyes.
Unfortunately, I had flashbacks to when I also first started as a volunteer. I altered my speech inappropriately as well, hoping to be supportive but coming off as patronizing instead.
- Speaking slowly
- Speaking loudly
- Using a sing-song voice
- Inflecting statements to sound like a question
- Using the pronouns “we,” “us,” and “our” in place of “you.”: “How are we doing today?”
- Using pet names such as “sweetheart,” “dearie,” or “honey”
- Shortening sentences
- Simplifying syntax (sentence structure)
- Simplifying vocabulary
- Repeating statements or questions
- Answering questions for the older adult: “You would like your lunch now, wouldn’t you?”
- In other ways talking for the older adult: “You are having a good time on the patio today, I see. And you have your pink sweater on, which you love. Right?”
- Asking people questions that assume role loss, idleness and powerlessness such as “Who did you used to be?” “What did you used to do?”
Even though this list describes various ways in which people sometimes alter their speech when talking to older adults, a couple of misperceptions generate the communication problem:
- Elderspeak assumes that the older adult is dependent, frail, weak, incompetent, childlike, etc.
- Elderspeak assumes that the speaker has greater control, power, value, wisdom, knowledge, etc than the older adult listening.
- Elderspeak assumes that all older adults equally suffer from memory problems, hearing problems, energy problems, etc.
Public health experts have found that when older adults are exposed to the patronizing language of elderspeak, their performance on tasks decreases and their rates of depression increase. Other studies show that even people with moderate to severe dementia can tell when people are talking down to them, and it decreases their level of co-operation.











I am an student from the AGING 200 Erikson School of Aging and I believe this topic of “elderspeak” really needs to be addressed. You discuss the issues of elderspeak that when seniors are spoken to in a condescending manner, as though they cannot understand or have no agency of their own, it makes their performance decrease and their depression increase. While many aids, nurses, home health caretakers and volunteers are educated on what to do in a practical way and how to handle the various scenarios encountered in a senior facility, it seems as if this important aspect of healthcare is left out: that seniors are still human beings with cognitive understanding and social development. Even more so, many do not realize that what they are doing is detrimental to the patient’s physical and mental health. I feel strongly about this issue and I think those who provide services to seniors do not understand the negative consequences of this type of behavior. I believe that preserving the dignity of patients in care facilities is definitely an aspect of care, but many who use elderspeak do not understand the detrimental effects.
What a wonderful article ~ I believe that the people I hear that use Elderspeak have the best intentions and do not realize the impact.
I am one who is mindful of speaking down to any person. May this be an elder, a child a neighbor or a stranger.
In this field of professional I am ever mindful of the proper language used with an elder. To give an elder dignity,repsect,honor is a path I am seeking to journey along. How is the use of the wording it to belong in these conversations for example- this is a day we are going to enjoy it together join us for a cup of tea?
The common usage of we/us are ok? we.us are having a meal? we are…? could be also a language phrase of inclusion-parts of this article I am in disagreement with-overall excellent points of interest 1
I have included a skit on how to respond to ageist language, including elderspeak, in my musical revue on aging, A New Wrinkle. The material in the skit is rather humorous and sometimes provides quite practical suggestions for responding to condescending remarks and styles of speech. The song Hip Hip Elder’s Rant also includes some material on elderspeak. I feel that it is important for all of us older adults to develop effective ways to counter ageist presumptions.
Hi Gaea; Did you mean to include a link to your skit in your musical revue on aging? I’d love to hear it.
I would LOVE to have a copy of your skit Gaea and wish I could see your musical revue on aging. What a wonderful way to inform people about communicating with elders.
another common thing that people do is that they don’t even talk to the elder if there is a younger person with them…they talk about them as if they weren’t there!
Oh Rosemary! I’d forgotten about that one! Talking about someone as if they’re not there – that’s one of the most offensive,demoralizing habits ever! How rude and thoughtless and just plain ignorant and mean.
Rosemary: That’s a good, related problem to invoke. I’ve seen that happen. I try to talk directly to the older adult, then if they want their adult child, spouse or CNA to help them answer, then they can look to that person, but I try to look at and talk directly to older adults.
Karen, what a great article! I actually talked about this during a staff meeting last week with our team. Are you by any chance able to e-mail me a copy so I can share it with our team? I tried to print it off but could not. If so, my e-mail is kmcelroy@mshosp.org. Thanks!
I think that it;s going to be the responsibility of each senior to speak up when confronted with individuals that use Elder Speak (Baby Talk) in their conversations you you. Can you remember any situations in childhood when you heard baby talk expressions to children when they are no longer children. Being senior friendly is critical to having more individuals respect seniors more. Seniors have enough maturity, wisdom, life experiences and resources to challenge anybody that wants to downgrade a senior for any particular reason.
Joe: I agree! I was corrected by a woman in her 90s in a quiet but firm way. Lesson learned! I think too often people self-segregate into their own generations when there is a richness to be found in intergenerational friendships. But it takes patience, empathy, trust and forgiveness on the part of all to make it work. Keep up the great work with encore careers. I recognize your handle from Twitter. *waving*
This is very important to keep in mind. I remember my great-grandma saying that someone really knew how to talk to older people. I wonder if she was referencing “Elder Speak.” I hope that I always treat someone with the dignity and never make an adult feel like a child.
Barb: I’m glad that you can still remember your great-grandmother’s attention to language issues. Too often people make older adults invisible and voiceless. It’s great to see you be an advocate for treating all with dignity.
Great post! Seems like the classic golden rule… I wouldn’t ever want anyone speaking to me this way. Why do so many of us do it to others?
Chip: For some reason, people think they are being helpful and supportive. They don’t realize that focusing on capabilities is more important than assigning someone a role of “hepless” and “needy” or “broken.” Hopefully, people can gain some insight and adopt new language.
I’ve, definitely, encountered elderspeak, but the most condescending thing anyone’s ever said to me when when I was in a hospital at age 32. I’d had a Caesarian section, and someone must have forgotten to wash his hands because I got an infection. I was isolated in a room and had to call for a bedpan to urinate.
Feeling a lot better after a few days, I got up and went to the women’s bathroom. A nurse found that I was not in my room and called out in an overly loud voice that I was “a bad, bad girl.”
What is it about hospitals that brings out the over-bearing side of some care providers?
Madeleine: That’s a wild story. Hopefully,the head nurse offers regular on-the-job training about preserving the dignity of patients. I know that it can be very taxing to work as a nurse (I had two roommates who worked as nurses), but even extreme stress shouldn’t erode respect towards patients.
This is SUCH a common problem Karen and so very offensive. Congratulations on a great article. You should wallpaper your observations over the entrance doors to every retirement home !
About 5 years ago, I had a guy who held a door opened for me. I use a walker and this is fairly common. When I thanked him, he replied “No problem, DEARIE”. With that one patronizing word, he negated his generous act.
Marcia: Ouch! It’s too bad that his politeness was undercut by his patronizing language. Maybe he will get some perspective soon. Let’s hope!
Never appropriate.
Agreed! Thanks for the comment. Karen
How about these:
1) “And how can we help you today, young lady?” or “What can I get for you girls?” (Said frequently at coffee shops and retail establishments.)
2) I recently read on a women’s web site about a woman whose car slid off the road. Three people from nearby houses came to help–two “elderly gentlemen” and a “little old lady.”
3) In a group of 50+ women, one person told the story of how her 85 year old aunt recently married a man of 90. The entire group cooed and said things like “oh, how sweet,” and “precious!” as if the 2 adults in question were precocious babies.
4) Being referred to as “75 years young.”