[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 agree with this. I’m only 20, but I get angry even when I hear 40 year olds talking to 80 year olds that way. The way I look at it is how would you like it if I talked to you like that? I know I would want to punch you in the nose! Then to talk to someone who has experienced much more life than you have like they are less than you is appalling.
Monique: Sorry for the delay in replying, but thank you for your comment. It’s encouraging to see you plug into this problem. Thanks for being an advocate for improved communication / interaction between various generations. We are stronger together. KDA
When speaking to older people ( or patients), it is not necessary to use the word “okay” at the end of every sentence as in, “We are going to the dining room now, okay?” or “The doctor will be here in a few minutes, okay?” or “Your son said he would phone tomorrow, okay?” The word “okay” is annoying slang. You wouldn’t tack it on to the end of every sentence when speaking with a friend or even with your dog (We’re going to go for a walk so go get your leash, okay?) so why then is it added onto almost every sentence when speaking to older people? Okay is an over-used crutch word like actually and basically and is irritating as sand in your eye.
That’s an interesting observation. I am guessing people do this as a way of checking to see if the person is paying attention / cognitively engaged. It is patronizing. I will be more self-aware about my own use of OK. I know I do this with small children, but I hope that I don’t do this with anyone over the age of 3!
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Thanks for your comment! Have a great 2018.
Using the “cutsy” language you described is simply not appropriate for anyone over eighteen months old—and even then, you are pushing it! Great article. I especially object to people calling me “dear”, or “hon”. It just rankles me! I’m over 75 years old, and the only person who can justifiably call me “dear” and “hon” is my husband! I have just written a blog post offering a host of rebuttals for anyone who wants to put the offenders in their place!
Oh, rebuttals are a great idea–better than mere eyerolling. I found your post “Don’t Call Me Dear.” Your rebuttals foreground some important points about interpersonal dynamics: 1) “You might not think so, but calling me “Dear” is not a compliment. It actually is condescending, so please don’t do it.”
2) “We usually call children, or spouses “Dear”, and since I’m neither, please don’t address me as “Dear”.”
3) “If I was a policemen, a doctor, or your teacher, would you call me “Dear”?” Thanks for deepening the conversation. (Sorry my reply is late. I moved from KS to IN and disengaged from a few projects until recently.)
I agree, it is so patronising to be called Dear, I finished working 2 years ago at the age of 67, I worked as a Personal Care Attendant in Aged Care for 21 years.
I can honestly say I did not patronise or tell them what they should be doing.
I enjoyed the company of older clients.
Now I am older and receive “Hello Dear” or am shouted at, I can hear perfectly well.
Interestingly enough I find its more likely to come from people 40 plus than teenagers.
Hazel: I am sorry that people are using patronizing language when speaking with you (“dear” and shouting). It’s ridiculous. I am not sure whether the best response is eye rolling, education, or rising above it all. There are pros and cons to each approach! That’s great to read about your many years’ experience as a caregiver who treated people with respect and dignity. All my best to you in all your current endeavors.
I am 78 and my way of giving this a heads up is to use rough language when appropriate like I did when I was younger. This shocks the baby talkers back to reality.
When my mother-in-law was living, her eldest daughter would consistently speak baby talk to her mother who was living with Dementia, I also found it strange that her eldest son would approach her in a very childlike manner and ultimately sing nursery rhymes to her – not with her! I spoke with the daughter about dignity and trying to avoid such demeaning communication and shared examples of her responses to interactions. I happened to be present when the son began singing the nursery rhymes and interacting with her as though she were a child – I stated – (I’ll use Mary as anonymous name) – “Oh Mary, it is so kind that you help him by listening to him practice his nursery rhymes with you as he practices for his grand kids.” Even if i was not telling the complete truth – to protect my mother-in-law I would say to Linda, your mother’s is really alert and her cognitive responses are really great today – I would avoid the baby talk. It was a difficult time – I was not more direct as I struggled to identify supportive resources to the topic of dignity and yes – I maintained a standard – while she lived at home and in communities… There must be more to this – relating to self-esteem, denial, self-centeredness – all wound up into some crazy coping mechanism. Some said I should have let it go – but my argument to that was – the journey wasn’t about them – if they had difficulty they should have sought out help. It was her journey that would be short and she deserved, while she was a live to live with dignity and joy while she was here.
Theresa: I’m sorry that these (probably very well meaning) relatives talked in a patronizing manner. Research shows that elderspeak actually sabotages a person’s mood level and cognition. Also, people with dementia can still read tone well into mid to late dementia. There’s a way to alter communication with ppl with dementia without devolving into baby talk–much like it’s possible to have less complex sentences when talking to someone who has English as a second language without transforming the structure into baby talk. Thanks for sharing your experience, and brava to you for advocating. Karen (at the Generation Above Me).
I think you did a great job refocusing their communication on your mother-in-law. It’s all too easy to subject them to other people’s agendas. I have to constantly remind myself to stay person-centered. That’s when the magic happens. All my best to you. (Sorry to be so tardy. I moved 600 miles recently, and I’m reclaiming areas of my life that I neglected with the move.)
Thank you! I will share this with my first semester nursing students.
Allison, sorry it took me a while to check back with this article from a while ago. How wonderful that you train nurses. That’s so vital. All my best to you and your students. (Karen Austin)
Thanks for writting this article. I found it after trying to understand why an ambulance driver talked to my grandfather as if he where a with a 3 year old toddler. I found the driver very rude. I bet it’s hard to be taken seriously when you get old because most people wrongfully think your stupid.
We should talk to the elderly as if they are normal people, because they are. “Elderspeak” is a form of harassment.
Marc: I’m sorry to read that your grandfather was treated in a patronizing manner. Hopefully, more and more people can gain awareness of how their attempts to be supportive of “needy” people actually are disrespectful. Karen Austin
I am so glad thIs issue is being raised. I have just tried to explain to Boots the Chemist customer care in England that as a 62 year old college lecturer I do not expect to be called “dearie” “sweetie” or “my darling” by the pharmacists. In Germany or Italy they could loose their job if they addressed mature citizens with unsolicited endearments. Boots responded by saying that they are sure staff did not mean to be patronising, but I tried to highlight that it is a form of benign ageism that needs to be addressed in staff training.
Elizabeth: I am sorry that the management dismissed your concern. Maybe if everyone who gets “dearied” lodges a complaint, the burden will finally shift to the employees and away from “overly sensitive customers.” It’s good that you spoke up. Karen
🙂
Excellent piece, Karen. As a speech pathologist, I understand that blowing seniors away with a rapid speech rate is not appropriate, but neither is speaking to them as if they’re your hearing impaired toddler with special language comprehension needs. Reducing speech rate and allowing more time for processing can be done very by simply practicing patience and rephrasing as needed. I truly believe that much of this “elderspeak” is born of the notion of youth supremacy. In a nutshell, it’s totally wack!
Jan: Good to meet you! I took a grad class from a SLP professor who highlighted this issue, and then I read more on my own (given that I used to teach college English and took sociolinguistics). Yes, I concede that older adults can benefit from some adjustments to how speech is delivered. I wish that SLPs had a greater conduit for conveying information to the general public. It would be great if NPR or PBS did a regular feature or something! Keep up the good work.
i just re-read this and it reminded me of some of the youtube video talks that teepa snow made about ways we talk to people with altheimers. it is well meant but so entirely lacking in understanding in how the other person receives this “well meaning” treatment. sometimes it is hard to put ourselves in someone elses place and there is so much misunderstanding of who we elders are…we are individuals first of all. maybe we need to politely and tactfully and possibly with humor, tell people when they use elderspeak. it might be useful to both sides and open up some real communication.
Rosemary, I need to go find that video by Teepa Snow. Thanks for the suggestion. I think that most people don’t realize that ppl with AD retain their ability to read tone and body language for a really long time. As a volunteer in a memory care unit, I observed a retired nurse who was a resident there call out the workers for trying to baby her. I tried to consider her view as valid and complex instead of labeling her speech as “non compliant behavior.” I’m still learning and growing in how I interact with people who have cognitive differences. I’m trying to remain a life-long student. Thanks for your insight.
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 [email protected]. 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.
My father, age 84, resides in assisted living. He was called a “bad boy” teasingly by a CNA (certified nursing assistant) for refusing to participate in the daily bingo game. Dad hates bingo and he hasn’t been a “boy” since Franklin Roosevelt was President!
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!
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.”